From the Guidelines
Leucovorin acid, also known as folinic acid, is a medication used as an antidote to folic acid antagonists and as a rescue therapy after high-dose methotrexate treatment. It is a reduced form of folic acid that bypasses the metabolic block caused by methotrexate, allowing normal cell function to continue despite the presence of methotrexate. Leucovorin is typically administered at doses ranging from 5-25 mg for routine supplementation, but can be given at much higher doses (up to 100-200 mg/m²) when used as rescue therapy after methotrexate 1. The timing of administration is critical when used as rescue therapy, usually starting 24 hours after methotrexate administration. Leucovorin is also used in combination with 5-fluorouracil in colorectal cancer treatment to enhance its therapeutic effect, with dosing regimens such as 400 mg/m² IV over 2 hours on day 1, followed by 5-FU bolus 400 mg/m² and then 1200 mg/m²/day x 2 days (total 2400 mg/m² over 46-48 hours) continuous infusion, repeated every 2 weeks 1. The medication works by providing reduced folate cofactors necessary for DNA synthesis, allowing healthy cells to continue dividing while cancer cells affected by methotrexate cannot utilize this pathway effectively. Leucovorin can be administered orally, intramuscularly, or intravenously depending on the clinical situation and urgency of treatment. In some cases, leucovorin is also used in the treatment of toxoplasmosis, with dosing regimens such as 10 mg PO TIW 1.
Some key points to consider when using leucovorin include:
- The equivalent dose of leucovorin is 400 mg/m², with levoleucovorin dose being 200 mg/m² 1
- Leucovorin should not be used as a substitute for folic acid 1
- The medication can be used in combination with other agents, such as pyrimethamine and sulfadiazine, for the treatment of toxoplasmosis 1
- The dosing regimen and duration of treatment may vary depending on the specific clinical scenario and patient population 1
From the Research
Definition and Description
There is no information available in the provided studies to define or describe Leucovorin (Folinic acid).
Related Information
- The studies provided are related to Alkaptonuria, a rare metabolic disease caused by deficiency of homogentisic acid oxidase 2, 3, 4, 5, 6.
- Alkaptonuria is characterized by the accumulation of homogentisic acid in the body, leading to ochronosis, a condition where connective tissues turn dark blue or black 2, 3, 4, 5, 6.