Leucovorin

Folinic Acid, the active ingredient in Leucovorin, is a reduced form of folic acid presented as a sterile solution for epidural, intrabursal and intracoronary use. It is employed to mitigate the toxic effects of antifolate chemotherapy and to support normal cellular function in specific clinical settings.

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

Leucovorin is used in clinical situations where folate metabolism is disrupted or where rescue from antifolate toxicity is required. - Methotrexate toxicity: reduces adverse effects and supports recovery of normal cells. - High‑dose methotrexate therapy: provides folate rescue to prevent severe bone‑marrow suppression. - 5‑Fluorouracil (5‑FU) toxicity: alleviates mucosal and hematologic side effects. - Folate deficiency: restores folate levels in patients unable to convert folic acid. - Certain congenital metabolic disorders: supplies active folate for enzymatic pathways.

Leucovorin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects: - Nausea or vomiting - Diarrhea - Mild rash or itching - Transient elevation of liver enzymes - Low-grade fever - Headache

Serious or Rare Side Effects: - Severe allergic reaction (anaphylaxis) - Acute renal impairment - Significant electrolyte disturbances - Unexplained bleeding or bruising - Persistent high fever with chills

Leucovorin should be used with careful clinical monitoring and adherence to prescribing information. - Renal function: assess before and during therapy in patients with kidney disease. - Hepatic function: monitor liver enzymes, especially in patients with pre‑existing liver disease. - Pregnancy: avoid unless clearly indicated; discuss risks with obstetric specialist. - Breastfeeding: consider potential excretion in milk; weigh benefits against risks. - Drug interactions: review concomitant medications for potential folate pathway effects. - Store below 25°C: keep in the original container, protect from moisture and direct sunlight.

Leucovorin can influence the activity of several drugs that affect folate metabolism or share similar pathways.

Major Interactions (Avoid): - Methotrexate: concurrent use without proper timing may diminish methotrexate efficacy. - Antifolate chemotherapy agents (e.g., pemetrexed): may reduce therapeutic effect if not appropriately scheduled.

Moderate Interactions (Monitor Closely): - Trimethoprim‑sulfamethoxazole: may increase risk of hematologic toxicity. - Phenytoin: potential alteration of folate levels, requiring monitoring. - Anticonvulsants (e.g., carbamazepine): may affect folate metabolism. - Vitamin B12 supplements: high doses can mask folate deficiency signs.