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leucovorin

Generic Wellcovorin

Used for Anemia, Colon Cancer

Leucovorin is an oral and injectable medication that's similar to folic acid. It's not really used as a vitamin, but it prevents side effects from methotrexate and other anti-folate medications, such as mouth sores and changes in your blood cell counts.

Reviewed by:

Hope Chang, PharmD, AAHIVP

Michelle Nguyen, PharmD

Last reviewed on September 10, 2021

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Cost Contraindications Latest news Images Prices Medicare

What is Leucovorin?

What is Leucovorin used for?

Methotrexate toxicity
Antidote for overdose of anti-folate medications

How Leucovorin works

Leucovorin is a ready-to-use form of folate (or folic acid) for your body. It's able to reverse the toxic effects of methotrexate and other anti-folate medications.

Drug Facts

Common BrandsWellcovorin (brand no longer available)

Drug ClassFolate / Chemotherapy antidote

Controlled Substance ClassificationNot a controlled medication

Generic StatusLower-cost generic available

AvailabilityPrescription only

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Avg retail price

$27.45(save 53.99%)

GoodRx discount

$12.63

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What are the side effects of Leucovorin?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

See Risks and Warnings.

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat

Pros and cons of Leucovorin

Pros

Prevents the toxic effects of methotrexate and other chemotherapy medications, so you can use higher doses against cancer cells

Can be given as an injection if you're vomiting or having a hard time swallowing pills

Available as a generic, which can be lower-cost

Cons

For methotrexate overdose, it needs to be given multiple times a day.

Doesn't help with kidney damage from methotrexate

If you take too much leucovorin, it can start to work against your chemotherapy medications.

Can interact with anti-seizure medications

Pharmacist tips for Leucovorin

Let your provider know if you're nauseous or vomiting. They can inject the medication until your stomach feels better.

Set an alarm to help you remember to take a dose every 6 hours.

Never take more than 25 mg at a time. Your body can't absorb that much medication, so it will be wasted.

Your dose of leucovorin will depend on your side effects from other medications and can change over time. Make sure you know what dose to take and stop taking it if your provider tells you to.

Tell your provider about all the medications you're taking. Leucovorin can interact with some seizure medications and Bactrim or Septra (sulfamethoxazole / trimethoprim), a commonly used antibiotic.

Frequently asked questions about Leucovorin

Is leucovorin the same as folic acid?

Leucovorin is also called folinic acid. It's very similar, but not the same as folic acid. Folic acid is an over-the-counter dietary supplement for low folate levels, whereas leucovorin is only available by prescription, and it treats side effects from methotrexate and other anti-folate medications.

Can you take leucovorin and folic acid at the same time?

If your provider has instructed you to take leucovorin, you should not take folic acid as well. Side effects can occur when your folate levels become too low, but if they're too high, your anti-folate medication might not work as well against cancer cells.

Does leucovorin prevent mucositis?

Yes, leucovorin can prevent and lower the amount of mouth sores (mucositis) associated with methotrexate and similar medications.

Is leucovorin chemotherapy?

No, leucovorin is not chemotherapy, and the tablets are often used to protect your body against harmful side effects of cancer medications. The injection is a little different and is used with 5-fluorouracil to help prolong survival time in people with advanced colon cancer.

Why is leucovorin given with pyrimethamine (Daraprim)?

Pyrimethamine (Daraprim) is an antibiotic used to treat certain infections in people living with HIV. It usually has to be given with at least one other antibiotic, and at high doses, it can cause low blood cell counts. Leucovorin will be given daily with pyrimethamine (Daraprim) to prevent these side effects.

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What are the risks and warnings for Leucovorin?

Leucovorin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Use right away in cases of overdose

Leucovorin should be used as soon as possible when there's an accidental overdose of an anti-folate medication. The medication is most effective against toxic side effects when it's given immediately after taking the anti-folate medication.

Interaction with Bactrim or Septra (sulfamethoxazole / trimethoprim)

Risk factors: Taking leuvovorin and Bactrim or Septra (sulfamethoxazole / trimethoprim) together

Bactrim or Septra (sulfamethoxazole / trimethoprim) is a common antibiotic used for a certain type of pneumonia (lung infection) that people with HIV can get. People taking leucovorin at the same time as Bactrim or Septra were not as successful at clearing the infection. Tell your provider about all the medications you're taking so they can check for interactions and determine the best medication options for you.

Leucovorin dosage forms

The average cost for 12 tablets of 5mg of Leucovorin is $12.63 with a free GoodRx coupon. This is 53.99% off the average retail price of $27.45.

Tablet

Dosage	Quantity	Price as low as	Price per unit
5mg	12 tablets	$12.63	$1.05
10mg	12 tablets	$33.88	$2.82
15mg	30 tablets	$61.57	$2.05
25mg	60 tablets	$97.65	$1.63

Typical dosing for Leucovorin

Methotrexate toxicity: The starting dose is 15 mg by mouth every 6 hours until your methotrexate levels are low enough.
Overdose of anti-folate medications: The recommended dose is 5 mg to 15 mg by mouth a day.

Leucovorin is also available as an intravenous (IV) injection that is administered into your vein by a healthcare provider.

How much does Leucovorin cost?

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Leucovorin (generic)

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$12.63

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Leucovorin contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Leucovorin will not be safe for you to take.