Is levoleucovorin (Fusilev) commonly used?

Levoleucovorin (Fusilev) was used when there was a shortage in supply of [leucovorin](https://www.goodrx.com/leucovorin/what-is). Due to the cost of levoleucovorin (Fusilev), leucovorin is the [drug of choice](https://pubmed.ncbi.nlm.nih.gov/23032661/) for most people. When leucovorin is available without any supply issues, levoleucovorin (Fusilev) isn't typically used.

levoleucovorin

Q: What is levoleucovorin (Fusilev)?

Levoleucovorin (Fusilev) is a medication used to lower the risk of toxic side effects of high-dose [methotrexate](https://www.goodrx.com/methotrexate/what-is) in people with [osteosarcoma](https://www.cancer.org/cancer/osteosarcoma/about/what-is-osteosarcoma.html) (a type of bone cancer). This medication can also treat people who overdose or can't get rid of methotrexate or other [anti-folate medications](https://www.goodrx.com/classes/antifolates) properly from their body. In addition, higher doses of levoleucovorin (Fusilev) can be used with the anticancer medication [fluorouracil](https://www.goodrx.com/fluorouracil/what-is) to help treat people with severe colorectal cancer that has spread to other parts of the body (metastatic). Levoleucovorin (Fusilev) is a folic acid analog (a form of folic acid) that works against the harmful effects of methotrexate. When given with fluorouracil, levoleucovorin (Fusilev) can boost the effects of fluorouracil to make it work better in your body.

Q: How is levoleucovorin (Fusilev) given?

Levoleucovorin (Fusilev) is given as an injection into the vein (intravenous, or IV) by a healthcare provider. To lower the risk of side effects from high-dose methotrexate therapy, levoleucovorin (Fusilev) is given every 6 hours for 10 doses, starting 24 hours after your methotrexate infusion has started. People experiencing methotrexate overdose are given levoleucovorin (Fusilev) every 6 hours as soon as possible or within 24 hours of the methotrexate infusion. You'll continue to receive levoleucovorin (Fusilev) until your blood methotrexate levels drop to a certain point. To treat advanced colorectal cancer, levoleucovorin (Fusilev) is typically given at higher doses than for methotrexate toxicity. It's given once daily before your fluorouracil injection for five days. This five-day treatment can be repeated every 4 to 5 weeks. Your provider will determine the levoleucovorin (Fusilev) dose you need.

Q: What are some side effects of levoleucovorin (Fusilev)?

Common side effects of levoleucovorin (Fusilev) can include vomiting, [mouth sores](https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/mouth-problems/mouth-sores.html), nausea, and diarrhea. Giving levoleucovorin (Fusilev) together with fluorouracil can make some side effects more common and severe. Fatal digestive tract inflammation, diarrhea, and dehydration have happened when older adults are given levoleucovorin (Fusilev) with fluorouracil. Let your provider know right away if you experience any severe side effects. Your provider will temporarily stop your treatment and monitor you until the severe side effects go away.

Q: What's the difference between levoleucovorin (Fusilev) and leucovorin?

Levoleucovorin (Fusilev) and leucovorin have very similar chemical structures. Levoleucovorin (Fusilev) can be used [interchangeably](https://pubmed.ncbi.nlm.nih.gov/23032661/) with [leucovorin](https://www.goodrx.com/leucovorin/what-is). This means that both medications can be substituted for one another and be used for the same conditions. While both levoleucovorin (Fusilev) and leucovorin are available as an injection, leucovorin is also available as oral tablets. Speak to your provider to see which medication is the best option for you.

Generic Fusilev

Used for Chemotherapy Overdose, Chemotherapy Side Effects

Levoleucovorin (Fusilev) is an injectable medication given by a healthcare provider to lower the toxic side effects of methotrexate or other anti-folate medications. At higher doses, levoleucovorin (Fusilev) can also be given with fluorouracil to help treat advanced colorectal cancer that has spread to other parts of the body.

Reviewed by:

Yen Nguyen, PharmD

Cydnee Ng, PharmD

Last reviewed on September 7, 2022

What is Levoleucovorin (Fusilev)?

What is Levoleucovorin (Fusilev) used for?

Methotrexate toxicity
Antidote for overdose of anti-folate medications
Advanced metastatic colorectal cancer

Are you looking for information on leucovorin instead?

Drug facts

Common Brands	Fusilev, Khapzory
Drug Class	Folate / Chemotherapy antidote
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Fusilev, Khapzory

Drug Class

Folate / Chemotherapy antidote

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Common questions about Levoleucovorin

Levoleucovorin is a medication used to lower the risk of toxic side effects of high-dose methotrexate in people with osteosarcoma (a type of bone cancer). This medication can also treat people who overdose or can't get rid of methotrexate or other anti-folate medications properly from their body. In addition, higher doses of Levoleucovorin can be used with the anticancer medication fluorouracil to help treat people with severe colorectal cancer that has spread to other parts of the body (metastatic). Levoleucovorin is a folic acid analog (a form of folic acid) that works against the harmful effects of methotrexate. When given with fluorouracil, Levoleucovorin can boost the effects of fluorouracil to make it work better in your body.

Levoleucovorin is given as an injection into the vein (intravenous, or IV) by a healthcare provider. To lower the risk of side effects from high-dose methotrexate therapy, Levoleucovorin is given every 6 hours for 10 doses, starting 24 hours after your methotrexate infusion has started. People experiencing methotrexate overdose are given Levoleucovorin every 6 hours as soon as possible or within 24 hours of the methotrexate infusion. You'll continue to receive Levoleucovorin until your blood methotrexate levels drop to a certain point. To treat advanced colorectal cancer, Levoleucovorin is typically given at higher doses than for methotrexate toxicity. It's given once daily before your fluorouracil injection for five days. This five-day treatment can be repeated every 4 to 5 weeks. Your provider will determine the Levoleucovorin dose you need.

Common side effects of Levoleucovorin can include vomiting, mouth sores, nausea, and diarrhea. Giving Levoleucovorin together with fluorouracil can make some side effects more common and severe. Fatal digestive tract inflammation, diarrhea, and dehydration have happened when older adults are given Levoleucovorin with fluorouracil. Let your provider know right away if you experience any severe side effects. Your provider will temporarily stop your treatment and monitor you until the severe side effects go away.

Levoleucovorin and leucovorin have very similar chemical structures. Levoleucovorin can be used interchangeably with leucovorin. This means that both medications can be substituted for one another and be used for the same conditions. While both Levoleucovorin and leucovorin are available as an injection, leucovorin is also available as oral tablets. Speak to your provider to see which medication is the best option for you.

Levoleucovorin was used when there was a shortage in supply of leucovorin. Due to the cost of Levoleucovorin, leucovorin is the drug of choice for most people. When leucovorin is available without any supply issues, Levoleucovorin isn't typically used.

Levoleucovorin (Fusilev) dosage

Typical dosage for Levoleucovorin (Fusilev)

Interactions between Levoleucovorin (Fusilev) and other drugs

Levoleucovorin (Fusilev) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Levoleucovorin (Fusilev). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

What are alternatives to Levoleucovorin (Fusilev)?

There are a number of medications that your doctor can prescribe in place of Levoleucovorin (Fusilev). Compare a few possible alternatives below.

Levoleucovorin (Fusilev)

Used for:

Methotrexate toxicity
Antidote for overdose of anti-folate medications
Advanced metastatic colorectal cancer

View prices

Leucovorin

Used for:

Methotrexate toxicity
Antidote for overdose of anti-folate medications

$37.15Lowest GoodRx priceView prices

What is Levoleucovorin (Fusilev)?

What is Levoleucovorin (Fusilev) used for?

Are you looking for information on leucovorin instead?

Drug facts

Common questions about Levoleucovorin

What is Levoleucovorin?

How is Levoleucovorin given?

What are some side effects of Levoleucovorin?

What's the difference between Levoleucovorin and leucovorin?

Is Levoleucovorin commonly used?

Levoleucovorin (Fusilev) dosage

Typical dosage for Levoleucovorin (Fusilev)

Interactions between Levoleucovorin (Fusilev) and other drugs

What are alternatives to Levoleucovorin (Fusilev)?

Common questions about Levoleucovorin

What is Levoleucovorin?

How is Levoleucovorin given?

What are some side effects of Levoleucovorin?

What's the difference between Levoleucovorin and leucovorin?

Is Levoleucovorin commonly used?