Levoleucovorin

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
  • 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

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
  • 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


Special Populations

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

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

Comments

See Also

References