Product image of Leucovorin (Folinic Acid) supplied by GNH India

Leucovorin

Active Ingredient:
Folinic Acid
Origin:
EU

Leucovorin (Folinic Acid)

Folinic Acid, the active ingredient in Leucovorin, is a reduced form of folic acid presented as a sterile solution for epidural, intrabursal and intracoronary use. It is employed to mitigate the toxic effects of antifolate chemotherapy and to support normal cellular function in specific clinical settings.

GNH India supplies Leucovorin as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, oncology centres, pharmacies and clinics worldwide.

Manufacturer / TM Owner

Teva Gyógyszergyár Zrt

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Indications & Clinical Uses

Leucovorin is used in clinical situations where folate metabolism is disrupted or where rescue from antifolate toxicity is required.

  • Methotrexate toxicity: reduces adverse effects and supports recovery of normal cells.
  • High‑dose methotrexate therapy: provides folate rescue to prevent severe bone‑marrow suppression.
  • 5‑Fluorouracil (5‑FU) toxicity: alleviates mucosal and hematologic side effects.
  • Folate deficiency: restores folate levels in patients unable to convert folic acid.
  • Certain congenital metabolic disorders: supplies active folate for enzymatic pathways.

How It Works

  • Folinic acid bypasses the dihydrofolate reductase step, delivering a reduced folate directly into the tetrahydrofolate pool. This enables nucleotide synthesis and methylation reactions in cells, counteracting the blockade caused by antifolate agents such as methotrexate and supporting normal DNA replication and repair processes.

Side Effects

Leucovorin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

  • Nausea or vomiting
  • Diarrhea
  • Mild rash or itching
  • Transient elevation of liver enzymes
  • Low-grade fever
  • Headache

Serious or Rare Side Effects

  • Severe allergic reaction (anaphylaxis)
  • Acute renal impairment
  • Significant electrolyte disturbances
  • Unexplained bleeding or bruising
  • Persistent high fever with chills

Precautions & Warnings

Leucovorin should be used with careful clinical monitoring and adherence to prescribing information.

  • Renal function: assess before and during therapy in patients with kidney disease.
  • Hepatic function: monitor liver enzymes, especially in patients with pre‑existing liver disease.
  • Pregnancy: avoid unless clearly indicated; discuss risks with obstetric specialist.
  • Breastfeeding: consider potential excretion in milk; weigh benefits against risks.
  • Drug interactions: review concomitant medications for potential folate pathway effects.
  • Store below 25°C: keep in the original container, protect from moisture and direct sunlight.

Avoid Interactions

Leucovorin can influence the activity of several drugs that affect folate metabolism or share similar pathways.

Major Interactions (Avoid)

  • Methotrexate: concurrent use without proper timing may diminish methotrexate efficacy.
  • Antifolate chemotherapy agents (e.g., pemetrexed): may reduce therapeutic effect if not appropriately scheduled.

Moderate Interactions (Monitor Closely)

  • Trimethoprim‑sulfamethoxazole: may increase risk of hematologic toxicity.
  • Phenytoin: potential alteration of folate levels, requiring monitoring.
  • Anticonvulsants (e.g., carbamazepine): may affect folate metabolism.
  • Vitamin B12 supplements: high doses can mask folate deficiency signs.

Frequently Asked Questions

Leucovorin (folinic acid) is employed to rescue normal cells from the toxic effects of antifolate chemotherapy such as methotrexate, to mitigate 5‑fluorouracil‑related side effects, and to treat folate deficiency in patients who cannot convert folic acid to its active form.

Folinic acid provides a reduced form of folate that bypasses the dihydrofolate reductase step, directly entering the tetrahydrofolate pool. This supports nucleotide synthesis and methylation reactions, allowing cells to continue DNA replication and repair even when antifolate drugs block the normal folate pathway.

The dose of Leucovorin is individualized by the prescribing clinician based on the specific indication, patient weight, renal function, and concurrent therapies. Healthcare professionals determine the appropriate amount and schedule for each patient.

Leucovorin should only be used during pregnancy or lactation when clearly indicated and after a risk‑benefit assessment by a qualified obstetrician or maternal‑fetal specialist. Potential benefits must outweigh any unknown risks to the fetus or infant.

To order Leucovorin, submit an enquiry on the product page at gnhindia.com specifying the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details (including cold‑chain if needed) and required import documentation.

Unlike folic acid, which requires metabolic activation, folinic acid is already in a reduced form and can be utilized directly by cells. This makes Leucovorin effective for rescuing cells during antifolate chemotherapy and for patients with impaired folate metabolism, whereas regular folic acid may not provide the same rapid therapeutic benefit.

Leucovorin should be stored below 25 °C, in its original packaging, protected from moisture and direct sunlight. Maintain a stable environment and avoid freezing. Follow any additional handling instructions provided by the supplier to preserve sterility and potency.

Leucovorin is supplied as a sterile solution for injection and can be given via epidural, intrabursal or intracoronary routes, depending on the clinical indication. Administration is performed by qualified healthcare professionals following aseptic technique and the prescribing information.

Serious risks include severe allergic reactions (anaphylaxis), acute renal impairment, significant electrolyte disturbances, and unexplained bleeding or bruising. Patients should be monitored closely for these events, and any signs of severe reaction require immediate medical attention.

Leucovorin is contraindicated in patients with known hypersensitivity to folinic acid or any component of the formulation. Caution is also advised for individuals with severe renal or hepatic impairment, and it should be avoided in pregnancy unless the potential benefit justifies the risk.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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