Kalciumfolinat Stada (Folinic Acid)

Folinic Acid supports folate metabolism in several clinical situations.

• Methotrexate toxicity: restores folate function and reduces toxic effects.
• Cancer chemotherapy adjunct: enhances efficacy of regimens that include antifolate agents.
• Folate deficiency: corrects low folate levels in patients with deficiency.

• Folinic Acid (5‑formyl tetrahydrofolate) enters cells via the reduced folate carrier and is directly utilized in purine and thymidylate synthesis, bypassing the dihydrofolate reductase step blocked by drugs such as methotrexate. By supplying the active reduced folate, it restores DNA synthesis, repair, and methylation processes essential for rapidly dividing cells.

Folinic Acid may be associated with several adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Vomiting: occasional emesis after administration.
• Rash: transient skin erythema or pruritus.
• Fever: low‑grade temperature elevation.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hepatic dysfunction: marked elevation of liver enzymes or hepatitis.
• Renal toxicity: acute kidney injury in predisposed patients.
• Seizures: rare neurologic events, especially with rapid infusion.

When using Folinic Acid, several safety considerations should be observed.

• Renal function: assess kidney function before high‑dose administration.
• Hepatic function: monitor liver enzymes in patients with liver disease.
• Hypersensitivity: discontinue if signs of allergic reaction appear.
• Pregnancy and lactation: use only if benefits outweigh potential risks.
• Drug interactions: review concomitant antifolate therapy.
• Store at 2‑8°C: keep refrigerated, protect from light, do not freeze or shake.

Folinic Acid can interact with other medications, requiring careful management.

Major Interactions (Avoid)

• Methotrexate: concurrent use may reduce methotrexate efficacy; timing must be controlled.
• Antifolate chemotherapy agents (e.g., pemetrexed, pralatrexate): may antagonize therapeutic effect.
• High‑dose vitamin C: may increase renal clearance, lowering folinic acid exposure.

Moderate Interactions (Monitor Closely)

• 5‑Fluorouracil: monitor for reduced anticancer efficacy.
• Phenytoin: may alter folate metabolism, requiring dose adjustment.
• Trimethoprim: may increase risk of folate deficiency, necessitating monitoring.