Folinic acid

CLINICAL USE

Folinic acid rescue Enhancement of 5-fluorouracil cytotoxicity in advanced colorectal cancerFolate deficiency

DOSE IN NORMAL RENAL FUNCTION

Varies according to indication

PHARMACOKINETICS

  • Molecular weight                           :511.5
  • %Protein binding                           :54
  • %Excreted unchanged in urine     : 80–90 (as inactive metabolites)
  • Volume of distribution (L/kg)       :17.5
  • half-life – normal/ESRD (hrs)      :32–35 minutes/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Some removal likely. Dose as in normal renal function
  • HD                     :Some removal likely. Dose as in normal renal function
  • HDF/high flux   :Dialysed. Dose as in normal renal function
  • CAV/VVHD      :Some removal likely. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsShould not be administered simultaneously with a folic acid antagonist as this may nullify the effect of the antagonist

    ADMINISTRATION

    Reconstition

    For

    IV infusion

    , compatible with: sodium chloride 0.9%, glucose 5%, sodium lactate injection

    Route

    IM, IV injection,

    IV infusion

    , oral

    Rate of Administration

    Because of the calcium content of leucovorin solutions, no more than 160 mg/minute should be injected IV

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