Folinic Acid

Generic Details

Generic Name

Folinic Acid

Other Names

  • Calcium Folinate
  • Levoleucovorin

Drug Class

  • Antidote
  • Vitamin

Chemical Formula

C20H23CaN7O7

Molecular Weight

511.51 g/mol

Mechanism of Action

  • Folinic acid is a reduced form of folic acid that helps in the synthesis of purine and thymidylate nucleotides necessary for DNA replication and cell division.

Indications

  • Rescue after high-dose methotrexate chemotherapy
  • Treatment of folic acid antagonists overdose
  • Adjunct in the treatment of megaloblastic anemia due to folate deficiency

Common Dosage Forms

  • Tablet
  • Injection

Typical Dosage

  • 5-50 mg orally once daily

Pediatric Dosage

  • Dosing based on weight and specific indication, always consult a healthcare provider

Geriatric Dosage

  • Dosing adjustments based on renal function

Side Effects

  • Nausea
  • Vomiting
  • Diarrhea
  • Allergic reactions

Contraindications

  • Hypersensitivity to folinic acid
  • Severe renal impairment

Pregnancy Category

  • A - Studies in pregnant women have not shown an increased risk of fetal abnormalities

Lactation Safety

  • Compatible with breastfeeding

Drug Interactions

  • May interact with phenytoin, fluorouracil, sulfamethoxazole-trimethoprim

Overdose Symptoms

  • Potential for exacerbation of side effects

Antidote for Overdose

  • Calcium folinate or leucovorin may be used as an antidote

Storage Conditions

  • Store at room temperature away from light and moisture

Pharmacokinetics

  • Absorption: Well absorbed orally
  • Distribution: Widely distributed in tissues
  • Metabolism: Metabolized to active metabolites in the liver
  • Excretion: Primarily excreted in urine

Precautions

  • Monitor for signs of allergic reactions
  • Monitor renal function during high-dose therapy

Warnings

  • Not a substitute for folic acid in the treatment of anemia without a confirmed deficiency

Others