Wellcovorin and GI toxicity

• Generic Name: leucovorin
• Dosage Forms: n.a.
• Other Brand Names: Wellcovorin

Antidote for unintentional overdosage of methotrexate (e.g., resulting from impaired elimination) and other folic acid antagonists (e.g., pyrimethamine, trimethoprim).

IV rescue therapy after high-dose methotrexate regimen (to control duration of exposure of sensitive cells to methotrexate) in the treatment of osteosarcoma (designated an orphan drug by FDA for this use).

Prevention of hematologic toxicity associated with pyrimethamine, trimethoprim, or trimetrexate therapy.

IV treatment of folate deficient megaloblastic anemias (e.g., serum folate concentration <0.002 mcg/mL) of infancy, pregnancy, sprue, and nutritional deficiencies when oral folic acid therapy is not feasible. No advantage over folic acid injection since ability to convert folic acid to tetrahydrofolic acid (THF) is not impaired in these anemias.

Effective in the treatment of megaloblastic anemia resulting from congenital dihydrofolate reductase deficiency.

Not effective in the treatment of pernicious anemia and other megaloblastic anemias secondary to lack of vitamin B12; avoid such use. (See Contraindications under Cautions.)

Adjunct to fluorouracil to prolong survival in the palliative treatment of advanced colorectal cancer (designated an orphan drug by FDA for this use).

First-line therapy for management of advanced colorectal cancer in a combination regimen consisting of fluorouracil, leucovorin, and either irinotecan or oxaliplatin.