DBL Calcium Folinate

DBL Calcium Folinate

calcium folinate

Manufacturer:

Pfizer

Distributor:

DKSH
Concise Prescribing Info
Contents
Ca folinate
Indications/Uses
Diminish toxicity & counteract effects of folic acid antagonist inadvertent overdosage; as rescue after high-dose methotrexate therapy. Megaloblastic anaemia due to sprue, nutritional deficiency, pregnancy & infancy when oral therapy is not possible. In combination w/ fluorouracil to prolong survival of patients w/ advanced colorectal cancer.
Dosage/Direction for Use
Leucovorin Ca rescue in impaired methotrexate elimination or inadvertent overdosage 10 mg/m2 IV or IM every 6 hr until serum methotrexate level is <10-8 M. If 24 hr serum creatinine >50% or methotrexate level is >5 x 10-6 M or 48 hr level is >9 x 10-7 M, increase dose to 100 mg/m2 IV every 3 hr until the methotrexate level is <10-8 M. Leucovorin Ca rescue after high-dose methotrexate therapy 15 mg every 6 hr for 10 doses starts 24 hr after methotrexate infusion until methotrexate level is <5 x 10-8 M. Megaloblastic anaemia due to folic acid deficiency Up to 1 mg daily. Advanced colorectal cancer 200 mg/m2 by slow IV inj over min of 3 min, followed by 5-fluorouracil 370 mg/m2 by IV inj or 20 mg/m2 by IV inj followed by 5-fluorouracil 425 mg/m2 by IV inj for 5 days. May be repeated at 4-wk (28 days) intervals for 2 courses & then repeated at 4-5 wk (28-35 days) intervals provided that patient has completely recovered.
Contraindications
Pernicious anaemia & other megaloblastic anaemias secondary to lack of vit B12.
Special Precautions
Not to be administered intrathecally. Not to be initiated or maintained in patients w/ GI toxicity symptoms. Not recommended in patients w/ recurrent neurological symptoms on rechallenge w/ folinic acid. Hydrocarbamide, cytarabine, mercaptopurine, thioguanine macrocytosis should not be treated w/ folinic acid. Severe enterocolitis, diarrhoea & dehydration; CNS tumours. Pre-existing or methotrexate-induced renal insufficiency. Decreased membrane transport. Not to be mixed w/ fluorouracil in same IV inj or infusion. Avoid excessive folinic acid doses. Monitor Ca levels. Pregnancy & lactation. Elderly or debilitated patients.
Adverse Reactions
Insomnia, agitation, depression after high doses; increased epileptic attacks frequency; abdominal pain; stomatitis, nausea, vomiting, diarrhoea.
Drug Interactions
Counteracted antiepileptic effect of phenobarb, phenytoin, primidone, succinimides. Reduced efficacy of intrathecally administered methotrexate. Enhanced toxicity of fluorouracil. Reduced or completely neutralized efficacy of folic acid antagonist eg, cotrimoxazole, pyrimethamine. Incompatibility w/ methotrexate, fluorouracil droperidol, fosacarnet, phosphonosulphate inj.
MIMS Class
Antidotes & Detoxifying Agents
ATC Classification
V03AF03 - calcium folinate ; Belongs to the class of detoxifying agents used in antineoplastic treatment.
Presentation/Packing
Form
DBL Calcium Folinate inj 10 mg/mL
Packing/Price
30 mL x 1's
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