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In a zebrafish model, compared with C3-carnitine, C18-carnitine and C18:1-carnitine can induce the inhibition of OXPHOS, interfere with the energy supply of cardiomyocytes, and lead to a significant impairment of cardiac systolic function, which manifests as a decreased heart rate and reduced shortening of the atrial and ventricular fractions [21]

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Intractable nausea, vomiting, or abdominal pain may indicate the need for dose reduction, temporary treatment interruption, or evaluation for other causes