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Without adequate carnitine: Mobilized fat cannot enter mitochondria to be burned Fat gets re-deposited in adipose tissue or organs Energy production from fat stalls Critical insight: Injectable L-Carnitine bypasses the digestive tract, delivering bioavailability equivalent to approximately 2,000mg of oral carnitine in a single injection

PBAC rejected the proposal, citing concerns it didnt consider the drug cost-effective at the price proposed

Other earlier studies have also found similar results

These structural modifications result in favorable pharmacokinetic properties that enable therapeutic efficacy even at low single-digit oral bioavailability, such as those demonstrated by oral semaglutide (Rybelsus), Mercks macrocyclic PCSK9 inhibitor MK-0616 (Enlicitide), as well as Protagonist and Janssens IL-23 receptor antagonist (Icotrokinra) (Johns et al., 2023

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For example, those with severe liver or kidney impairment, unstable heart disease, or other significant systemic illnesses are typically approached carefully if considering NAD+ therapy