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Folinic acid (Generic Leucovorin)

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Why is this medication prescribed?

Leucovorin, also known as folinic acid or citrovorum factor, is prescribed for several medical purposes, primarily in the treatment of certain types of cancer and to mitigate the toxic effects of methotrexate, a chemotherapy drug. Here’s why it is prescribed:

  • Cancer Treatment: Leucovorin is often used as part of combination chemotherapy regimens to enhance the effectiveness of certain chemotherapy drugs, particularly fluorouracil (5-FU). Leucovorin works by helping to protect healthy cells from the toxic effects of chemotherapy while enhancing the killing of cancer cells.
  • Methotrexate Rescue: Methotrexate is a chemotherapy drug that can cause toxic effects by inhibiting the action of dihydrofolate reductase, an enzyme necessary for the synthesis of DNA, RNA, and proteins. Leucovorin acts as a “rescue” agent by bypassing this inhibition and providing cells with the necessary forms of folate for DNA synthesis. This helps reduce the toxicity of methotrexate, particularly in cases of methotrexate overdose or when high doses of methotrexate are used for cancer treatment.

How should this medicine be used?

The usage of Leucovorin is typically determined by the prescribing physician or healthcare provider based on the specific condition being treated and the individual patient’s needs. However, here are some general guidelines:

  • Dosage: The dosage of Leucovorin can vary depending on the specific treatment regimen and the patient’s condition. It is usually administered orally or intravenously.
  • Frequency: The frequency of administration can vary. For cancer treatment, it is often given on a specific schedule along with other chemotherapy drugs. In cases of methotrexate rescue, it may be given at specific intervals after methotrexate administration to reduce toxicity.
  • Administration: Leucovorin may be administered by a healthcare professional in a clinical setting, such as a hospital or cancer treatment center. For oral administration, it is typically taken with water or as directed by the healthcare provider.
  • Duration of Treatment: The duration of Leucovorin treatment depends on the specific condition being treated, the patient’s response to treatment, and other factors determined by the healthcare provider.

It’s essential for patients to follow the instructions provided by their healthcare provider carefully and to inform them of any side effects or concerns during treatment.

Other uses for this medicine

Leucovorin, besides its primary uses in cancer treatment and methotrexate rescue, has other medical applications as well. These include:

  • Treatment of Folinic Acid Deficiency: Leucovorin can be used to treat folinic acid deficiency, a condition where the body lacks sufficient folate, leading to various health issues.
  • Treatment of Megaloblastic Anemia: Leucovorin may be used in the treatment of megaloblastic anemia, a condition characterized by abnormally large and immature red blood cells, often caused by folate deficiency.
  • Treatment of Certain Poisonings: Leucovorin has been used in the treatment of overdoses or toxicities caused by certain medications, such as trimethoprim-sulfamethoxazole (Bactrim) and pyrimethamine.

What special precautions should I follow?

Special precautions should be taken when using Leucovorin. Here are some important considerations:

  • Medical History: starting Leucovorin treatment, patients should inform their healthcare provider about their medical history, especially if they have any allergies, kidney disease, liver disease, or blood disorders.
  • Pregnancy and Breastfeeding: It’s important for pregnant or breastfeeding individuals to discuss the risks and benefits of using Leucovorin with their healthcare provider. While it’s generally considered safe during pregnancy and breastfeeding, caution is advised, and the potential risks should be carefully weighed.
  • Interactions: Leucovorin may interact with other medications or supplements. Patients should inform their healthcare provider about all the medications, vitamins, and supplements they are taking to avoid potential interactions.
  • Side Effects: Common side effects of Leucovorin may include nausea, vomiting, diarrhea, abdominal pain, and allergic reactions. Patients should report any unusual or severe side effects to their healthcare provider promptly.
  • Monitoring: Regular monitoring of blood counts and liver function may be necessary during Leucovorin treatment, especially when used in combination with chemotherapy drugs or in patients with certain medical conditions.
  • Dosage Adjustment: Dosage adjustments may be necessary for patients with kidney or liver impairment to avoid potential toxicity.
  • Administration: Leucovorin should be administered exactly as prescribed by the healthcare provider. Patients should not adjust the dosage or stop taking the medication without consulting their healthcare provider first.

As with any medication, it’s crucial to follow the healthcare provider’s instructions carefully and to ask any questions or express concerns about Leucovorin treatment.

What special dietary instructions should I follow?

Special dietary instructions for Leucovorin are typically not required. However, maintaining a healthy and balanced diet rich in folate-containing foods, such as leafy green vegetables, fruits, legumes, and fortified grains, may be beneficial. These foods can help support overall health and supplement the effects of Leucovorin treatment.

What should I do if I forget a dose?

If you forget a dose of Leucovorin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you have any concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Leucovorin, like any medication, can cause side effects, although not everyone experiences them. Common side effects of Leucovorin may include:

  • Nausea: Feeling sick to your stomach, which may or may not be accompanied by vomiting.
  • Vomiting: The forceful expulsion of stomach contents through the mouth.
  • Diarrhea: Frequent, loose, or watery stools.
  • Abdominal Pain: Pain or discomfort in the stomach area.
  • Allergic Reactions: Rarely, Leucovorin can cause allergic reactions such as rash, itching, swelling, or difficulty breathing. Seek immediate medical attention if you experience any signs of an allergic reaction.

Less common side effects may include:

  • Fever
  • Chills
  • Dizziness
  • Fatigue
  • Mouth Sores

It’s important to note that the above list may not include all possible side effects. Some individuals may experience side effects not listed here. Additionally, side effects can vary in severity from person to person.

If you experience any side effects while taking Leucovorin, it’s essential to inform your healthcare provider. They can provide guidance on managing side effects or adjust your treatment regimen if necessary. In some cases, your healthcare provider may recommend medications or other interventions to alleviate side effects.

What should I know about storage and disposal of this medication?

Storage and Disposal:


  • Room Temperature: Store Leucovorin at room temperature away from light and moisture.
  • Keep Away from Children and Pets: Store Leucovorin in a safe place out of reach of children and pets.
  • Do Not Freeze: Do not freeze Leucovorin unless specifically instructed by the manufacturer.
  • Avoid Extreme Temperatures: Do not expose Leucovorin to extreme temperatures or direct sunlight.
  • Original Container: Keep Leucovorin in its original container to protect it from light and moisture.
  • Check Expiration Date: Check the expiration date on the label and do not use Leucovorin if it has expired.


  • Follow Local Guidelines: Dispose of unused or expired Leucovorin according to local guidelines or regulations.
  • Do Not Flush: Do not flush Leucovorin down the toilet or pour it down the drain unless instructed to do so.
  • Drug Take-Back Programs: Check if there are any drug take-back programs in your area where you can safely dispose of Leucovorin.
  • Ask Your Pharmacist: If you are unsure about how to dispose of Leucovorin, ask your pharmacist for guidance.

In case of emergency/overdose

  • Seek Medical Help: In case of an emergency or suspected overdose of Leucovorin, seek immediate medical attention or contact a poison control center.
  • Symptoms of Overdose: Symptoms of Leucovorin overdose may include severe nausea, vomiting, diarrhea, abdominal pain, and allergic reactions.

What other information should I know?

  • Regular Monitoring: Your healthcare provider may recommend regular monitoring of blood counts, liver function, and kidney function during Leucovorin treatment.
  • Follow Instructions: Take Leucovorin exactly as prescribed by your healthcare provider. Do not change the dosage or stop taking it without consulting your healthcare provider.
  • Inform Healthcare Provider: Inform your healthcare provider about all medications, vitamins, and supplements you are taking, as Leucovorin may interact with certain drugs.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Leucovorin with your healthcare provider.
  • Allergic Reactions: Be aware of signs of allergic reactions such as rash, itching, swelling, or difficulty breathing. Seek immediate medical attention if you experience any allergic reactions.
  • Storage: Store Leucovorin out of reach of children and pets, and keep it in its original container away from light and moisture.

Always consult your healthcare provider or pharmacist if you have any questions or concerns about Leucovorin or its usage.

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