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What is cifolinate, is it an antidote? With the main ingredient is folinic acid, Cifolinate has a strong detoxifying effect of folic acid antagonists.
1. What is Cifolinate?
Cifolinate belongs to the group of emergency and detoxifying drugs, with the main ingredient being folinic acid (in the form of calcium folinate) with a content of 30mg. Calcium folinate has a strong detoxifying effect on the antidotes of folic acid antagonists such as methotrexate, pyrimethamine, trimethoprim, ...
Cifolinate is prepared in the form of an injection solution packed in 3ml ampoules and is indicated for use in the following cases:
Detoxification and prevention of toxicity of folic acid antagonists. In combination with high-dose methotrexate in chemotherapy. Treatment of megaloblastic anemia. In combination with 5-fluorouracil in the treatment of late rectal cancer.
2. Usage and dosage of Cifolinate
Cifolinate is used by injection, the injection technique is performed by medical staff or doctors. In the treatment of late rectal cancer in combination with 5-fluorouracil, it should be administered separately to prevent precipitation.
Note, with doses above 10mg/m2 body surface area, Cifolinate should be mixed with sterile injection solution and used immediately after reconstitution. Do not administer intravenously at a rate of 160 mg/min.
Dosage of Cifolinate in the detoxification and prevention of toxicity of folic acid antagonists: Intravenous or intramuscular injection with a dose equivalent to the amount of antagonist used, inject as soon as possible, as soon as drug is detected. Overdose. Dosage of Cifolinate in combination with medium dose methotrexate: Intramuscular with a dose of 6-12mg/time, 4 times/day, 6 hours apart. Dosage of Cifolinat in combination with high-dose methotrexate in chemotherapy: After taking methotrexate for 6-24 hours, inject cifolinat 10mg/m2 body surface area, injected every 6 hours until the concentration of methotrexate in the blood is reduced. serum is lower than 5x10-8 mol/liter. If the serum creatinine concentration increases by more than 50% after taking methotrexate 24 hours before administration or the methotrexate value is above 5x10-6 mol/L, the dose of Cifolinate should be increased immediately to 100mg/m2 and administered every 3 hours. until the serum methotrexate concentration is reduced to less than 5x10-8 mol/L. Dosage of Cifolinate in the treatment of megaloblastic anemia: If folic acid deficiency, intramuscular injection of 1mg/day and depending on the response of the drug, the doctor will appoint an appropriate treatment time. If due to congenital dihydrofolate reductase deficiency, IM 3-6mg/day. Dosage of Cifolinate when combined with 5-fluorouracil in the treatment of late rectal cancer: Use one of two regimens, regimen 1 is slow intravenous injection of folinic acid at a dose of 200mg/m2/day for 3 minutes, then injection intravenous 5-fluorouracil at a dose of 370 mg/m2. Regimen 2 is slow intravenous injection of folinic acid at a dose of 20 mg/m2/day, followed by intravenous 5-fluorouracil at a dose of 425 mg/m2. Duration of treatment is 5 days and after 4 weeks, repeat injection, 2 more similar courses, then repeat the regimen after 4-5 weeks when the toxicity has decreased in the previous treatment.
3. Cifolinate side effects
Cifolinate can cause some unwanted side effects when used in combination with 5-fluorouracil . Side effects are the toxicity of 5-fluorouracil such as anorexia, stomatitis, nausea, vomiting, pharyngitis, esophagitis, diarrhea, leukopenia, dermatitis, hair loss.
If you see any symptoms after taking Cifolinate, the patient should be closely monitored and immediately reported to the treating doctor for a health check.
4. Some notes when using Cifolinate
Do not use Cifolinate in people with hypersensitivity to the ingredients of the drug, people with pernicious anemia, anemia of unknown cause or megaloblastic anemia but due to vitamin B12 deficiency. When combining cifolinate with 5-fluorouracil for the treatment of late rectal cancer, the dose of 5-fluorouracil should be adjusted down if the patient has moderate to severe toxicity in the gastrointestinal system or hematology. Stop treatment with cifolinate when the white blood cell count is 4,000/mm3 and the platelet count is 130,000/mm3, or the patient is diagnosed with an advanced tumor, is elderly or debilitated. Women who are pregnant or breast-feeding should only use Cifolinate if absolutely necessary. Co-administration of cifolinate with 5-fluorouracil increases the toxicity of 5-fluorouracil. Concomitant administration of high doses of cifolinate with phenobarbital, phenytoin, and primidone may reduce the antiepileptic effect and increase the number of seizures in susceptible pediatric patients. High doses of cifolinate may reduce the effect of methotrexate when injected into the spinal canal. Cifolinate is used to detoxify folic acid antagonists. In addition, the drug is also used in combination with other drugs in cancer chemotherapy.
