Generic
Leucovorin [Folinic Acid]
Pharmacology
Folinic Acid is the formyl derivative of tetrahydrofolic acid which is a metabolite and active form of folic acid. It is effective in the treatment of megaloblastic anemia caused by folic acid deficiency and is a potent antidote for both the haematompoietic and reticuloendothelial toxic effects of folic acid antagonist, e.g. methotrexate, pyrimethamine, trimethoprim. In some cancers, Folinic Acid enters and rescues normal cells, from the toxic effect of folic acid antagonists, due to a defference in membrane transport mechanism. This principle is applied in high dose methotrexate therapy with Folinic Acid rescue.
Side Effects
Leucovorin therapy is contraindicated for the following: Known hypersensitivity to Calcium Folinate, or to any components of the product formulation. Pernicious anemia or other Megaloblastic anemia where Vitamin B12 is deficient.
Pregnancy And Lactation
Allergic reaction: one may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing). Fits and fainting.
Therapeutic
Leucovorin treatment may mask pernicious anemia and other Megaloblastic anemia resulting from Vitamin B12 deficiency. Leucovorin should only be used with 5-fluorouracil or Methotrexate under the direct supervision of a clinician experienced in the use of cancer chemotherapeutic agents. Many cytotoxic medicinal products- direct or indirect DNA synthesis inhibitors- lead to macrocytosis (hydroxycarbamide, cytarabine, mercaptopurine, thioguanine). Such macrocytosis should not be treated with Folinic acid. In epileptic patients treated with Phenobarbital, Phenytoin, Primidone, and Succinimides, there is a risk to increase the frequency of seizures due to a decrease of plasma concentrations of anti-epileptic drug.
Storage Conditions
There have been no reported sequelae in patients who have received significantly more Calcium Folinate than the recommended dosage. However, excessive amounts of Calcium Folinate may ify the chemotherapeutic effect of folic acid antagonists.
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