Leucovorin Teva (Calcium Folinate)

Leucovorin Teva is a folate analog used in several therapeutic pathways related to folate metabolism and chemotherapy support.

• Rescue from methotrexate toxicity: restores normal folate pools and reduces toxic effects of high‑dose methotrexate.
• Adjunct in cancer chemotherapy: enhances the efficacy of certain antimetabolite regimens by stabilising DNA synthesis.
• Treatment of folate deficiency: supplies reduced folate to patients with inadequate dietary intake or malabsorption.

• Calcium folinate provides a reduced form of folic acid that bypasses dihydrofolate reductase inhibition. By entering the folate cycle downstream of the blocked step, it restores tetrahydrofolate pools, enabling normal purine and pyrimidine synthesis and supporting DNA replication in healthy cells while allowing antimetabolite drugs to target malignant cells.

Leucovorin Teva is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: loose stools, often transient.
• Rash: skin erythema or itching.
• Fever: low‑grade temperature elevation.
• Headache: mild to moderate head discomfort.
• Elevated liver enzymes: transient increase in hepatic transaminases.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hemolytic anemia: destruction of red blood cells, especially in patients with G6PD deficiency.
• Acute renal failure: sudden loss of kidney function, rare but serious.
• Thromboembolic events: blood clot formation in veins or arteries.
• Hypersensitivity pneumonitis: inflammatory lung condition following exposure.

When handling Leucovorin Teva, consider the following precautions to ensure patient safety and product integrity.

• Assess renal function: adjust use in patients with impaired kidney clearance.
• Monitor hepatic enzymes: watch for liver function changes during therapy.
• Evaluate for G6PD deficiency: avoid use in individuals prone to hemolysis.
• Observe for allergic reactions: discontinue if signs of hypersensitivity appear.
• Use under medical supervision: only administer as directed by a qualified prescriber.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Leucovorin Teva may interact with several medications, requiring careful management.

Major Interactions (Avoid)

• Methotrexate: concurrent use without proper timing can diminish methotrexate's anticancer effect.
• Pemetrexed: may reduce efficacy of this antifolate if given together.
• Trimethoprim: can increase risk of folate deficiency when combined.

Moderate Interactions (Monitor Closely)

• NSAIDs: may affect renal clearance of calcium folinate.
• Phenytoin: can accelerate folate metabolism, lowering therapeutic levels.
• Oral contraceptives: may decrease folate availability, requiring monitoring.