Isovorin

Calcium Levofolinate, the active ingredient in Isovorin, is a folinic acid (Leucovorin) analog presented as an injectable solution for intramuscular or intravenous use. It provides a reduced form of folic acid that bypasses dihydrofolate reductase inhibition, helping to restore DNA synthesis and reduce toxicity of antifolate agents in patients receiving chemotherapy.

GNH USA supplies Isovorin as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, oncology centres and pharmacies worldwide.

Isovorin is used in clinical settings where folate pathways are compromised or where antifolate toxicity needs mitigation.

- Rescue therapy after high‑dose methotrexate: reduces methotrexate‑induced toxicity and supports rapid recovery. - Reduction of methotrexate toxicity: lessens adverse effects during standard methotrexate regimens. - Folate deficiency: restores normal folate levels in patients with inadequate folate status. - Supportive care in cancer chemotherapy: enhances DNA synthesis and cell recovery during cytotoxic treatment.

Common Side Effects: - Nausea or vomiting: mild gastrointestinal discomfort that usually resolves without intervention. - Transient flushing or warmth: brief sensation of heat, often occurring shortly after infusion. - Mild rash or pruritus: limited skin irritation that does not require treatment. - Low-grade hypotension: slight drop in blood pressure that is typically self‑limiting.

Serious or Rare Side Effects: - Anaphylactic reaction: severe allergic response requiring immediate medical attention. - Acute renal impairment: sudden decline in kidney function, especially in patients with pre‑existing renal disease. - Severe hypotension or shock: marked circulatory collapse that may need emergency support. - Hemolytic anemia: rapid destruction of red blood cells, presenting with fatigue and jaundice.

Before initiating therapy, consider patient‑specific factors and monitor appropriately. - Renal impairment: adjust dose and monitor renal function closely. - Hepatic dysfunction: evaluate liver enzymes and use caution. - Known folate hypersensitivity: avoid use in patients with documented allergy to folate compounds. - Pregnancy and lactation: use only if potential benefit outweighs risk, as safety data are limited. - Concomitant nephrotoxic agents: increase monitoring for renal toxicity. - Store at ambient temperature: keep in original container, protect from moisture and light.

Potential drug interactions may influence efficacy or safety.

Major Interactions (Avoid): - Concurrent use of high‑dose folate antagonists (e.g., pemetrexed) may diminish rescue effect. - Co‑administration with nephrotoxic agents (e.g., cisplatin) can exacerbate renal toxicity. - Simultaneous use with other folate supplements may lead to excessive folate levels.

Moderate Interactions (Monitor Closely): - NSAIDs and aspirin: may affect renal clearance, requiring renal function monitoring. - Penicillins and sulfonamides: possible competition for renal tubular transport. - Antacids containing aluminum or magnesium: may reduce absorption if oral formulations are used.