Levofolinato De Cálcio Farmoz (Calcium Levofolinate)

Levofolinato De Cálcio Farmoz is used in clinical situations that involve folate pathway disruption or deficiency.

• Rescue therapy after high‑dose methotrexate: restores folate pools and reduces methotrexate‑related toxicity.
• Adjunct in cancer chemotherapy regimens: supports normal cell proliferation during antifolate‑based treatment.
• Treatment of folate deficiency: provides a bioavailable reduced folate to correct deficiency states.

• Calcium levofolinate supplies a reduced form of folic acid that bypasses dihydrofolate reductase inhibition. By entering cells directly, it replenishes tetrahydrofolate cofactors required for thymidylate and purine synthesis, thereby restoring DNA replication in normal tissues and mitigating the toxic effects of antifolate agents such as methotrexate.

Adverse reactions may occur with calcium levofolinate therapy.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Transient elevation of liver enzymes: mild, usually reversible.
• Fatigue: generalized tiredness without specific cause.
• Headache: mild to moderate intensity.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: including rash, swelling, or anaphylaxis.
• Renal failure: acute kidney injury in susceptible patients.
• Significant hepatic dysfunction: marked elevation of transaminases or bilirubin.
• Bone marrow suppression: pancytopenia or severe neutropenia.
• Stevens‑Johnson syndrome: rare severe skin reaction.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors.

• Renal function monitoring: adjust dose in impaired clearance.
• Hepatic enzyme assessment: watch for significant elevations.
• Folate status evaluation: confirm deficiency or need for rescue.
• Dose adjustment in renal impairment: reduce dose as recommended.
• Avoid in known hypersensitivity: discontinue if allergic reaction occurs.
• Store at room temperature: keep in the original pack, protect from moisture and direct sunlight.

Calcium levofolinate may interact with several drug classes.

Major Interactions (Avoid)

• High‑dose methotrexate: requires rescue dosing to prevent toxicity.
• Other antifolate agents (e.g., pemetrexed): may increase folate demand.
• Trimethoprim and pyrimethamine: compete for folate pathways.
• NSAIDs that reduce renal clearance: can exacerbate renal toxicity.

Moderate Interactions (Monitor Closely)

• Penicillins: may affect renal excretion.
• Sulfonamides: potential additive folate antagonism.
• Phenytoin and carbamazepine: may alter folate metabolism.
• Oral contraceptives: possible reduction in efficacy.
• Vitamin B12 supplements: monitor for synergistic effects on hematopoiesis.