EMEDZ.NET

Leucovorin (calcium folinate)

Leucovorin or calcium folinate is the reduced or activated form of folic acid that restores folate stores required for the synthesis of RNA and DNA. It is used in the treatment of the following conditions:

For the palliative treatment of advanced Colorectal cancer in combination with 5-fluorouracil.
As a rescue drug to reduce the toxicity of high-dose Methotrexate treatment in patients with osteosarcoma.
For the treatment of megaloblastic anemia due to folate deficiency when oral therapy is not feasible.
Off label Uses of Leucovorin in Adults include:
- As a cofactor therapy in methanol toxicity
- In the neoadjuvant treatment of Bladder cancer
- Advanced or metastatic oesophagal cancer
- Advanced or metastatic Gastric cancer
- Metastatic Pancreatic cancer
- For the prevention of pyrimethamine-induced hematologic toxicity
- For the treatment of ectopic tubal Pregnancy in combination with methotrexate.

Leucovorin or calcium folinate Dose in Adults

Note: Oral dose of more than 25 mg per day is not recommended

Dose in the treatment of advanced Colorectal cancer:

200 mg/m² /day intravenous over at least three minutes for 5 days every 4 weeks for 2 cycles, then every 4 - 5 weeks in combination with fluorouracil or
20 mg/m² /day for 5 days every 4 weeks for 2 cycles, then every 4 - 5 weeks in combination with fluorouracil.

Use in the treatment of Folic acid antagonist (eg, trimethoprim, pyrimethamine) overdose:

5 to 15 mg orally once a day

Use in the treatment of Folate-deficient megaloblastic anemia:

1 mg or less intravenous or intramuscular once a day.

Use in the treatment of High-dose methotrexate-rescue:

15 mg orally, intramuscular, or intravenous (10 mg/m² ) 24 hours after beginning methotrexate infusion.
Continue therapy every 6 hours for 10 doses until the methotrexate level is 0.05 micromoles/L or less.
The dose may be adjusted as follows:
- 15 mg orally, Intramuscular, or Intravenous every 6 hours for 60 hours (Total 10 doses) beginning 24 hours after the start of methotrexate infusion in patients with normal methotrexate elimination or
- Continue leucovorin calcium 15 mg orally, Intramuscular or Intravenous every 6 hours until the methotrexate level is 0.05 micromoles/L or less in patients with delayed late methotrexate elimination or
- 150 mg Intravenous every three hours until methotrexate level is less than 1 micromoles/L, then 15 mg every three hours until methotrexate level is less than 0.05 micromoles/L in patients with delayed early methotrexate elimination and/ or acute kidney injury.
Definitions of methotrexate elimination:
- Normal Methotrexate elimination:
  - Serum methotrexate level of 10 micromoles/L at 24 hours after administration, 1 micromole/L at 48 hours, and less than 0.2 micromoles/L at 72 hours.
- Delayed late methotrexate elimination:
  - Serum methotrexate levels of more than 0.2 micromoles/L at 72 hours and more than 0.05 micromoles/L at 96 hours after administration
- Delayed early methotrexate elimination and/ or acute kidney injury:
  - Serum methotrexate level of 50 micromoles/L or more at 24 hours, or 5 micromoles/L or more at 48 hours, or a doubling of serum creatinine level at 24 hours after methotrexate administration.

Use in the treatment of High-dose methotrexate overexposure:

At 24 hours:
- For methotrexate levels of 100 micromoles/L or more at 24 hours:
  - leucovorin is dosed at 1,000 mg/m² intravenous every 6 hours.
- For methotrexate levels of more than 10 to less than 100 micromoles/L at 24 hours:
  - leucovorin is dosed at 100 mg/m² intravenous every 3 to 6 hours.
- For methotrexate levels of 1 - 10 micromoles/L at 24 hours, leucovorin is initially dosed at 10 mg/m² intravenous or orally every 3 - 6 hours.
At 48 hours:
- For methotrexate levels of 100 micromoles/L or more at 48 hours:
  - leucovorin is dosed at 1,000 mg/m² intravenous every 6 hours
- For methotrexate levels of more than 10 to less than 100 micromoles/L at 48 hours:
  - leucovorin is dosed at 100 mg/m² intravenous every 3 hours
- For methotrexate levels of 1 - 10 micromoles/L at 48 hours:
  - leucovorin is dosed at 100 mg/m² intravenous every 6 hours or
  - 10 mg/m² intravenous or orally to 100 mg/m² intravenous every 3 hours.
At 72 hours:
- For methotrexate levels of more than 10 micromoles/L at 72 hours:
  - Leucovorin is dosed at 100 - 1,000 mg/m² intravenous every 3 - 6 hours
- For methotrexate levels of 0.1 - 1 micromolar at 72 hours:
  - Leucovorin is dosed at 10 mg/m² intravenous or orally every 3 - 6 hours
- If serum creatinine is increased more than half above the baseline:
  - Increase the standard leucovorin dose to 100 mg/m² intravenous every 3 hours.
Methotrexate levels should be followed daily. The dose may be discontinued when the methotrexate level is 0.1 micromoles/L or less.

Use in the inadvertent treatment of Methotrexate overdose:

10 mg/m² orally, Intramuscular, or Intravenous every 6 hours until the methotrexate level is less than 0.01 micromoles/L or less.
If 24 hours after methotrexate administration, the serum creatinine increases by more than half above the baseline or the methotrexate level is 5 micromoles/L or more, or the methotrexate level is more than 0.9 micromoles/L or more after 48 hours, the leucovorin dose should be increased to 100 mg/m² intravenous every 3 hours until the methotrexate level is less than 0.01 micromoles/L.

Off-label use in the treatment of neoadjuvant Bladder cancer:

15 mg orally or Intravenous every 6 hours for 4 doses on days 2 and 9, starting 24 hours after each methotrexate dose in combination with methotrexate, vinblastine, and cisplatin.

Off-label use in the treatment of Cofactor therapy in methanol toxicity:

1 mg/kg Intravenous to a maximum dose of 50 mg over 30 - 60 minutes every 4 - 6 hours until methanol and formic acid have been completely eliminated.

Off-label use in the treatment of advanced or metastatic Esophageal cancer:

400 mg/m² Intravenous over 2 hours once every 2 weeks in combination with fluorouracil and irinotecan [FOLFIRI]) until disease progression or unacceptable toxicity or
200 mg/m² over 2 hours once every 2 weeks in combination with fluorouracil and oxaliplatin until disease progression or unacceptable toxicity.

Off-label use in the treatment of advanced or metastatic Gastric cancer:

400 mg/m² Intravenous over 2 hours once every 2 weeks in combination with fluorouracil and irinotecan [FOLFIRI]) until disease progression or unacceptable toxicity or
200 mg/m² over 2 hours once every 2 weeks in combination with fluorouracil and oxaliplatin until disease progression or unacceptable toxicity.

Off label use in the treatment of metastatic Pancreatic cancer:

400 mg/m² Intravenous over 2 hours once every 2 weeks in combination with fluorouracil, oxaliplatin, and irinotecan [FOLFIRINOX]) for at least 6 months.

Off label use in the treatment of Pemetrexed toxicity (cytopenias or mucositis):

100 mg/m² Intravenous once, followed by 50 mg/m² every 6 hours for 8 days.

Off label use in the treatment of Prevention of pyrimethamine-induced hematologic toxicity in HIV-infected patients:

Isosporiasis (Isospora belli):
- Treatment:
  - 10 to 25 mg orally once a day in combination with pyrimethamine.
  - Chronic maintenance as secondary prophylaxis:
    - 5 - 10 mg once a day in combination with pyrimethamine.
For the primary and secondary prophylaxis of Pneumocystis pneumonia (PCP):
- 25 mg once a week in combination with pyrimethamine (and dapsone) or
- 10 mg once a day in combination with pyrimethamine (with atovaquone)
For the primary prophylaxis of Toxoplasma gondii encephalitis:
- 25 mg once a week in combination with pyrimethamine (with dapsone) or
- 10 mg once a day in combination with pyrimethamine (with atovaquone)
For Treatment:
- 10 - 25 mg once a day in combination with pyrimethamine (with either sulfadiazine, clindamycin, atovaquone, or azithromycin).
Chronic maintenance (secondary prophylaxis):
- 10 - 25 mg once a day in combination with pyrimethamine (with either sulfadiazine or clindamycin) or
- 10 mg once a day in combination with pyrimethamine (with atovaquone).

Off label use in the treatment of Tubal ectopic pregnancy in combination with a multidose methotrexate regimen:

Methotrexate on days 1, 3, 5, and 7 alternating with leucovorin calcium 0.1 mg/kg Intramuscular on days 2, 4, 6, and 8.
Measure serum hCG on the day of methotrexate administration.
- If the serum hCG decreases by 15% or more from the previous measurement, treatment may be discontinued.
- If serum hCG decreases by less than 15% from the previous measurement, administer methotrexate (maximum 4 doses) and then leucovorin calcium the next day.

Leucovorin or calcium folinate Dose in Children

Use in the treatment of Folic acid antagonist (eg, pyrimethamine, trimethoprim) overdose:

Infants, Children, and Adolescents:
- 5 to 15 mg orally once a day

Use in the treatment of Folinic-acid-dependent seizures:

Infants and Children:
- 2.5 - 5 mg orally two times a day up to 8 mg/kg/day (25 mg three times a day have been reported.

Use in the treatment of Megaloblastic anemia secondary to folate deficiency:

Infants, Children, and Adolescents:
- 1 mg/day or less Intravenous or Intramuscular.

Use in the treatment of High-dose methotrexate rescue:

Infants, Children, and Adolescents:
- 15 mg ( or10 mg/m²) orally, Intramuscular, or Intravenous every 6 hours 24 hours after the beginning of methotrexate infusion
- Leucovorin should be continued along with hydration and alkalinization until the methotrexate level is 0.05 micromoles/L or less.
- Adjust the dose as follows:
  - 15 mg orally, intramuscular, or intravenous every 6 hours for 10 doses beginning 24 hours after the start of methotrexate infusion in patients with normal methotrexate elimination.
  - Continue leucovorin calcium 15 mg Orally, Intramuscular, Intravenous every 6 hours until the methotrexate level is 0.05 micromoles/L or less in patients with delayed late methotrexate elimination.
  - 150 mg Intravenous every 3 hours until methotrexate level is less than 1 micromoles/L, then 15 mg every 3 hours until methotrexate level is less than 0.05 micromoles/L in patients with delayed early methotrexate elimination and/or acute kidney injury.
Definitions of methotrexate elimination:
- Normal Methotrexate elimination:
  - Serum methotrexate level of 10 micromoles/L at 24 hours after administration, 1 micromole/L at 48 hours, and less than 0.2 micromoles/L at 72 hours.
- Delayed late methotrexate elimination:
  - Serum methotrexate levels of more than 0.2 micromoles/L at 72 hours and more than 0.05 micromoles/L at 96 hours after administration
- Delayed early methotrexate elimination and/ or acute kidney injury:
  - Serum methotrexate level of 50 micromoles/L or more at 24 hours, or 5 micromoles/L or more at 48 hours, or a doubling of serum creatinine level at 24 hours after methotrexate administration.

Use in the treatment of High-dose methotrexate overexposure:

Infants, Children, and Adolescents:
- At 24 hours:
  - For methotrexate levels of 100 micromoles/L or more at 24 hours:
    - leucovorin is dosed at 1,000 mg/m² intravenous every 6 hours.
  - For methotrexate levels of more than 10 to less than 100 micromoles/L at 24 hours:
    - leucovorin is dosed at 100 mg/m² intravenous every 3 to 6 hours.
  - For methotrexate levels of 1 - 10 micromoles/L at 24 hours, leucovorin is initially dosed at 10 mg/m² intravenous or orally every 3 - 6 hours.
- At 48 hours:
  - For methotrexate levels of 100 micromoles/L or more at 48 hours:
    - leucovorin is dosed at 1,000 mg/m² intravenous every 6 hours
  - For methotrexate levels of more than 10 to less than 100 micromoles/L at 48 hours:
    - leucovorin is dosed at 100 mg/m² intravenous every 3 hours
  - For methotrexate levels of 1 - 10 micromoles/L at 48 hours:
    - leucovorin is dosed at 100 mg/m² intravenous every 6 hours or
    - 10 mg/m² intravenous or orally to 100 mg/m² intravenous every 3 hours.
- At 72 hours:
  - For methotrexate levels of more than 10 micromoles/L at 72 hours:
    - Leucovorin is dosed at 100 - 1,000 mg/m² intravenous every 3 - 6 hours
  - For Methotrexate levels of 1 - 10 micromoles/L at 72 hours:
    - Leucovorin is dosed at 10 mg//m² intravenous or 100 mg/m² orally every 3 hours.
  - For methotrexate levels of 0.1 - 1 micromolar at 72 hours:
    - Leucovorin is dosed at 10 mg/m² intravenous or orally every 3 - 6 hours
  - If serum creatinine is increased more than half above the baseline:
    - Increase the standard leucovorin dose to 100 mg/m² intravenous every 3 hours.
- Methotrexate levels should be followed daily. The dose may be discontinued when the methotrexate level is 0.1 micromoles/L or less.

Use in the treatment of inadvertent Methotrexate overdose:

Infants, Children, and Adolescents:
- 10 mg/m² /dose orally, Intramuscular, or Intravenous every 6 hours until the methotrexate level is less than 0.01 micromole/L.
- If after 24 hours of methotrexate administration, the serum creatinine is increased to more than half above baseline, the methotrexate level is more than 5 micromole/L after 24 hours or more than 0.9 micromole/L after 48 hours, increase the leucovorin dose to 100 mg/m²Intravenous every 3 hours until the methotrexate level is less than 0.01 micromole/L.

Use in the treatment of Megaloblastic anemia secondary to congenital deficiency of dihydrofolate reductase:

Infants, Children, and Adolescents:
- 3 - 6 mg/day orally or Intramuscular

Use in the prevention of hematologic toxicity due to Pyrimethamine:

Treatment of Toxoplasmosis (Toxoplasma gondii):
- Infants with Congenital toxoplasmosis:
  - HIV-exposed or HIV-positive patients:
    - 10 mg Intramuscular or orally with every pyrimethamine dose for 12 months.
  - HIV-negative and non-exposed patients:
  - 10 mg orally or intramuscularly three times a week for 12 months.
- Acquired infection in infants, children, and adolescents:
  - - HIV-exposed or HIV-positive patients:
      - Acute induction: 10 - 25 orally mg once a day for 6 weeks or more
    - HIV-negative and non-exposed patients:
      - Chorioretinitis: 10 - 20 orally mg three times a week.
- Prophylaxis of Toxoplasmosis:
  - Primary prophylaxis in infants and children:
    - HIV-exposed or HIV-positive: 5 mg orally once every 3 days.
  - Primary prophylaxis in Adolescents:
    - 25 mg orally once a week with pyrimethamine and dapsone or 10 mg once a day with pyrimethamine and atovaquone.
  - Hematopoietic stem cell transplantation recipients In Children:
    - 5 mg orally every 3 days after engraftment and administer as long as the patient remains on immunosuppressive therapy.
    - Hematopoietic stem cell transplantation recipients In Adolescents:
      - 10 - 25 mg orally once a day after engraftment and administer as long as the patient remains on immunosuppressive therapy.
  - Secondary prophylaxis in HIV-exposed or HIV-positive patients in Infants and Children:
    - 5 mg orally once every 3 days
  - Secondary prophylaxis in HIV-exposed or HIV-positive patients in Adolescents:
    - 10 - 25 mg orally once a day or 10 mg once a day.
- For the primary and secondary prophylaxis of Pneumocystis jirovecii pneumonia(PCP) in adolescents:
  - 25 mg orally once a week or 10 mg once a day.
- For the treatment of acute Isosporiasis (Isospora belli) in infants, children, and adolescents:
  - 10 - 25 mg orally once a day.
- For the secondary prophylaxis of Isospora belli infection in infants and children:
  - 10 - 25 mg orally once a day
- For the secondary prophylaxis of Isospora belli infection in Adolescents:
  - 5 - 10 mg orally once a day.

Use as a cofactor in the treatment of Methanol toxicity:

Infants, Children, and Adolescents:
- 1 mg/kg Intravenous to a maximum dose of 50 mg over 30 - 60 minutes every 4 - 6 hours.
- Continue treatment until methanol and formic acid have been completely eliminated.

Pregnancy Risk Factor C

Folic acid should be taken during the first trimester of pregnancy.
However, pregnant women are not advised to take leucovorin (the active form) of folic acids.

Leucovorin use during breastfeeding:

During breastfeeding, it is important to take adequate Folic Acid.
Lucovorin should be used with caution.

Leucovorin or calcium folinate Dose in Renal Disease:

The manufacturer has not recommended any dose adjustment in patients with kidney disease.

Leucovorin or calcium folinate Dose in Liver Disease:

The manufacturer has not recommended any dose adjustment in patients with liver disease.

Side effects of Leucovorin (Frequency of the side effects has not been defined):

Dermatologic:
- Erythema
- Pruritus
- Skin rash
- Urticaria
Hematologic & oncologic:
- Thrombocythemia
Hypersensitivity:
- Anaphylactoid reaction
- Hypersensitivity reaction
Respiratory:
- Wheezing

Contraindication to Leucovorin include:

Megaloblastic anemias or Pernicious anemia secondary to vitamin B 12 deficiency.
Allergy to leucovorin and any component of the formulation
Administration intrathecal

Warnings and Precautions

Hypersensitivity
- Hypersensitivity reactions can occur, ranging from anaphylactic and severe allergic reactions to urticaria.
Seizures:
- Patients receiving leucovorin have reported syncope and seizures.
- However, the majority of patients had CNS metastasis or other predisposing factors, so a causal relationship between the two has not been established.
Anemias:
- Leucovorin can worsen neurological symptoms associated with megaloblastic or pernicious anemia.
Renal impairment
- As the waste is excreted through the kidneys, patients may develop renal impairment.

Leucovorin: Drug Interaction

Risk Factor C (Monitor therapy)
Capecitabine	Leucovorin Calcium-Levoleucovorin may enhance the adverse/toxic effect of Capecitabine.
Floxuridine	Leucovorin Calcium-Levoleucovorin may enhance the adverse/toxic effect of Floxuridine.
Fluorouracil (Systemic)	Leucovorin Calcium-Levoleucovorin may enhance the adverse/toxic effect of Fluorouracil (Systemic). This effect is associated with the ability of leucovorin or levoleucovorin to enhance the anticancer effects of ﬂuorouracil.
Fluorouracil (Topical)	Leucovorin Calcium-Levoleucovorin may enhance the adverse/toxic effect of Fluorouracil (Topical).
Fosphenytoin	Leucovorin Calcium-Levoleucovorin may decrease the serum concentration of Fosphenytoin.
PHENobarbital	Leucovorin Calcium-Levoleucovorin may decrease the serum concentration of PHENobarbital.
Phenytoin	Leucovorin Calcium-Levoleucovorin may decrease the serum concentration of Phenytoin.
Primidone	Leucovorin Calcium-Levoleucovorin may decrease the serum concentration of Primidone. Additionally, leucovorin/levoleucovorin may decrease concentrations of active metabolites of primidone (e.g., phenobarbital).
Tegafur	Leucovorin Calcium-Levoleucovorin may enhance the adverse/toxic effect of Tegafur. This effect is associated with the ability of leucovorin or levoleucovorin to enhance the anticancer effects of ﬂuorouracil.
Risk Factor D (Consider therapy modification)
Glucarpidase	May decrease serum concentrations of the active metabolite(s) of Leucovorin Calcium-Levoleucovorin. Speciﬁcally, 6S-5-methyltetrahydrofolate concentrations may be reduced. Glucarpidase may decrease the serum concentration of Leucovorin CalciumLevoleucovorin. Management: Avoid leucovorin administration within 2 hours of glucarpidase dosing. Continue to administer the pre-glucarpidase leucovorin dose for at least the ﬁrst 48 hours after glucarpidase administration, and dose based on methotrexate concentration thereafter.
Risk Factor X (Avoid combination)
Raltitrexed	Leucovorin Calcium-Levoleucovorin may diminish the therapeutic effect of Raltitrexed.
Trimethoprim	Leucovorin Calcium-Levoleucovorin may diminish the therapeutic effect of Trimethoprim. Management: Avoid concurrent use of leucovorin or levoleucovorin with trimethoprim (plus sulfamethoxazole) for Pneumocystis jirovecii pneumonia. If trimethoprim is used for another indication, monitor closely for reduced eﬃcacy.

Monitoring Parameters:

Monitoring in patients on high-dose methotrexate therapy:

Monitor plasma methotrexate concentration. Leucovorin is continued until the plasma methotrexate level is less than 0.05 micromoles/L.

Monitoring in patients on Fluorouracil therapy:

Monitor CBC with differential and platelet counts
Liver function tests
Serum electrolytes.

Monitoring when methotrexate is used for tubal ectopic pregnancy:

Measure serum HCG on the days of methotrexate administration. When HCG levels decrease by more than 15%, continue monitoring weekly until non-pregnant levels are reached. If the HCG does not decrease after 4 doses, consider surgical management.
CBC with differential counts.
Liver function tests
Serum creatinine
Blood type and Rh.

How to administer Leucovorin?

Since leucovorin (or calcium folinate) contains calcium, the intravenous formulation should not be administered at a rate exceeding more than 160 mg/minute.
It can be administered orally, as an Intramuscular injection, Intravenous push, or Intravenous infusion over 15 minutes to 2 hours.

Leucovorin use in patients on Methotrexate:

Leucovorin should not be administered concurrently with methotrexate. To reduce the risk of toxicity associated with methotrexate without compromising the efficacy of methotrexate, leucovorin is commonly initiated one day after the start of methotrexate.
In case toxicity develops, it may be irreversible if leucovorin is not initiated within 40 hours after the start of methotrexate.

As a rescue after folate antagonists:

Administer Intravenously or as intramuscularly or orally. If the patient has nausea and vomiting, oral administration should be avoided. Oral administration
Do not administer orally in the presence of nausea or vomiting. Oral leucovorin at doses greater than 25 mg is not recommended.

Combination therapy with fluorouracil:

Fluorouracil is usually given after or at the midpoint of leucovorin infusion. It may be administered as an intravenous bolus injection or as an intravenous infusion over 10 - 120 minutes.

For the treatment of methanol toxicity:

Infuse leucovorin over 30 - 60 minutes.

Mechanism of action of Leucovorin:

Leucovorin calcium can be described as the activated or reduced form folic acid.
It displaces methotrexate intracellular binding sites and restores active folate stocks required for DNA and synthesis by competing against methotrexate.

It increases fluorouracil's activity stabilizes and stabilises the binding of 5-dUMP & thymidylate synthetase. Leucovorin lowers the riskHematologic toxicities of pyrimethamine(for the treatment of opportunistic infection). It is also useful in eliminating toxic metabolites of methanol, such as formic acid, from the body.Patients with methanol toxicities. Leucovorin provides a source of tetrahydrofolate, enhancing the action of 10-formyltetrahydrofolate dehydrogenase that converts methanol to carbon dioxide and water. [select-faq faq_id='7317'] It is well absorbed when administered orally or as an intramuscular injection. It is metabolized by the liver and the intestinal mucosa to the active form - 5-methyltetrahydrofolate (5MTHF). Bioavailability depends on the strength of oral tablets. Bioavailability is 97% at doses of 25 mg, 75% at doses of 50 mg, and 37% at doses of 100 mg. It has a Half-life elimination of about 4 - 8 hours The time to peak serum concentration is about 2 hours after oral ingestion, 10 minutes after intravenous administration, and 52 minutes after intramuscular administration.It is primarily excreted in the feces.

Leucovorin (Calcium Folinate) International brand names:

Acido Folinico/ Leucovorina
Antrex
Asovorin
Cafona
Cafonate
Calcium folinate Faulding
Calciumfolinat Pharmalink
Calcium folinate
Calciumfolinat-Ebewe
Calfonat
Chemovorin
Dalisol
Ferbon
Folcasin
Folical
Folina 15
Folinato de Calcio Dakota
Farma
Kalcij-folinat
Kunyrin
Lederfolin
Lederfoline
Ledervorin
Calcium
Leucan
Leucocalcin
Leuconolver
Leucovorin
Leucovorin Ca
Leucovorin Calcium
Leucovorine Abic
Lifacor
Likelin
Lovorin
Medifolin
MPL Coverin
Novorin
Nyrin
Refolinon
Rescuvolin
Robin
Rontafur
Tecnovorin

Leucovorin (calcium folinate injection) brand name in Pakistan:

Leucovorin (Calcium Folinate) [Inj 15 Mg]
Leucocin	Pharmedic (Pvt) Ltd.

Leucovorin (Calcium Folinate) [Inj 30 Mg]
Calcium Folinate	Bio Pharma

Leucovorin (Calcium Folinate) [Inj 50 Mg]
Calcium Folinate	Atco Laboratories Limited
Leucocin	Pharmedic (Pvt) Ltd.
Leucofolate	Consolidated Chemical Laboratories (Pvt) Ltd.

Leucovorin (calcium folinate)

Pregnancy Risk Factor C

Side effects of Leucovorin (Frequency of the side effects has not been defined):

Contraindication to Leucovorin include:

Risk Factor C (Monitor therapy)

Risk Factor D (Consider therapy modification)

Risk Factor X (Avoid combination)

How to administer Leucovorin?

Mechanism of action of Leucovorin:

Leucovorin (Calcium Folinate) International brand names:

Leucovorin (calcium folinate injection) brand name in Pakistan:

Recent Posts

Related Posts