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The Centers for Medicare and Medicaid Services allow intravenous levocarnitine administration to patients on hemodialysis who have ESA-resistant anemia and decreased serum carnitine levels [64]

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There is one Phase I trial registered as NCT02637284 in 2015, intended to enrol forty-two participants, which was subsequently cancelled with no published results [7]

The price difference between a 95% pure peptide and a 99% pure peptide might only be $10 to $20 per vial, but that 4% difference can mean contamination, degradation products, or synthesis errors that affect both safety and efficacy

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