From the Guidelines
Leukovirdin is not a recognized medication, drug, or established medical term in current medical literature or practice, and it is likely that you are referring to leucovorin, a medication used to reduce the toxic effects of methotrexate therapy and as a treatment for folate deficiency. If you're seeking information about a medication with a similar name, leucovorin (also called folinic acid) is a medication used in cancer treatment protocols, particularly colorectal cancer, when combined with 5-fluorouracil, as seen in the FOLFOX and FOLFIRI regimens 1. Leucovorin works by providing an active form of folic acid that bypasses the metabolic block caused by certain medications.
Key Points
- Leucovorin is used to mitigate systemic toxicity of methotrexate, with a dose of 10 mg orally, twice daily, beginning on the day of treatment and continuing for 3 days 1.
- Leucovorin is commonly used in combination with 5-fluorouracil in cancer treatment protocols, such as the FOLFOX and FOLFIRI regimens 1.
- The dosage of leucovorin can vary depending on the specific treatment protocol, with doses ranging from 200 mg/m2 to 400 mg/m2 1. If you're looking for information about leucovorin or another specific medication, I would recommend consulting with a healthcare provider for accurate information tailored to your specific medical needs.
From the FDA Drug Label
Tetrahydrofolic acid derivatives are distributed to all body tissues but are stored primarily in the liver Normal serum levels of total folate have been reported to be 5 to 15 ng/mL; normal cerebro-spinal fluid levels are approximately 16 to 21 ng/mL. Normal erythrocyte folate levels have been reported to range from 175 to 316 ng/mL. In general, folate serum levels below 5 ng/mL indicate folate deficiency, and levels below 2 ng/mL usually result in megaloblastic anemia N5-formyltetrahydrofolic acid is leucovorin.
Leucovorin is another term for N5-formyltetrahydrofolic acid, a derivative of tetrahydrofolic acid, which is involved in nucleoprotein synthesis and the maintenance of normal erythropoiesis 2.
From the Research
Leukovirdin (Folinic Acid) Overview
- Leukovirdin, also known as folinic acid, is used to prevent toxicity and side effects associated with high-dose methotrexate (HD-MTX) therapy 3, 4.
- It is highly beneficial in preventing myelosuppression, gastric toxicity, and neurotoxic effects after HD-MTX therapy 3.
- Folinic acid supplementation can reduce the incidence of hepatotoxicity and gastrointestinal side-effects of methotrexate in patients with rheumatoid arthritis (RA) 5, 6.
Mechanism of Action and Dosage
- Leucovorin rescue is a cornerstone for toxicity prevention in HD-MTX treatment, and its dose adjustment is crucial to prevent overrescue 4.
- Various methods for calculating leucovorin doses have been proposed, including empirical calculations based on MTX plasma concentration and the Bleyer nomogram 4.
- The optimal dosage regimen for leucovorin rescue in various tumors using HD-MTX is still a topic of debate and requires further studies 4.
Efficacy and Safety
- Folate supplementation, including leucovorin, can reduce patient withdrawal from methotrexate treatment due to toxicity 5, 7, 6.
- Leucovorin supplementation has been shown to reduce the frequency of side effects, such as elevated liver enzyme levels, without affecting the efficacy of methotrexate in patients with RA 5, 7.
- High-dose folate (≥25 mg per week) and low-dose folate (≤10 mg per week) have been compared, and no significant difference was found in terms of methotrexate efficacy or toxicity 6.