Leucovorin Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Leucovorin Injection (leucovorin calcium, also called calcium folinate) is a prescription medicine related to folic acid, given by a health care provider in a hospital or clinic as a shot into a vein or muscle. It is used to reduce side effects from high-dose methotrexate chemotherapy, treat methotrexate overdose, treat certain folic acid-related anemias, support treatment of some colorectal cancers with 5-fluorouracil, and treat FOLR1-CFD, a rare inherited condition. It belongs to the folic acid analog (reduced folate) drug class.

What is Leucovorin Injection

Leucovorin injection is a prescription medicine related to folic acid. It is given by a health care provider in a hospital or clinic as a shot into a vein or muscle.

Leucovorin Injection uses

• Reducing side effects from high-dose chemotherapy with methotrexate
• Treating people who have accidentally received an overdose of methotrexate or similar medications
• Treating certain types of anemia caused by low levels of folic acid
• Treating some forms of colorectal cancer, often together with the chemotherapy medicine 5-fluorouracil
• Treating folate receptor 1-related cerebral folate deficiency (FOLR1-CFD), a rare inherited condition that can cause seizures, movement problems, and developmental delays

Benefits of Leucovorin Injection

• Protects healthy cells from the harmful effects of high-dose methotrexate
• Supplies folic acid needed for red blood cell formation to help treat anemia
• Increases the effectiveness of 5-fluorouracil chemotherapy for colorectal cancer
• Provides an active form of folate that can reach the brain in FOLR1-CFD

How Leucovorin Injection works

Leucovorin turns into folic acid in the body. This protects healthy cells from the harmful effects of high-dose methotrexate, helps certain chemotherapies work better against cancer cells, and supplies an active form of folate that can reach the brain in people with FOLR1-CFD.

Leucovorin Injection dosage

This medicine is usually given by a health care provider in a hospital or clinic, so you will not store or give it yourself. When used to prevent harm from methotrexate or treat a methotrexate overdose, it is usually given on a regular schedule until lab tests show it is no longer needed. When used for anemia, it is usually given once a day. When used for colorectal cancer, it is usually given once a day for several days as part of a treatment cycle that may be repeated every few weeks.

Make sure to attend all appointments for your injection doses. If you miss an appointment for your dose, call to make another appointment as soon as possible. Unless your doctor tells you otherwise, continue your normal diet while receiving this medicine. If receiving this medicine along with chemotherapy, drink plenty of water to help your kidneys flush out the chemotherapy medicines.

Available forms and strengths

• Injection liquid
• Oral tablet

Side effects of Leucovorin Injection

Common

• Nausea
• Vomiting
• Diarrhea
• Mouth sores (stomatitis)
• Rash or itching
• Fatigue
• Headache
• Dizziness

Serious

• Severe allergic reactions, including breathing problems or wheezing, racing heart, fever or feeling generally unwell, swollen lymph nodes, swelling of the face, lips, mouth, tongue, or throat, trouble swallowing or throat tightness, itching, skin rash, hives, nausea or vomiting, dizziness or fainting, stomach cramps, and joint pain
• Seizures
• Fainting

Warnings and precautions

• Do not use leucovorin if you have certain types of anemia, such as pernicious anemia or anemia caused by lack of vitamin B12. This medicine will not treat that type of anemia and could hide its symptoms while the underlying problem continues.
• Do not have this medicine injected into the spinal fluid (intrathecally) — this can be harmful or even fatal.
• This medicine may make seizure medicines less effective and can raise the risk of seizures, especially in certain children. Tell your doctor if you have ever had a seizure.
• When used with the chemotherapy drug 5-fluorouracil, stomach and bowel side effects such as mouth sores and diarrhea can be more common and more severe. Treatment should not be started or continued if these symptoms are present until they go away completely, and diarrhea should be watched closely since it can become serious quickly.
• Elderly or frail patients receiving this medicine together with 5-fluorouracil have a higher risk of severe stomach and bowel side effects.
• This medicine does not have any effect on kidney damage caused by methotrexate itself.
• Pregnancy: It is not known if or how leucovorin could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant.
• Breastfeeding: It is not known if leucovorin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.
• Kidney: Caution is advised if you have kidney problems. Talk with your doctor before taking this medicine, and tell your doctor if you have or have ever had kidney disease.
• Liver: Caution is advised if you have liver problems. Discuss this with your doctor before taking this medicine.
• Alcohol: It is not known if drinking alcohol will affect this medicine, so caution is advised and you should talk with your doctor.
• Driving: Be careful driving or operating machinery after receiving this medicine, since some people may feel dizzy or tired afterward.

Storage

• Leucovorin injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.
• Store at room temperature.
• Keep the vials protected from light.
• Store in the original packaging until ready to use.
• Keep all medicines out of sight and reach of children.
• Check the expiry date before use and do not use if expired.
• Inspect solution for particles or discolouration before administration.

When to see a doctor

• Stop and get help right away if you have signs of a serious allergic reaction, such as breathing problems or wheezing, a racing heart, fever or feeling very unwell, swollen glands, swelling of the face, lips, mouth, tongue, or throat, trouble swallowing or a tight throat, itching, skin rash, hives, nausea or vomiting, dizziness or fainting, stomach cramps, or joint pain.
• Call your doctor right away if you have seizures, fainting, diarrhea, rash, hives, itching, or trouble breathing or swallowing.
• If you or someone else has taken too much of this medicine, get medical help right away.

Alternatives

• Calcium Leucovorin
• Calcium Folinate
• Folinic Acid