Folinic acid (Leucovorin)

General information

Class/mechanism: Folic acid analog; 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.
Route: PO, IM, 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 such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is established (work in progress)

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)

• Colorectal cancer
  • Colon cancer‎
  • Rectal cancer
• Hepatocellular carcinoma

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)

• Anal cancer
• Cervical cancer ‎
• Cholangiocarcinoma
• Esophageal cancer ‎
  • Esophageal adenocarcinoma
• Gallbladder cancer
• Gastric cancer ‎ ‎
• Pancreatic cancer ‎ ‎

Diseases for which it was 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)

• Breast cancer

Patient drug information

• Folinic acid (Leucovorin) package insert
• Folinic acid (Leucovorin) patient drug information (Chemocare)
• Folinic acid (Leucovorin) patient drug information (UpToDate)

History of changes in FDA indication

• 1952-06-20: Initial FDA approval
• Uncertain date: Indicated for use in combination with 5-fluorouracil to prolong survival in the palliative treatment of patients with advanced colorectal cancer. (Based on O'Connell 1989 & Poon et al. 1989)

Also known as

• Generic names: calcium folinate, citrovorum factor, folinate calcium, folinato de calcio, leucovorin calcium, LV, sodium folinate
• Brand names:

Synonyms
Antrex	Asovorin	Biovorin	Buateron	Calcifolin	Calciumfolin	Calciumfolinat	Calcium Folinato
Calcium Folint	Calcium Leucovorin	Calcium Leucovorn	Calcivoran	Calc Leucovorn	Calfolex	Calfolin	Calinat
Cehafolin	Citofolin	Claro	Cromatonbic Folinico	Dalisol	Degalin	Divifolin	Durofolin
Ecofol	Elvefocal	Emovis	Erbanfol	Estroquin	Fastovorin	Fauldleuco	Fayining
Fedolen	Ferbon	Folaren	Folaxin	Foliben	Foli Cell	Folidan	Folidar
Foliment	Folinac	Folinato	Folinfabra	Folinoral	Folinoxan	Folinvit	Foliplus
Folmigor	Ifavor	Isovorin	Kalciumfolinat Perivita	Kalsiumfolinat	Kunyrin	Lederfolat	Lederfolin
Lederfoline	Ledervorin	Legifol	Leucocalcin	Leuconolver	Leucosar	Leucovorin	Leucovorina
Leucovorine	Leukovorin	Lovorin	Medicofolin	Medifolin	Medsavorina	Neofolin	Nyrin
O Folin	Osfolate	Osfolato	Perfolate	Prefolic	Prevax	Recovorin	Reotan
Rescuvolin	Resfolin	Ribofolin	Rontafor	Sanifolin	Tecnovorin	Tonofolin	Veravorin
Vorina	Wellcovorin	Zyofolin	Zytofolin