See Available Brands of Calcium Folinate in India

P - Caution when used during pregnancy

Folinic acid, generally administered as calcium folinate (or leucovorin calcium), is an adjuvant used in cancer chemotherapy involving the drug methotrexate. It is also used in synergistic combination with the chemotherapy agent 5-fluorouracil. Folinic acid should be distinguished from folic acid.

Pharmacodynamics

Pharmacokinetics

Calcium folinate enters the cells as 5-methyl tetrahydrofolate and supplies the cofactor blocked by methotrexate. It stabilises the binding of 5-dUMP and thrymidylate synthetase, enhances flourouracil activity and neutralises the effects of folic acid antagonists such as methotrexate but increases those of 5-fluorouracil.

Absorption Well absorbed (oral, IM).

Distribution Widely distributed; concentrated in the liver and CSF.

Metabolism Hepatic, intestinal; converted to biologically active 5-methyltetrahydrofolate.

Excretion Urine, faeces (small amounts).

Calcium Folinate Indications / Calcium Folinate Uses

Information Not Available

Calcium Folinate Adverse Reactions / Calcium Folinate Side Effects

Allergic sensitisation, rash, pruritus, eythema, urticaria, nausea, vomiting, pyrexia.

Precautions

Information Not Available

Special Precautions

Undiagnosed megaloblastic anaemia, folate dependent tumors; pregnancy. Monitor calcium levels in patients receiving combined 5-Fluorouracil/Folinic acid treatment. To be given parenterally in the presence of GI toxicity, nausea or vomiting. Monitor serum levels of methotrexate to determine the optimal dose and duration of folinic acid admin. Monitor CBC, electrolytes and liver function tests before and regularly during treatment.

Other Drug Interactions

Reduces methotrexate toxicity. Enhances cytotoxic and anti-neoplastic effects of fluorouracil. Increases risk of seizures in epileptic patients treated with primidone, phenytoin, phenobarbital and succinimides.

Other Interactions

Information Not Available

Dosage

Oral Antidote for methotrexate toxicity Adult: 15 mg every 6 hr for 10 doses starting 24 hr after the start of methotrexate infusion. Continue admin until serum levels of methotrexate is <0.05 micromolar. May also be given via IM/IV inj. Oral Folate-deficient megaloblastic anaemia Adult: 15 mg daily. Intravenous Adjunct to fluorouracil in colorectal cancer Adult: 200 mg/m2 BSA by slow IV inj over at least 3 min followed by 370 mg/m2 fluorouracil by IV inj. Treatment is given for 5 consecutive days and repeated at intervals of 28 days for 2 courses. Subsequently, may repeat at 4-5 wkly intervals if the patient has recovered completely from the toxic effects of the prior treatment course. Intramuscular Folate-deficient megaloblastic anaemia Adult: Up to 1 mg/day. Incompatibility Incompatible with fluorouracil when mixed in various ratios and stored in PVC containers at various temperatures.

Food(before/after)

Information Not Available

List of Contraindications

Calcium Folinate and Pregnancy

Information Not Available

Calcium Folinate and Lactation

Information Not Available

Calcium Folinate and Children

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Calcium Folinate and Geriatic

Information Not Available

Calcium Folinate and Other Contraindications

Hypersensitivity, pernicious anaemia and other megaloblastic anaemias secondary to vit B12-deficiency, intrathecal and intraventricular admin.

Storage

Intravenous Store at 15-30℃ Oral Store at 15-30 ℃

Lab interference

Information Not Available