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leucovorin (Wellcovorin)
Tradename: Wellcovorin. (calcium leucovorin).
Indications:
1) high dose methotrexate (10-15 mg/m2) rescue:
a) 15 mg (10 mg/m2) every 6 hours for 10 doses starting 24 hours after after beginning methotrexate infusion
b) IV administration if risk of vomiting
2) used in combination with 5-fluorouracil for treatment of advanced colon cancer
a) 200 mg/m2 IV over 3 minutes followed by 5-fluorouracil 370 mg/m2 IV
b) 20 mg/m2 IV followed by 5-fluoruracil 425 mg/m2 IV
c) administer separately to avoid precipitation
3) megaloblastic anemia
a) due to folate deficiency: 1 mg QD
b) due to congenital deficiency of dihydrofolate reductase: 3-6 mg IM QD
4) adjunctive therapy with antimicrobial agents (pyrimethamine)
a) 2-15 mg/day for 3 days or until blood counts are normal
b) 6 mg/day needed for platelet counts < 100,000/mm3
Tabs: 5 mg, 25 mg
Powder for injection: 50, 100, 350 mg vials.
Injection: 3 mg/mL (1 mL)
Adverse effects:
1) uncommon (< 1%)
- rash, pruritus, erythema, urticaria, wheezing, thrombocytosis
2) other
- nausea
- abdominal distension
- bad taste
- anaphylactoid reactions
Drug interactions:
1) may diminish anti-seizure effects of phenobarbital, phenytoin, & primidone
2) leucovorin enhances activity of 5-fluoruracil, effectiveness & toxicity [4]
Related
folate metabolism
General
N5-formyltetrahydrofolate (folinic acid, citrovorum factor, Fusilev)
antidote
Database Correlations
PUBCHEM correlations
References
- Physicians Desk Reference. 52nd edition, Medical Economics, 1998
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
Department of Veterans Affairs, VA National Formulary
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Medical Knowledge Self Assessment Program (MKSAP) 16,
American College of Physicians, Philadelphia 2012
Component-of
5-fluorouracil/irinotecan/leucovorin/oxaliplatin (FOLFIRINOX)