We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Levoleucovorin
From WikEM
Contents
Administration
- Type: Folinic Acid
- Dosage Forms: IV
- Routes of Administration: Intravenous
- Common Trade Names: Fusilev
Adult Dosing
- Methotrexate toxicity, levoleucovorin rescue
- 7.5 mg IV q6h
- Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination
- Continue until methotrexate level <0.01 micromolar
- Adjust dose/frequency based on elimination and renal function
- 7.5 mg IV q6h
- Levoleucovorin rescue, high dose methotrexate
- 7.5 mg IV q6h x10 doses
- Start: 24 hr after methotrexate start
- Adjust dose/frequency based on elimination and renal function
- 7.5 mg IV q6h x10 doses
Pediatric Dosing
- 6+ yo, Methotrexate toxicity, levoleucovorin rescue
- 5 mg/m^2 IV q6h
- Start: ASAP after overdose and w/in 24 hr if delayed methotrexate elimination
- Continue until methotrexate level <0.01 micromolar
- Adjust dose/frequency based on elimination and renal function
- 5 mg/m^2 IV q6h
- 6+ yo, high-dose methotrexate, levoleucovorin rescue
- 5 mg/m^2 IV q6h x10 doses
- Start: 24 hr after methotrexate start
- Adjust dose/frequency based on elimination and renal function
- 5 mg/m^2 IV q6h x10 doses
Special Populations
- Pregnancy Rating: C; No human data available
- Lactation risk: L3; Safety unknown
- Renal dosing: not defined
- Hepatic dosing: not defined
Contraindications
- Allergy to class/drug/component
- Hypersensitivity to folic acid or folinic acid
- Intrathecal administration
Adverse Reactions
Serious
- Severe diarrhea, severe stomatitis
- Hypersensitivity reaction
Common
- Nausea/vomiting, diarrhea, stomatitis, dyspepsia, taste changes
- Dyspnea
- Confusion
- Neuropathy
- Renal impairment
- Dermatitis, pruritus, rash, alopecia
- Fever, rigors
Pharmacology
- Half-life: 6.8 hr
- Metabolism: Liver, GI tract; CYP450: Unknown
- Excretion: Urine
Mechanism of Action
- Participates in reactions utilizing folates
- Counteracting folate antagonists
- Enhances the effects of fluoropyrimidines
