calcium folinate




Concise Prescribing Info
Ca folinate
Advanced colorectal cancer in combination w/ fluorouracil (5-FU). High-dose methotrexate therapy. Overdosage of folic acid antagonists. Megaloblastic anemias due to folate deficiency & pregnancy & infancy.
Dosage/Direction for Use
Advanced colorectal cancer Bimonthly regimen: Folinic acid 200 mg/m2 IV infusion over 2 hr, followed by 5-FU 400 mg/m2 IV bolus & 22-hr infusion of 5-FU 600 mg/m2 for 2 consecutive days every 2 weeks on days 1 & 2. Wkly regimen: Folinic acid 20 mg/m2 IV bolus injection or 200-500 mg/m2 as IV infusion over 2 hr + IV bolus inj of 5-FU 500 mg/m2 in the middle or end of folinic acid infusion. Monthly regimen: Folinic acid 20 mg/m2 IV bolus injection or 200-500 mg/m2 as IV infusion over 2 hr immediately followed by IV bolus injection of 425 or 370 mg/m2 5-FU during 5 consecutive days. Folinic acid rescue after chemotherapy w/ methotrexate >500 mg/m2 Start rescue therapy w/in 24 hr of methotrexate administration. Dosage schedule: 10 mg/m2 parenterally followed by 10 mg/m2 orally (if there is adequate GI function) every 6 hr until serum methotrexate conc has declined to <10-8 M. Antidote to methotrexate toxicity 75 mg IV infusion w/in 12 hr followed by 12 mg IM every 6 hr for 4 doses. When average methotrexate doses appear to have an adverse effect: 6-12 mg IM every 6 hr for 4 doses. Antidote to trimetrexate toxicity 20 mg/m2 every 6 hr. Total daily dose: 80 mg/m2. Folinic acid should be given daily during trimetrexate treatment either orally or IV over 5-10 min & should be continued for at least 72 hr after the last trimetrexate dose. Recommended course: 21 days trimetrexate therapy & 24 days folinic acid. Overdosage w/ trimetrexate >90 mg/m2 w/o folinic acid administration 40 mg/m2 IV every 6 hr for 3 days. Antidote to pyrimethamine toxicity 3-9 mg/day IM for 3 days. Antidote to trimethoprim toxicity 3-10 mg/day. Megaloblastic anemia due to folate deficient 1 mg IM daily.
Hypersensitivity. Not to be used for treatment of undiagnosed anemia, pernicious anemia, vit B12 deficiency or other megaloblastic anemias secondary to vit B12 deficiency.
Special Precautions
Aciduria (urine pH <7), ascites, dehydration, GI obstruction, pleural or peritoneal effusions, renal function impairment. Do not mix w/ 5-FU in the same IV inj or infusion. May increase frequency in seizures in childn. Pregnancy & lactation. Elderly.
Adverse Reactions
Hypersensitivity reactions eg, anaphylactoid reactions, urticaria. Thrombocytosis.
Drug Interactions
Reduced effects of folinic acid antagonists. 5-FU. Increased frequency of seizures w/ phenobarb, phenytoin, primidone & succinimides. Direct or indirect DNA synthesis inhibitors (eg, hydroxycarbamine, cytarabine, mercaptopurine, thioguanine) may lead to macrocytosis.
ATC Classification
V03AF03 - calcium folinate ; Belongs to the class of detoxifying agents used in antineoplastic treatment.
Lovorin soln for inj 50 mg/5 mL
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