Leucovorin-LENS, lyophilizate 25 mg 5 pcs

Calcium folinate is a reduced form of folic acid and is used as an antidote to drugs that act as folic acid antagonists. This compound is also known as folinic acid.

Indications

Intoxication with folic acid antagonists (methotrexate, trimethoprim and pyrimethamine).
– Prevention of toxic effects of methotrexate when using it in high and high doses.
– Colorectal cancer (as part of combined therapy with fluorouracil).
– Megaloblastic anemia against folic acid deficiency (including malabsorption syndrome, malnutrition, pregnancy, constipation, in early childhood with congenital deficiency of dihydrofolate reductase).

Active ingredient

Calcium folinate

How to take, the dosage

The solution is administered intramuscularly or intravenously. Due to the fact that different regimens of Leucovorin-LNS are used, the doctor should be guided by special medical literature when choosing a specific dose.

In combination with high doses of methotrexate (12-15 g/m3 ), administration usually begins 24 hours after methotrexate treatment ends at a dose of 10 mg/m2 every 6 hours for 72 hours or until plasma methotrexate concentrations are less than 5×10 -8 M.

Patients with acidic urine reactions, exudative effusions, impaired renal function, or bowel obstruction may require a higher dose of Leucovorin-LNS and/or longer duration of treatment because methotrexate excretion may be delayed in this group of patients. The use of Leucovorin-LENS® in these cases is recommended to be based on obligatory determination of methotrexate concentration in blood plasma. In order to prevent development of CPN, hydration (3 liters/day) and administration of sodium bicarbonate to maintain urine pH at 7 or higher is performed.

In case of accidental methotrexate overdose Leucovorin-LENS® is administered in dose equal or higher than dose of injected methotrexate not later than 1 hour after methotrexate injection, further the drug is injected every 3 hours by 10 mg/m2 until signs of toxicity disappear. When combined with fluorouracil, Leukovorin-LNS is administered:

– at a dose of 200 mg/m2 intravenously slowly (at least 3 minutes) or intravenously drip followed by intravenous fluorouracil at a dose of 370 mg/m2 or

– at a dose of 20 mg/m2 intravenously followed by intravenous fluorouracil at a dose of 425 mg/m2.

The drugs are administered daily for 5 days with an interval of 4-5 weeks between repeated courses. In treatment of megaloblastic anemia caused by folic acid deficiency Leucovorin-LENS® is administered by 1 mg intramuscularly or intravenously per day.

Interaction

Calcium folinate concomitantly reduces the effectiveness of folic acid antagonists.

Special Instructions

The use of Leucovorin-LENS in pernicious and other megaloblastic anemias caused by cyanocobalamin (vitamin B12) deficiency may lead to hematological remission with simultaneous progression of neurological disorders.

Contraindications

• High sensitivity to calcium folinate or any other substance in the drug.
• Megaloblastic anemia due to cyanocobalamin (vitamin B12) deficiency.

With caution – alcoholism, epilepsy, chronic renal insufficiency (CKF), children (under 2 years – safety and effectiveness for children is not established).

Side effects

Allergic reactions: skin rash, urticaria, pruritus, anaphylactic shock. Dyspeptic disorders are possible when using high doses of calcium folinate. Rarely, sleep disturbance, agitation.

Overdose

Calcium folinate is not toxic. Even when using very high doses, there are no signs of overdose.