Levoleucovorin: Difference between revisions
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***Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination | ***Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination | ||
***Continue until methotrexate level <0.01 micromolar | ***Continue until methotrexate level <0.01 micromolar | ||
***Adjust dose/ | ***Adjust dose/frequency based on elimination and renal function | ||
*Levoleucovorin rescue, high dose methotrexate | *Levoleucovorin rescue, high dose methotrexate | ||
**7.5 mg IV q6h x10 doses | **7.5 mg IV q6h x10 doses | ||
| Line 21: | Line 21: | ||
***Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination | ***Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination | ||
***Continue until methotrexate level <0.01 micromolar | ***Continue until methotrexate level <0.01 micromolar | ||
***Adjust dose/ | ***Adjust dose/frequency based on elimination and renal function | ||
*6+ yo, high-dose methotrexate, levoleucovorin rescue | *6+ yo, high-dose methotrexate, levoleucovorin rescue | ||
**5 mg/m^2 IV q6h x10 doses | **5 mg/m^2 IV q6h x10 doses | ||
| Line 31: | Line 31: | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C; No human data available | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C; No human data available | ||
*[[Lactation risk categories|Lactation risk]]: L3; Safety unknown | *[[Lactation risk categories|Lactation risk]]: L3; Safety unknown | ||
*Renal dosing: not defined | |||
*Hepatic dosing: not defined | |||
* | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug/component | *Allergy to class/drug/component | ||
*Hypersensitivity to folic acid | *Hypersensitivity to folic acid or folinic acid | ||
*Intrathecal administration | *Intrathecal administration | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
* | *Severe diarrhea, severe stomatitis | ||
*Hypersensitivity reaction | |||
**[[Typhlitis]] | |||
===Common=== | ===Common=== | ||
*[[Nausea/vomiting]], [[diarrhea]], stomatitis, [[dyspepsia]], taste changes | |||
*[[Nausea]] | |||
*[[Dyspnea]] | *[[Dyspnea]] | ||
*[[Confusion]] | *[[Confusion]] | ||
*[[Neuropathy]] | *[[Neuropathy]] | ||
*Renal impairment | *Renal impairment | ||
*Dermatitis, [[pruritus]], rash, alopecia | |||
*Dermatitis | *[[Fever]], rigors | ||
*[[Fever]] | |||
==Pharmacology== | ==Pharmacology== | ||
| Line 82: | Line 67: | ||
==See Also== | ==See Also== | ||
*[[Methotrexate toxicity]] | *[[Methotrexate toxicity]] | ||
*[[Leucovorin]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Revision as of 02:00, 11 December 2016
Administration
- Type: Folinic Acid
- Dosage Forms: IV
- Routes of Administration: Intravenous
- Common Trade Names: Fusilev
Adult Dosing
- Methotrexate toxicity, levoleucovorin rescue
- 7.5 mg IV q6h
- Start: ASAP after overdose and w/in 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 w/in 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