Difference between revisions of "Levoleucovorin (Fusilev)"
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Warner-admin (talk | contribs) m (Text replacement - "please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [https://online.lexi.com/lco/action/login UpToDate Lexidrug], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information" to "please refer to your preferred pharmacopeias or the prescribing information") |
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==General information== | ==General information== | ||
| − | Class/mechanism: Folic acid analog that is the pharmacologically active isomer of 5-formyl tetrahydrofolic acid (racemic d,l [[Folinic acid | + | Class/mechanism: Folic acid analog that is the pharmacologically active isomer of 5-formyl tetrahydrofolic acid (racemic d,l [[Leucovorin (Folinic acid)]]). Counteracts the effects of folic acid antagonists such as [[Methotrexate (MTX) | methotrexate]], which acts by inhibiting dihydrofolate reductase. Enhances the activity of [[Fluorouracil (5-FU)]] by inhibiting thymidylate synthase.<ref name="insert">[https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020140s002lbl.pdf Levoleucovorin (Fusilev) package insert]</ref><ref>[[:File:Levoleucovorin.pdf | Levoleucovorin (Fusilev) package insert (locally hosted backup)]]</ref><ref>[http://fusilev.com/ Fusilev manufacturer's website]</ref> |
<br>Route: IV | <br>Route: IV | ||
<br>Extravasation: no information | <br>Extravasation: no information | ||
| − | For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias | + | For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.<ref name="insert"></ref> |
==Diseases for which it is used== | ==Diseases for which it is used== | ||
| Line 11: | Line 11: | ||
*[[Cervical cancer]] | *[[Cervical cancer]] | ||
*[[Cholangiocarcinoma]] | *[[Cholangiocarcinoma]] | ||
| − | *[[Colon cancer]] | + | *[[Colorectal cancer]] |
| − | *[[Esophageal cancer]] | + | **[[Colon cancer]] |
| + | **[[Rectal cancer]] | ||
| + | *[[Esophageal cancer]] | ||
| + | **[[Esophageal adenocarcinoma]] | ||
*[[Gastric cancer]] | *[[Gastric cancer]] | ||
*[[Hepatocellular carcinoma]] | *[[Hepatocellular carcinoma]] | ||
| − | *[[Pancreatic cancer]] | + | *[[Pancreatic cancer]] |
| − | *[[ | + | *[[Small bowel adenocarcinoma]] |
==Patient drug information== | ==Patient drug information== | ||
| Line 23: | Line 26: | ||
==History of changes in FDA indication== | ==History of changes in FDA indication== | ||
| − | * | + | *2008-03-07: [http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020140lbl.pdf FDA approved] "to diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosage of folic acid antagonists." "Levoleucovorin rescue is indicated after high-dose methotrexate therapy in [[Bone sarcoma | osteosarcoma]]." |
| + | ==History of changes in PMDA indication== | ||
| + | *2013-12-20: New additional indication and a new dosage for the treatment of unresectable [[pancreatic cancer]]. | ||
| + | *2018-09-21: New indication and a new dosage for the treatment of [[small bowel adenocarcinoma|small intestine cancer]]. | ||
==Also known as== | ==Also known as== | ||
*'''Generic name:''' levoleucovorin calcium | *'''Generic name:''' levoleucovorin calcium | ||
| − | *'''Brand name:''' Fusilev | + | *'''Brand name:''' Fusilev, Isovorin |
==References== | ==References== | ||
| Line 35: | Line 41: | ||
[[Category:Intravenous medications]] | [[Category:Intravenous medications]] | ||
| + | [[Category:Folic acid analog]] | ||
[[Category:Chemotherapy protective agents]] | [[Category:Chemotherapy protective agents]] | ||
| Line 40: | Line 47: | ||
[[Category:Cholangiocarcinoma medications]] | [[Category:Cholangiocarcinoma medications]] | ||
[[Category:Colon cancer medications]] | [[Category:Colon cancer medications]] | ||
| + | [[Category:Colorectal cancer medications]] | ||
| + | [[Category:Esophageal adenocarcinoma medications]] | ||
[[Category:Esophageal cancer medications]] | [[Category:Esophageal cancer medications]] | ||
[[Category:Gastric cancer medications]] | [[Category:Gastric cancer medications]] | ||
| Line 45: | Line 54: | ||
[[Category:Pancreatic cancer medications]] | [[Category:Pancreatic cancer medications]] | ||
[[Category:Rectal cancer medications]] | [[Category:Rectal cancer medications]] | ||
| + | [[Category:Small bowel adenocarcinoma medications]] | ||
[[Category:FDA approved in 2008]] | [[Category:FDA approved in 2008]] | ||
Latest revision as of 01:06, 29 June 2024
General information
Class/mechanism: Folic acid analog that is the pharmacologically active isomer of 5-formyl tetrahydrofolic acid (racemic d,l Leucovorin (Folinic acid)). Counteracts the effects of folic acid antagonists such as methotrexate, which acts by inhibiting dihydrofolate reductase. Enhances the activity of Fluorouracil (5-FU) by inhibiting thymidylate synthase.[1][2][3]
Route: IV
Extravasation: no information
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.[1]
Diseases for which it is used
Note: these are diseases where folinic acid is used as an adjuvant to Fluorouracil (5-FU), as opposed to an antidote as it is used in conjunction with Methotrexate (MTX)
- Cervical cancer
- Cholangiocarcinoma
- Colorectal cancer
- Esophageal cancer
- Gastric cancer
- Hepatocellular carcinoma
- Pancreatic cancer
- Small bowel adenocarcinoma
Patient drug information
- Levoleucovorin (Fusilev) package insert[1]
- Levoleucovorin (Fusilev) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 2008-03-07: FDA approved "to diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosage of folic acid antagonists." "Levoleucovorin rescue is indicated after high-dose methotrexate therapy in osteosarcoma."
History of changes in PMDA indication
- 2013-12-20: New additional indication and a new dosage for the treatment of unresectable pancreatic cancer.
- 2018-09-21: New indication and a new dosage for the treatment of small intestine cancer.
Also known as
- Generic name: levoleucovorin calcium
- Brand name: Fusilev, Isovorin
References
Categories:
- Drugs
- Intravenous medications
- Folic acid analog
- Chemotherapy protective agents
- Cervical cancer medications
- Cholangiocarcinoma medications
- Colon cancer medications
- Colorectal cancer medications
- Esophageal adenocarcinoma medications
- Esophageal cancer medications
- Gastric cancer medications
- Hepatocellular carcinoma medications
- Pancreatic cancer medications
- Rectal cancer medications
- Small bowel adenocarcinoma medications
- FDA approved in 2008