From the Research
Leucovorin (folinic acid) is not typically used as a primary treatment for brain or cerebral deficits, but for patients with cerebral folate deficiency, the recommended starting dose is usually 0.5-1 mg/kg/day, which can be gradually increased to 2-3 mg/kg/day based on clinical response, as supported by the most recent study 1. The medication is administered orally, typically divided into 2-3 doses per day. Some key points to consider when using leucovorin for cerebral folate deficiency include:
- Treatment duration is often long-term or indefinite as the condition requires ongoing management.
- Leucovorin works by bypassing the folate receptor alpha defect that prevents normal folate transport into the brain, thereby restoring folate levels in the central nervous system.
- Folate is essential for numerous neurological functions including neurotransmitter synthesis and myelin formation.
- Before starting treatment, patients should undergo cerebrospinal fluid analysis to confirm folate deficiency, and regular monitoring of folate levels and clinical symptoms is necessary to adjust dosing appropriately.
- Side effects are generally minimal but may include gastrointestinal disturbances. It's also important to note that the use of leucovorin as a neuroprotective agent has been suggested in the context of methotrexate-induced neurotoxicity, as seen in studies such as 1 and 2, which highlight the potential benefits of leucovorin in reducing the risk of neurotoxicity associated with methotrexate treatment.