Formulary
Levofolinic acid: Indications, Dosing, Side Effects and Interactions
Levofolinic acid is an isomer of folinic acid.
MedNext Academy | 3 min read
Levofolinic acid: Indications, Dosing, Side Effects and Interactions
Levofolinic acid is an isomer of folinic acid.
Drug action
Levofolinic acid is an isomer of folinic acid.
Indications and dose
**Prevention of methotrexate-induced adverse effects**
- **Adult** (By Intramuscular Injection, Or By Intravenous Injection, Or By Intravenous Infusion): Usual dose 7.5 mg every 6 hours for 10 doses, usually started 12-24 hours after beginning of methotrexate infusion.
**Suspected methotrexate overdosage**
- **Adult** (By Intravenous Infusion, Or By Intravenous Injection): Initial dose at least 50% of the dose of methotrexate, intravenous infusion to be administered 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 Slow Intravenous Injection): (consult product literature).
**Reduction of methotrexate-induced toxicity for levofolinic acid**
- **Child** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): (consult local protocol).
**Methotrexate overdose for levofolinic acid**
- **Child** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): (consult local protocol).
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 Dehydration; diarrhoea; mucosal toxicity; nausea; vomiting Uncommon Fever Rare or very rare Agitation (with high doses); depression (with high doses); epilepsy exacerbated; gastrointestinal disorder; insomnia (with high doses); urticaria
Pregnancy
Not known to be harmful; benefit outweighs risk.
Breast feeding
Presence in milk unknown but benefit outweighs risk.
Medicinal forms
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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