Formulary
Folinic acid: Indications, Dosing, Side Effects and Interactions
Folinic acid clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Folinic acid: Indications, Dosing, Side Effects and Interactions
Folinic acid clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Prevention of methotrexate-induced adverse effects**
- **Adult** (By Intramuscular Injection, Or By Intravenous Injection, Or By Intravenous Infusion): 15 mg every 6 hours for 24 hours, to be started usually 12-24 hours after start of methotrexate infusion, dose may be continued by mouth, consult local treatment protocol for further information.
**Suspected methotrexate overdosage**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): Initial dose equal to or exceeding dose of methotrexate, to be given at a maximum rate of 160 mg/minute, consult poisons information centres for advice on continuing management.
**Adjunct to fluorouracil in colorectal cancer**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): (consult product literature).
**As an antidote to methotrexate**
- **Adult** (By Intravenous Infusion, Or By Intravenous Injection): (consult product literature).
**Reduction of methotrexate-induced toxicity for folinic acid**
- **Child** (By mouth, or by intravenous infusion, or by intravenous injection): (consult local protocol).
**Methotrexate overdose for folinic acid**
- **Child** (By intravenous infusion, or by intravenous injection): (consult local protocol).
**Megaloblastic anaemia due to folate deficiency for folinic acid**
- **Child 1 month-11 years** (By mouth): 250 micrograms/kg once daily.
- **Child 12-17 years** (By mouth): 15 mg once daily.
**Metabolic disorders leading to folate deficiency for folinic acid**
- **Child** (By mouth, or by intravenous infusion): 15 mg once daily, larger doses may be required in older children.
**Prevention of megaloblastic anaemia associated with pyrimethamine and sulfadiazine treatment of congenital toxoplasmosis for folinic acid**
- **Neonate** (By mouth): 5 mg 3 times a week; increased if necessary up to 20 mg 3 times a week, if the patient is neutropenic.
- **Child 1-11 months** (By mouth): 10 mg 3 times a week.
**As an antidote to methotrexate for Sodiofolin**
- **Child** (By intravenous infusion, or by intravenous injection): (consult product literature).
Cautions
Avoid simultaneous administration of methotrexate; not indicated for pernicious anaemia or other megaloblastic anaemias caused by vitamin B 12 deficiency
Contraindications
Intrathecal injection
Side effects
Common or very common With intravenous use Bone marrow failure; dehydration; diarrhoea; mucositis; nausea; oral disorders; skin reactions; vomiting Uncommon With intramuscular use Fever With intravenous use Fever Rare or very rare With intramuscular use Agitation (with high doses); depression (with high doses); epilepsy exacerbated; gastrointestinal disorder; insomnia (with high doses); urticaria With intravenous use Agitation (with high doses); depression (with high doses); epilepsy exacerbated; gastrointestinal disorder; insomnia (with high doses); sensitisation Frequency not known With intravenous use Hyperammonaemia
Interactions
**Other interactions (2):**
- When disodium folinate is given in conjunction with a folic acid antagonist (e.g.
- Disodium folinate may diminish the effect of anti-epileptic substances: phenobarbital, primidone, phenytoin, and succinimides, and may increase the frequency of seizures (decreased plasma levels of...
Pregnancy
Not known to be harmful; benefit outweighs risk.
Breast feeding
Presence in milk unknown but benefit outweighs risk.
Medicinal forms
Solution,Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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