DBL Calcium Folinate

DBL Calcium Folinate

calcium folinate




Concise Prescribing Info
Ca folinate
Diminish toxicity & counteract effects of folic acid antagonist inadvertent overdosage; as rescue after high-dose MTX 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 CRC.
Dosage/Direction for Use
Leucovorin Ca rescue in impaired MTX elimination or inadvertent overdosage 10 mg/m2 IV or IM every 6 hr until serum MTX level is <10-8 M. If 24 hr serum creatinine >50% or MTX 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 MTX level is <10-8 M. Leucovorin Ca rescue after high-dose MTX therapy 15 mg every 6 hr for 10 doses starting 24 hr after MTX infusion until MTX level is <5 x 10-8 M. Megaloblastic anaemia due to folic acid deficiency Up to 1 mg daily. Advanced CRC 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.
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. Not to use folinic acid in in hydrocarbamide, cytarabine, mercaptopurine, thioguanine macrocytosis. Not suitable for pernicious anaemias & other anaemias resulting from lack of vit B12. Severe enterocolitis, diarrhoea & dehydration; CNS metastases. Decreased membrane transport. Monitor Ca levels. Not to be mixed w/ fluorouracil in same IV inj or infusion. Avoid excessive folinic acid doses. Pre-existing or MTX-induced renal insufficiency. Not to be used during 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 MTX. Enhanced toxicity of fluorouracil. Reduced or completely neutralized efficacy of folic acid antagonist co-trimoxazole, pyrimethamine. Incompatibility w/ MTX, 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.
DBL Calcium Folinate inj 10 mg/mL
30 mL x 1's
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