Leucovorin

Details About Generic Salt ::  Leucovorin 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

21A. TOXICITY AND POISON MANAGEMENT (ANTIDOTES) in 21. TOXICITY AND POISON MANAGEMENT (ANTIDOTES)
LEUCOVORIN
5-FORMYL DERIVATIVE OF TETRAHYDROFOLIC ACID | ANTIDOTE TO FOLIC ACID ANTAGONIST, ANTI-NEOPLASTIC ADJUNCT, ANTI-ANEMIC, VITAMIN
also comes under 18A. Anti-Neoplastic Agents in 18. Anti-Neoplastic Agents,  5E. Hematinics/Hematopoietics in 5. Hematological System
PK: A: Well absorbed D: Extensive M: Intestinal mucosa & hepatic E: Urine

Indications & Dose: ADVANCED COLORECTAL CANCER Combination therapy IV Adult 200mg/m2 over at least 3min with fluorouracil (370mg/m2) or 20mg/m2 with fluorouracil (425mg/m2) | FOLATE DEFICIENT MEGALOBLASTIC ANEMIA IM Adult < 1mg/day | HIGH-DOSE METHOTREXATE RESCUE DOSE PO/IV/IM Adult Initially 15mg (~10mg/m2) q6h, started 24h after initiation of methotrexate infusion & continued until serum methotrexate level drops below <0.05µmole/L. Adjust dose as follows: For normal methotrexate elimination (PO/IM/IV): 15mg q6h , delayed early methotrexate elimination (IV): 150mg q3h, until serum methotrexate level drops below <1µmole/L, then 15mg q3h until methotrexate level is < 0.05µmole/L Child Same as adult dose | METHOTREXATE TOXICITY IV Adult 7.5mg (~5mg/m2) q6h, until serum methotrexate level drops to <0.01 micromolar. SeCr & serum methotrexate concentration should be monitored q24h. If 24h SeCr level rises 50% over baseline or if 24h methotrexate level exceeds 5 micromolar or 48h level exceeds 0.9 micromolar, increase leucovorin dosage to 50mg/m2 q3h until methotrexate level drops below 0.01 micromolar. Maintain hydration (3L/day) & urinary alkalization (pH >7) concomitantly

Contra: Treatment of pernicious anemia & other megaloblastic anemias caused by vitamin B12 deficiency

Precautions: Anemia, patients receiving 5-FU concomitantly, children

ADR: Serious: Hypersensitivity, Others: Pyrexia, GI disturbances, insomnia, agitation, depression

DDI: Serious Phenytoin level decreases by drug, Capecitabine max tolerated dose decreases by drug