Leucovorin

Generic Name : Leucovorin

TradeName : Wellcovorin®

Other Name : Folinic Acid

Why it is prescribed (Indications) :
• Leucovorin is generally prescribed for cancer patients,although it is incapable of fighting cancer on its own.
• It is given, either to protect healthy cells from anti-cancer drugs or to enhance the anticancer activity of chemotherapeutic drugs,like5-fluorouracil (5-FU).
• It may also be administered during treatment with Methotrexate, to ‘rescue’ healthy cells from the cytotoxic action of Methotrexate.
• This drug is used to reduce the toxicity and counter the effects of folic acid antagonists overdose.
• It effectively treats Methotrexate- overdose
• Leucovorin is also used to treat Megaloblastic anemia, caused by folate deficiency, especially those that occur during pregnancy and childhood.

When it is not to be taken (Contraindications) :
• Leucovorin is not ideal for the treatment of pernicious anemia or secondary megaloblastic anemias arising from vitamin B12 deficiency, as it causes and enhances neurological damage.
• In children prone to seizures, leucovorin may increase the frequency of its occurrence.
• The presence of other medical conditions may lessen the impact of leucovorin.
• Leucovorin should be given to a pregnant woman only if absolutely necessary.
• Caution should be exercised when leucovorin is administered to a nursing mother.

How it should be taken :
• Leucovorin is available only as a prescription drug.It is administered usually by health- care professionals.
• Leucovorin calcium injection may be administered intramuscularly or intravenously
• The injection must be checked for leakage, clarity or discoloration
• To make an I.V.solution , the drug should be diluted with 5% Dextrose Injection, 0.9% Sodium Chloride Injection, Lactated Ringer's Injection or Ringer's Injection to make up a final concentration of 0.05 mg/mL leucovorin.
• This diluted working solution may be stored for 24 hours at room temperature and discarded afterwards.
• Due to the presence of calcium in the leucovorin solution,an I.V dose should be restricted to within 160 mg/minute of leucovorin.
• Leucovorin is administered after a few minutes of fluorouracil administration or 24 hours after the beginning of the Methotrexate administration.
• Treatment with fluorouracil involves 5 consecutive days of treatment.
• In cases of folic acid antagonist overdose, leucovorin calcium must be administered within four hours for the treatment to be ineffective.
• In case of Methotrexate chemotherapy, leucovorin is usually administered about 6 - 24 hours following methotrexate administration, in doses equal to the amount of methotrexate administered.
• The treatment for megaloblastic anemia due to folate deficiency involves a dose of the drug, not exceeding 1 mg administered, everyday, orally.

Special Instruction :
• Leucovorin reduces the effectiveness of anti-seizure drugs such as phenobarbital, phenytoin, and primidone.
• It may also lower the effectiveness of the antibiotics Trimethoprim (Bactrim) and Cotrimoxozole (Septra).

Side Effects :Leucovorin alone does not produce side-effects.In combination with other drugs it may cause
• Skin rash
• Itching;
• Wheezing
• Diorrhea
• Guiddiness
• Mouth sores
• Vomitting
• Convulsions.
• Mucositis,
• Stomatitis
• Leukopenia

Other Precautions :
• Leucovorin injection should not be injected into the spinal fluid (intrathecally).
• Caution should be exercised when leucovorin is administered to a nursing mother.

Storage Conditions :
• Keep out of the reach of children.
• Store in refrigerated conditions (2 to 8°C)
• Protect from direct light and heat
• Do not store near damp places.
• Heat / moisture may cause the medicine to break down.