Diminish toxicity & counteract the effects of inadvertent overdose of folic acid antagonist. In combination w/ 5-fluorouracil to prolong survival in the palliative treatment of patients w/ advanced colorectal carcinoma.
Dosage/Direction for Use
Folic acid antagonist overdose 5-15 mg daily by IM. Leucovorin Ca rescue after high-dose MTX therapy 15 mg/m2 body surface by IM or IV every 6 hr for 10 times initially 24 hr after the beginning of MTX infusion. Advanced CRC Administer 200 mg/m2 body surface by slow IV over 3 min, followed by 5-fluorouracil at 370 mg/m2 body surface by IV or 20 mg/m2 body surface by IV inj, followed by 5-fluorouracil at 425 mg/m2 body surface by IV inj. Treatment repeated daily for 5 days. 5-day treatment course may be repeated at 4-wk (28 days) intervals.
Contraindications
Pernicious anemia & other megaloblastic anemia secondary to the lack of vit B12. Hematologic remission may occur while neurologic manifestations continue to progress.
Special Precautions
Should only be used w/ folic acid antagonist eg, MTX or fluoropyrimidines eg, 5-fluorouracil. Prefer parenteral administration if vomiting occurs. Enhanced toxicity of fluorouracil. Perform CBC w/ differential & platelets prior to each treatment w/ leucovorin Ca & 5-fluorouracil. Monitor electrolytes & liver function prior to treatment for the 1st 3 cycles, then prior to every other cycles. Defer treatment until WBCs are 4,000/mm3 & platelets 130,000/mm3. Follow-up physical exam prior to each treatment course & radiological exam. Discontinue when there is evidence of tumor progression. Pregnancy & lactation.
Antiepileptic effect of phenobarb, phenytoin & primidone & increased frequency of seizures in susceptible childn. Reduced efficacy of intrathecally administered MTX w/ high oral, IV or IM doses of leucovorin Ca.
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