部份中文左亚叶酸钙处方资料（仅供参考）
英文名：Calcium Levofolinate Hydrate
商品名：ISOVORIN
中文名：左亚叶酸钙注射剂
剂  型：注射液
生产商：辉瑞制药
药品简介
Isovorin（Calcium Levofolinate）是亚叶酸的钙盐，是用于癌症化疗的佐剂，本品与5-氟尿嘧啶合用，用于治疗胃癌和结直肠癌。 
アイソボリン点滴静注用25mg/アイソボリン点滴静注用100mg
药用分类名称
活性叶酸制剂
批准日期：2008年6月
商標名
ISOVORIN INJECTION 25mg
ISOVORIN INJECTION 100mg
一般名
レボホリナートカルシウム水和物（Calcium Levofolinate Hydrate）
化学名
Monocalcium N-［4-（｛［（6S）-2-amino-5-formyl-4-oxo-1,4,5,6,7,8-hexahydropteridin-6-yl］methyl｝amino）benzoyl］-L-glutamate pentahydrate
構造式
分子式
C20H21CaN7O7・5H2O
分子量
601.58
旋光度
〔α〕25D：−10〜−15゜
（脱水及び脱溶媒物に換算したもの0.25g、pH8.1の0.2mol/Lトリス緩衝液、25mL、100mm）。
性状
本产品为白色至浅黄色结晶粉末。
本产品在水中有点不溶于水，几乎不溶于甲醇或乙醇（99.5）。
本产品是吸湿性的。
药效药理
1. 抗肿瘤效果增强作用
（1） 体外测试
人类结肠和直肠癌细胞（COLO201），在体外试验中使用20μM浓度的代谢物，人类胃癌细胞（TMK-1，KATOIII，MKN28），观察到氟尿酸的抗肿瘤作用增强作用。
（2） 在体内测试
对于移植人类结肠癌Co-4细胞和人类胃癌H-111细胞的裸鼠，在左旋地平线（200mg/kg）和氟尿酸（90mg/kg）的组合中表现出肿瘤细胞生长抑制作用。
2. 作用机制
莱沃霍利纳特通过生物化学Modulation增强氟尿酸的抗肿瘤作用。氟尿酸是一种活性代谢物，氟脱氧二氮单磷酸（FdUMP）与胸酸合成酶（thymidylate synthase：TS）结合，通过抑制TS活性，抑制胸酸合成，抑制DNA合成。 莱博霍利纳特在细胞中还原，成为5，10亚甲基四氢叶酸（5，10-CH2-THF）。5，10-CH2-THF形成FdUMP，TS和强三元复合物（三元复合），通过延迟TS的解离，增强氟尿酸的抗肿瘤作用。
适应症
1. Calcium Levofolinate Hydrate氟尿酸疗法
增强氟尿酸对胃癌（不可手术或复发）和结肠直肠癌的抗肿瘤作用
2. Calcium Levofolinate Hydrate氟尿酸持续静脉注射联合治疗
增强氟尿酸对结肠癌、直肠癌、小肠癌和无法治愈的胰腺癌的抗肿瘤作用
用法与用量
1. Calcium Levofolinate Hydrate氟尿酸疗法
通常，成人一次250mg/m2（身体表面积）作为流糖素注射2小时静脉注射。 在Calcium Levofolinate Hydrate的输液静脉注射开始1小时后，一次600mg/m2（体表面积）作为氟尿酸（体表面积）在3分钟内缓慢静脉注射。每周重复六次，然后休息两周。
2. 结肠癌和直肠癌的Calcium Levofolinate Hydrate-氟尿酸持续静脉注射联合治疗
（1） 通常，成人一次100mg/m2（身体表面积）作为流糖素注射2小时静脉注射。400mg/m2作为氟尿酸在静脉注射后立即在流旋翼注射后立即静脉注射，600mg/m2作为氟尿酸（身体表面积）持续静脉注射22小时。连续两天执行此操作，每两周重复一次。
（2） 通常，成人一次250mg/m2（身体表面积）作为流糖素注射2小时静脉注射。2600mg/m2（身体表面积）在输液静脉注射完成后立即作为氟尿酸（身体表面积）持续静脉注射24小时。每周重复六次，然后休息两周。
（3） 通常，成人一次200mg/m2（身体表面积）作为流糖素注射2小时静脉注射2小时。400mg/m 2作为氟尿酸在静脉注射后立即静脉注射，在流旋静脉注射后立即，2400~3000mg/m2（表面积）作为氟尿酸（表面积）持续静脉注射46小时。每两周重复一次。
3. 对小肠癌和无法治愈的胰腺癌的Lebo Horinerto氟尿酸持续静脉注射联合治疗
通常，成人一次200mg/m2（身体表面积）作为流糖素注射2小时静脉注射。 400mg/m2作为氟尿酸在静脉注射后立即在流旋静脉注射后立即，2400mg/m2作为氟尿酸（身体表面积）持续静脉注射46小时。每两周重复一次。
包装
点滴静注用
25mg：10小瓶
100mg：5小瓶
制造与销售
辉瑞公司
注：以上中文处方资料不够完整，使用者以原处方资料为准。
完整说明附件
http://www.info.pmda.go.jp/downfiles/guide/ph/671450_3929407D1160_2_00G.pdf
ISOVORIN INJECTION 25mg（Calcium levofolinate hydrate）
Brand name:ISOVORIN INJECTION 25mg
Active ingredient:Calcium levofolinate hydrate
Dosage form:injection
Print on wrapping:
Effects of this medicine
This medicine boosts the effectiveness of antitumor effect with concomitant use of fluorouracil.
It is usually used for the purpose of enhancing the effect of fluorouracil in the treatment of gastric cancer (which isinoperable or recurrent), colorectal cancer, small intestinal cancer and pancreatic cancer not amenable to curativeresection.
Before using this medicine, be sure to tell your doctor and pharmacist
• If you have previously experienced any allergic reactions(itch, rash etc)to any medicines.
If you have: fever, generalized dullness, diarrhea, varicella (chickenpox) or other infectious disease, ascites,pleural effusion, heart disease or its history, poor general condition, discontinuation of receiving thecombination preparation of tegafur, gimeracil and oteracil potassium(TS-1)within 7 days, liver disorder, renal
disorder, liver metastasis, gastrointestinal ulcer or bleeding, ongoing treatment by radiation.
• If you are pregnant or breastfeeding.
• If you are taking any other medicinal products.(Some medicines may interact to enhance or diminish medicinaleffects. Beware of over-the-counter medicines and dietary supplements as well as other prescriptionmedicines)
Dosing schedule(How to take this medicine)
• Your dosing schedule prescribed by your doctor is (to be written by a healthcare professional)
• In general, for adults, this medicine is administered by intravenous drip infusion at one time over the period of2 hours.
•The administration intervals depend on concomitant drugs and symptoms/condition. Contact your doctorabout the specific dosing schedule.
Precautions while taking this medicine
• If you have decreased bone-marrow function, infection or bleeding may tend to occur. However, it is difficultto find out these symptoms so that you should receive clinical examination (blood test, liver/renal functiontest, etc) regularly (frequently during early treatment period, in particular) to find any symptoms early.
Possible adverse reactions to this medicine
The most commonly reported adverse reactions include diarrhea, loss of appetite, nausea/vomiting, stomatitis,fever, rash, taste abnormality, abdominal pain, epigastric pain, thirst, constipation, gingivitis, cheilitis/angularstomatitis, glossitis, abdominal bloating, melena and heartburn. If any of these symptoms occur, consult with yourdoctor or pharmacist.
The symptoms described below are rarely seen as initial symptoms of the adversereactions indicated in brackets. If any of these symptoms occur, stop taking thismedicine and see your doctor immediately.
• persistent muddy or watery stool [severe diarrhea]
• chills, fever, bleeding tendency [bone-marrow depression]
• severe abdominal pain, diarrhea [serious enteritis]
• respiratory distress, generalized hot flashes, hives [shock, anaphylaxis]
• general dullness, loss of appetite, yellowing of the skin or whites of the eyes [liver dysfunction, jaundice]
• decreased urine output, edema of limbs, general dullness [acute renal disorder]
The above symptoms do not describe all the adverse reactions to this medicine.
Consult with your doctor or pharmacist if you notice any symptoms of concern otherthan those listed above
Injection
Revised: 07/2019
The information on this sheet is based on approvals granted by the Japanese regulatory authority. Approvaldetails may vary by country. Medicines have adverse reactions (risks) as well as efficacies (benefits). It isimportant to minimize adverse reactions and maximize efficacy. To obtain a better therapeutic response,patients should understand their medication and cooperate with the treatment.