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What is this medication?

Leucovorin/Folinic Acid
Antidote; Chemotherapy Modulating Agent; Water Soluble Vitamin

Leucovorin/Folinic Acid is officially indicated in combination with fluorouracil for advanced colorectal cancer, to treat megaloblastic anemia due to folate deficiency, and to treat methotrexate toxicity.  It is also prescribed off-label as part of many other chemotherapy regimens for various forms of cancer.  (may be used for conditions not listed)

How does this medication work? 

Leucovorin calcium is the reduced form of folic acid which is a cofactor blocked by methotrexate.  It actively competes with methotrexate for transport sites, displaces methotrexate from intracellular binding sites, and restores active folate stores required for DNA/RNA synthesis. Leucovorin also helps stabilize 5-dUMP binding and thymidylate synthetase which can enhance the effects of fluorouracil.  It also can be combined with pyrimethamine for the treatment of opportunistic infections to reduces the risk for hematologic toxicity from pyrimethamine.

How should I take this medication? 

Oral: Dosing regimens for leucovorin are very highly varied and can be complex, some even requiring blood level monitoring.  Oral absorption is limited to 25mg so any dosages over 25mg should be converted to parenteral therapy.  

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed.

What should I watch for while using this medication? 

Before starting Leucovorin/Folinic Acid make sure your physician is aware of any allergies or medications you currently take, if you have B12 deficiency, kidney disease, are pregnant, or breastfeeding.  

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Fatigue, lethargy, malaise, alopecia, dermatitis, stomatitis, nausea, diarrhea, vomiting, anorexia, drug toxicity.

Note this is not a complete list of side effects for Leucovorin, only common ones.