Leucovorin
Administration
- Type: Antidote; Chemotherapy Modulating Agent; Rescue Agent (Chemotherapy)
- Dosage Forms: 5,10,15,25
- Routes of Administration: IV, IM
- Common Trade Names: Lederle Leucovorin
Adult Dosing
- Fluorouracil adjuvant treatment, adv. colorectal CA
- high dose: 200mg/m^2 IV QD x5 days
- low dose: 20mg/m^2 IV QD x5 days
- Leucovorin rescue, high-dose methotrexate
- normal methotrexate elimination: 15mg PO/IM/IV q6h x10 doses
- delayed late methotrexate elimination: 15mg PO/IM/IV q6h; Max: 25mg/dose PO, May give higher doses IM/IV
- Delayed early methotrexate elimination and/or acute renal injury: 150mg IV q3h until methotrexate level <1 micromolar, then 15mg IV q3h
- Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
- Folate antagonist overdose
- pemetrexed: 50mg/m^2 IV q6h x8 days; Start: 100mg/m^2 IV x1
- pyrimethamine, trimethoprim: 5-15mg PO/IM/IV QD until hematopoiesis restored
- Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
- Max: 1mg/day
Pediatric Dosing
- Leucovorin rescue, high-dose methotrexate
- normal methotrexate elimination: 10mg/m^2 PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25mg/dose PO
- delayed late methotrexate elimination: 10mg/m^2 PO/IM/IV q6h; Max: 25mg/dose PO
- delayed early methotrexate elimination and/or acute renal injury: 100mg/m^2 IV q3h until methotrexate level <1 micromolar, then 10mg/m^2 IV q3
- Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
- Folate antagonist overdose: 5-15mg PO/IM/IV QD until hematopoiesis restored
- Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
- Max: 1mg/day
Special Populations
- Pregnancy Risk Factor: C
- Breast Feeding: Leucovorin is a form of folic acid and is present in breast milk which may be beneficial to the newborn.
Renal Dosing
- Not defined
Hepatic Dosing
- Not defined
Contraindications
- Allergy to class/drug
- intrathecal administration
- caution if pernicious anemia
- caution if megaloblastic anemia, vitamin B12 deficient
- caution if vitamin B-12 deficiency
Adverse Reactions
Serious
- anaphylactoid reaction
- seizures
- syncope
Common
- urticaria
- nausea/vomiting (IV use)
Pharmacology
- Half-life: 6hr
- Metabolism: liver, GI, CYP450
- Excretion: Urine
Mechanism of Action
Comments
See Also
References
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