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10.1007/s11095-006-9217-9PubMed Abstract | CrossRef Full Text | Google Scholar 166 YokoyamaY.SasakiY.TerasakiN.KawatakiT.TakekawaK.IwaseY.et al (2018)

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L-carnitine may work best in people who actually have low levels (for example, strict vegetarians or older adults)

[2] [10] The low risk of hypoglycaemia when used as monotherapy or with metformin is another important benefit, as the glucose-dependent mechanism of insulin secretion means these medicines do not typically cause dangerously low blood sugar levels

However, if it is almost time for your next dose, skip the missed dose and continue on your regular dosage schedule