Leucovorin Rx

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Leucovorin

Anemias
Colorectal and other GI cancers
Cytoprotective and supportive care agents
Only 4 drugs may be compared at once

Generic Name and Formulations:

Leucovorin calcium 100mg/vial, 350mg/vial; lyophilized pwd for IV or IM inj after reconstitution; preservative-free.

Select therapeutic use:

Indications for Leucovorin:

Megalobastic anemia due to folic acid deficiency when oral therapy is not feasible.

Adult:

Up to 1mg daily.

Children:

See literature.

Contraindications:

Pernicious anemia and other megaloblastic anemias due to Vit. B12 deficiency.

Warnings/Precautions:

Do not administer intrathecally. CNS metastases. Monitor CBCs with differential, platelets, electrolytes, liver function tests prior to each treatment, then periodically. Elderly. Debilitated. Pregnancy (Cat.C). Nursing mothers.

Interactions:

Potentiates toxicity of 5-fluorouracil; use lower 5-fluorouracil dose. May antagonize phenobarbital, phenytoin, and primidone. Caution with trimethoprim-sulfamethoxazole.

Pharmacological Class:

Folic acid derivative.

Adverse Reactions:

Leukopenia, thrombocytopenia, infection, GI upset, stomatitis, constipation, lethargy, malaise, fatigue, alopecia, dermatitis, anorexia; seizures, syncope.

How Supplied:

Single-use vials—1

Indications for Leucovorin:

Palliative treatment of advanced colorectal cancer in combination with 5-fluorouracil.

Adult:

Max IV infusion rate: 160mg/min. 200mg/m2 by slow IV inj over a minimum of 3 minutes, followed by 5-fluorouracil (370mg/m2); or 20mg/m2 IV followed by 5-fluorouracil (425mg/m2); both regimens: daily for 5 days, may be repeated at 4-week intervals for 2 courses and then repeated at 4–5 week intervals (if completely recovered from toxic effects of previous course).

Children:

See literature.

Contraindications:

Pernicious anemia and other megaloblastic anemias due to Vit. B12 deficiency.

Warnings/Precautions:

Do not administer intrathecally. CNS metastases. Monitor CBCs with differential, platelets, electrolytes, liver function tests prior to each treatment, then periodically. Elderly. Debilitated. Pregnancy (Cat.C). Nursing mothers.

Interactions:

Potentiates toxicity of 5-fluorouracil; use lower 5-fluorouracil dose. May antagonize phenobarbital, phenytoin, and primidone. Caution with trimethoprim-sulfamethoxazole.

Pharmacological Class:

Folic acid derivative.

Adverse Reactions:

Leukopenia, thrombocytopenia, infection, GI upset, stomatitis, constipation, lethargy, malaise, fatigue, alopecia, dermatitis, anorexia; seizures, syncope.

How Supplied:

Single-use vials—1

Indications for Leucovorin:

Rescue treatment after high-dose methotrexate therapy in osteosarcoma.

Adult:

Max IV infusion rate: 160mg/min. Based on methotrexate dose. Normal methotrexate elimination: 15mg IM or IV every 6 hours for 10 doses starting 24 hours after the beginning of the methotrexate infusion. Delayed late or delayed early methotrexate elimination, and/or evidence of acute renal injury, impaired methotrexate elimination or inadvertent overdosage: see literature.

Children:

See literature.

Contraindications:

Pernicious anemia and other megaloblastic anemias due to Vit. B12 deficiency.

Warnings/Precautions:

Do not administer intrathecally. Monitor serum methotrexate concentration. CNS metastases. Monitor CBCs with differential, platelets, electrolytes, liver function tests prior to each treatment, then periodically. Elderly. Debilitated. Pregnancy (Cat.C). Nursing mothers.

Interactions:

Potentiates toxicity of 5-fluorouracil; use lower 5-fluorouracil dose. May antagonize phenobarbital, phenytoin, and primidone. Caution with trimethoprim-sulfamethoxazole.

Pharmacological Class:

Folic acid derivative.

Adverse Reactions:

Leukopenia, thrombocytopenia, infection, GI upset, stomatitis, constipation, lethargy, malaise, fatigue, alopecia, dermatitis, anorexia; seizures, syncope.

How Supplied:

Single-use vials—1