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Leucovorin (folinic acid) is used as an antidote to folic acid antagonists, in combination with other drugs for the treatment of advanced colorectal cancer, for the prevention and treatment of megaloblastic anemia..
1. What does Leucovorin do?
Leucovorin (folinic acid) is a form of folic acid used to prevent and treat toxicity caused by folic acid antagonists (eg, high doses of methotrexate).At the same time, Leucovorin is also indicated for use in the following cases:
Combined with Fluorouracil to treat colorectal cancer; Treatment and prevention of macrocytic anemia caused by folate deficiency during treatment with drugs such as Trimethoprim, Pyrimethamine, Sulfasalazine... Currently, Leucovorin is prepared in the following forms and strengths:
Tablets 15mg; 5mg capsules; 25mg; Solution for injection: 3mg/ml, 7.5mg/ml, 10mg/ml; Calcium Folinate powder for solution for injection: 15mg, 30mg vials.
Leucovorin là thuốc giải độc với các chất đối kháng axit folic
2. Instructions for using Leucovorin
Folinic acid is usually given as calcium (or sodium) folinate although doses are expressed as folinic acid.
Leucovorin is administered orally, intramuscularly or intravenously. Precautions for administration and dosage are as follows:
Prophylaxis and treatment of toxicity associated with folic acid antacids: Leucovorin is administered intramuscularly or intravenously at a dose equivalent to that of the antagonist used, as long as possible. as soon as possible after detecting an inadvertent overdose (preferably within the first hour). Intramuscular injection 6-12mg each time, every 6 hours, 4 times to handle side effects that occur when overdose Methotrexate; Treatment of megaloblastic anemia: intramuscular injection of folinic acid 1mg/day; In combination with Fluorouracil to treat late colorectal cancer: use 1 of 2 regimens as follows: Slow intravenous injection of folinic acid 200mg/m2 over 3 minutes, then intravenous Fluorouracil 370mg/m2; Slow intravenous injection of folinic acid 20mg/m2 followed by intravenous Fluorouracil 425mg/m2; Note:
It is necessary to inject folinic acid and fluorouracil separately to avoid precipitation; With both regimens, treatment for 5 days, repeat treatment after 4 weeks.
3. Leucovorin side effects
Leucovorin has low toxicity in humans, even when used for a long time. However, in the process of taking the drug, users may encounter some side effects as follows:
Allergies (anaphylaxis, urticaria); Nausea and vomiting; Severe diarrhea (especially when combined with Fluorouracil); Fever after injection; Insomnia (rare); Agitation, increased frequency of seizures (rare); Gastrointestinal disorders (rare);
4. Note when using Leucovorin drug
Leucovorin should not be used in the following cases:
Patients at risk of allergy to folinic acid; Patients with pernicious anemia , macrocytic anemia caused by vitamin B12 deficiency ; Notes on drug use:
Leucovorin should only be used by intramuscular or intravenous injection. Avoid intradermal injection, which can be fatal; Leucovorin should only be taken with Methotrexate or Fluorouracil under the direct supervision of a physician.
Người bệnh nên thận trọng khi sử dụng thuốc Leucovorin
5. Leucovorin drug interactions
Drug interactions can change how Leucovorin works or increase the severity of side effects. Some notes on drug interactions include:
Concurrent use of Leucovorin with folic acid antagonists (such as Pyrimethamine, Cotrimoxazol) may reduce the effectiveness or disable the effect of folic acid antagonists; Taking large amounts of folic acid in combination with antiepileptic drugs (such as Phenobarbital, Phenytoin, Primidon) may reduce the anticonvulsant effect (especially in pediatric patients); Concomitant use of Leucovorin with Fluorouracil may increase the toxicity as well as anticancer effects of Fluorouracil, especially on the gastrointestinal tract. When used in combination, the dose of Fluorouracil must be reduced more than when using Fluorouracil alone; Leucovorin is an antagonist of methotrexate, so this drug should not be used concurrently with methotrexate, unless it is necessary to reverse the effect of methotrexate. The article provides basic information about Leucovorin drug. To ensure the effective treatment of the drug as well as prevent unwanted side effects and interactions, users should take Leucovorin as directed by their doctor.
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