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A reduced initial dose should be considered for patients known to be homozygous for the UGT1A1*28 alleleHowever, the precise dose reduction in this patient population is not known 43 Smith, Phase II Metabolism, UNC Chapel Hill, 8/2012 Other polymorphisms of UGT due to random genetic differences have been reported, but only a few have suggested to influence drug metabolism in the clinic.e.g

This is common and does not reflect a lack of willpower or effort

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Finally, there is some clinical evidence suggesting that high doses of carnitine may lower the seizure threshold in susceptible individuals, making medical supervision essential for those with a history of seizure disorders