leucovorin
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.
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
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.
The following Leucovorin 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
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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.
Common questions about Leucovorin
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.
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.
Yes, leucovorin can prevent and lower the amount of mouth sores (mucositis) associated with methotrexate and similar medications.
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.
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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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
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 60 tablets | $94.08 | $1.57 |
| 10mg | 12 tablets | $33.88 | $2.82 |
| 15mg | 60 tablets | $93.07 | $1.55 |
| 5mg | 30 tablets | $22.82 | $0.76 |
Typical dosage 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?
$22.82
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.
- Not to be used for pernicious anemia and other megaloblastic anemias due to the lack of vitamin B12
News about Leucovorin
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