Leucovorin: Difference between revisions
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric))
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==Adult Dosing==
==Adult Dosing==
*Fluorouracil adjuvant treatment, adv. colorectal CA
===Indications by Disease===
**high dose: 200mg/m^2 IV QD x5 days
{{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Adult]]
**low dose: 20mg/m^2 IV QD x5 days
|?Treats disease=Disease
 
|?Has Dose=Dose
*Leucovorin rescue, high-dose [[methotrexate]]
|?Has Context=Context
**normal methotrexate elimination: 15mg PO/IM/IV q6h x10 doses
|format=table
**delayed late methotrexate elimination: 15mg PO/IM/IV q6h; Max: 25mg/dose PO, May give higher doses IM/IV
|limit=50
 
|mainlabel=-
*Delayed early methotrexate elimination and/or acute renal injury: 150mg IV q3h until methotrexate level <1 micromolar, then 15mg IV q3h
|headers=show
 
|sort=Treats disease
*Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
}}
 
*Folate antagonist overdose
**pemetrexed: 50mg/m^2 IV q6h x8 days; Start: 100mg/m^2 IV x1
**pyrimethamine, trimethoprim: 5-15mg PO/IM/IV QD until hematopoiesis restored
 
*Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
**Max: 1mg/day


==Pediatric Dosing==
==Pediatric Dosing==
*Leucovorin rescue, high-dose methotrexate
===Indications by Disease===
**normal methotrexate elimination: 10mg/m^2 PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25mg/dose PO
{{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Pediatric]]
**delayed late methotrexate elimination: 10mg/m^2 PO/IM/IV q6h; Max: 25mg/dose PO
|?Treats disease=Disease
**delayed early methotrexate elimination and/or acute renal injury: 100mg/m^2 IV q3h until methotrexate level <1 micromolar, then 10mg/m^2 IV q3
|?Has Dose=Dose
 
|?Has Context=Context
*Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
|format=table
 
|limit=50
*Folate antagonist overdose: 5-15mg PO/IM/IV QD until hematopoiesis restored
|mainlabel=-
 
|headers=show
*Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
|sort=Treats disease
**Max: 1mg/day
}}


==Special Populations==
==Special Populations==

Revision as of 01:53, 20 March 2026

Administration

  • Type: Antidote; Chemotherapy Modulating Agent; Rescue Agent (Chemotherapy)
  • Dosage Forms: 5,10,15,25
  • Routes of Administration: IV, IM
  • Common Trade Names: Lederle Leucovorin

Adult Dosing

Indications by Disease

DiseaseDoseContext
Toxoplasmosis10mg PO q24hrsImmunocompetent adjunct
Toxoplasmosis25mg PO q24hrsImmunosuppressed adjunct

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Toxoplasmosis10mg PO 3x/weekCongenital/Pediatric adjunct

Special Populations

  • Pregnancy Risk Factor: C
  • Breast Feeding: Leucovorin is a form of folic acid and is present in breast milk which may be beneficial to the newborn.

Renal Dosing

  • Not defined

Hepatic Dosing

  • Not defined

Contraindications

  • Allergy to class/drug
  • intrathecal administration
  • caution if pernicious anemia
  • caution if megaloblastic anemia, vitamin B12 deficient
  • caution if vitamin B-12 deficiency

Adverse Reactions

Serious

  • anaphylactoid reaction
  • seizures
  • syncope

Common

  • urticaria
  • nausea/vomiting (IV use)

Pharmacology

  • Half-life: 6hr
  • Metabolism: liver, GI, CYP450
  • Excretion: Urine

Mechanism of Action

Comments

See Also

References

<Epocrates, UpToDate>

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