Levofolinate De Sodium Medac (Levoleucovorin Disodium)

Levoleucovorin Disodium is used in oncology and supportive care to counteract the effects of antifolate chemotherapy agents.

• High‑dose methotrexate therapy: reduces systemic toxicity and facilitates rapid clearance of methotrexate.
• Fluoropyrimidine‑based chemotherapy (e.g., 5‑FU, capecitabine): lessens mucosal and hematologic adverse effects.
• Folate deficiency in patients receiving antifolate drugs: restores intracellular folate pools.

• Levoleucovorin Disodium is a reduced form of folic acid that bypasses dihydrofolate reductase, directly supplying 5‑methyltetrahydrofolate to cells. This restores folate‑dependent one‑carbon transfer reactions, supporting DNA synthesis and repair in normal tissues while allowing antifolate agents to continue inhibiting tumor cell proliferation.

Levoleucovorin Disodium is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Vomiting: occasional emesis after infusion.
• Diarrhea: transient loose stools.
• Rash: mild skin erythema.
• Fever: low‑grade temperature elevation.
• Headache: transient mild headache.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Hypotension: sudden drop in blood pressure during infusion.
• Renal impairment: worsening kidney function in susceptible patients.
• Severe allergic reactions: angioedema or bronchospasm.
• Cardiac arrhythmia: irregular heart rhythm in rare cases.

When using Levoleucovorin Disodium, clinicians should consider several safety measures.

• Renal function: assess baseline creatinine and monitor during therapy.
• Hepatic impairment: use with caution and monitor liver enzymes.
• Concurrent antifolate therapy: adjust timing to avoid antagonism.
• Pregnancy: administer only if potential benefits justify the risk.
• Allergy: discontinue immediately if hypersensitivity signs appear.
• Store at ambient temperature: keep in original container, protect from moisture and light.

Levoleucovorin Disodium may interact with other medications, requiring monitoring.

Major Interactions (Avoid)

• Concurrent high‑dose pemetrexed: may diminish the rescue effect of levoleucovorin.
• Strong folate antagonists (e.g., trimethoprim at high doses): can reduce efficacy of levoleucovorin.

Moderate Interactions (Monitor Closely)

• Nephrotoxic agents (e.g., aminoglycosides): increased risk of renal toxicity.
• NSAIDs: may affect renal clearance of folate compounds.
• Loop diuretics: can alter folate excretion and plasma levels.
• Vitamin B12 deficiency: may exacerbate hematologic effects if not corrected.