Levoleucovorin: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: Folinic Acid | *Type: Folinic Acid | ||
*Dosage Forms: | *Dosage Forms: Solution 50mg, 175mg, 300mg | ||
*Routes of Administration: Intravenous | *Routes of Administration: Intravenous | ||
*Common Trade Names: Fusilev | *Common Trade Names: Fusilev, Khapzory | ||
==Adult Dosing== | ==Adult Dosing== | ||
*[[Methotrexate toxicity]], levoleucovorin rescue | *[[Methotrexate toxicity]], levoleucovorin rescue | ||
**7.5 mg IV q6h | **7.5 mg IV q6h | ||
***Start: ASAP after overdose and | ***Start: ASAP after overdose and within 24 hr if delayed methotrexate elimination | ||
***Continue until methotrexate level <0.01 micromolar | ***Continue until methotrexate level <0.01 micromolar | ||
***Adjust dose/frequency based on elimination and renal function | ***Adjust dose/frequency based on elimination and renal function | ||
| Line 19: | Line 19: | ||
*6+ yo, [[Methotrexate toxicity]], levoleucovorin rescue | *6+ yo, [[Methotrexate toxicity]], levoleucovorin rescue | ||
**5 mg/m^2 IV q6h | **5 mg/m^2 IV q6h | ||
***Start: ASAP after overdose and | ***Start: ASAP after overdose and within 24 hr if delayed methotrexate elimination | ||
***Continue until methotrexate level <0.01 micromolar | ***Continue until methotrexate level <0.01 micromolar | ||
***Adjust dose/frequency based on elimination and renal function | ***Adjust dose/frequency based on elimination and renal function | ||
Latest revision as of 21:23, 26 January 2019
Administration
- Type: Folinic Acid
- Dosage Forms: Solution 50mg, 175mg, 300mg
- Routes of Administration: Intravenous
- Common Trade Names: Fusilev, Khapzory
Adult Dosing
- Methotrexate toxicity, levoleucovorin rescue
- 7.5 mg IV q6h
- Start: ASAP after overdose and within 24 hr if delayed methotrexate elimination
- Continue until methotrexate level <0.01 micromolar
- Adjust dose/frequency based on elimination and renal function
- 7.5 mg IV q6h
- Levoleucovorin rescue, high dose methotrexate
- 7.5 mg IV q6h x10 doses
- Start: 24 hr after methotrexate start
- Adjust dose/frequency based on elimination and renal function
- 7.5 mg IV q6h x10 doses
Pediatric Dosing
- 6+ yo, Methotrexate toxicity, levoleucovorin rescue
- 5 mg/m^2 IV q6h
- Start: ASAP after overdose and within 24 hr if delayed methotrexate elimination
- Continue until methotrexate level <0.01 micromolar
- Adjust dose/frequency based on elimination and renal function
- 5 mg/m^2 IV q6h
- 6+ yo, high-dose methotrexate, levoleucovorin rescue
- 5 mg/m^2 IV q6h x10 doses
- Start: 24 hr after methotrexate start
- Adjust dose/frequency based on elimination and renal function
- 5 mg/m^2 IV q6h x10 doses
Special Populations
- Pregnancy Rating: C; No human data available
- Lactation risk: L3; Safety unknown
- Renal dosing: not defined
- Hepatic dosing: not defined
Contraindications
- Allergy to class/drug/component
- Hypersensitivity to folic acid or folinic acid
- Intrathecal administration
Adverse Reactions
Serious
- Severe diarrhea, severe stomatitis
- Hypersensitivity reaction
Common
- Nausea/vomiting, diarrhea, stomatitis, dyspepsia, taste changes
- Dyspnea
- Confusion
- Neuropathy
- Renal impairment
- Dermatitis, pruritus, rash, alopecia
- Fever, rigors
Pharmacology
- Half-life: 6.8 hr
- Metabolism: Liver, GI tract; CYP450: Unknown
- Excretion: Urine
Mechanism of Action
- Participates in reactions utilizing folates
- Counteracting folate antagonists
- Enhances the effects of fluoropyrimidines