Quick Facts About: Folinic Acid

Calcium folinate, Leucovorin, Leucovorin Calcium, Wellcovorin, Citrovorum Factor

Yes, in 2002.

Colorectal cancer (palliative treatment); used in combination with fluorouracil

Folinic acid is administered intravenously.

Dosage is dependent on drug combination in the treatment regimen and is based on the patient’s body surface area (milligram per square meter, mg/m²).

Folinic acid is administered in a 200 mg/m² dosage through a slow IV injection over 3 minutes or more. Thereafter, 370 mg/m² of fluorouracil is administered. This treatment regimen is given for 5 consecutive days every 28 days for 2 courses.

This regimen may be repeated for subsequent treatments every 4-5 weeks depending on the patient’s recovery following the toxic effects of the prior treatment course.

In cases where the patient is experiencing high gastrointestinal toxicity levels, nausea or vomiting, folinic acid may then be administered parenterally (outside of the large intestine). Methotrexate (a chemotherapy agent and immune system suppressant) levels should also be monitored to determine the optimal folinic acid dosage and duration.

Special precautions are required for patients with:

• Undiagnosed megaloblastic anemia
• Folate dependent tumors
• Pregnancy

Patients may experience allergic reactions to folinic acid. In such cases, folinic acid administration must cease and patients should seek immediate medical attention.

Allergic reaction-related side effects include:

• Sudden difficulty breathing, chest tightening or pain
• Swelling of eyelids, face, tongue or lips
• Skin rash or “hives” on the body, itchiness
• Fever

In addition, patients may also experience:

• Nausea, vomiting or diarrhea
• Swollen and painful mouth or throat, presence of ulcers or sores
• A drop in white blood cell count

Folinic acid is a drug that is used in chemotherapy, but is not a chemotherapy drug.

Folinic acid is an active metabolite of folic acid and an essential coenzyme for nucleic acid synthesis. It works to reduce methotrexate toxicity, and enhances cytotoxic and anti-neoplastic effects of fluorouracil by inhibiting thymidylate synthase.