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Leucovorin Calcium (Leucovorin Calcium)

Trade Name : Leucovorin Calcium

West-Ward Pharmaceuticals Corp.

TABLET

Strength 5 mg/1

LEUCOVORIN CALCIUM Folate Analog [EPC],Folic Acid [CS]

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Trade Marks displayed in compliance with provisions of: Trademark Act, 1999 u/s 30 and 30 (1) of "Fair use"

GNH India is WHO GDP and ISO 9001 2015 Certified Pharmaceutical Wholesaler/ Supplier/ Exporters/ Importer from India of Leucovorin Calcium (Leucovorin Calcium) which is also known as Leucovorin Calcium and Manufactured by West-Ward Pharmaceuticals Corp.. It is available in strength of 5 mg/1 per ml. Read more

Leucovorin Calcium (Leucovorin Calcium) is supplied for Tenders/ Emergency imports/ Un - licensed, Specials, Orphan drug/ Name patient line/ RLD supplies/ Reference listed drugs/ Comparator Drug/ Bio-Similar/ Innovator samples For Clinical trials.  Click to know price.     Read less

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We deliver your medicines through a validated cold chain shipment process. This process is used as these medicines need to manufactured, transported and stored at very specific temperatures, utilizing thermal and refrigerated packaging methods.

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We deliver your medicines through a validated cold chain shipment process. This process is used as these medicines need to manufactured, transported and stored at very specific temperatures, utilizing thermal and refrigerated packaging methods.

We deliver your medicines through a validated cold chain shipment process. This process is used as these medicines need to manufactured, transported and stored at very specific temperatures, utilizing thermal and refrigerated packaging methods.

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  • Leucovorin calcium tablets USP contain either 5 mg, 10 mg, 15 mg or 25 mg leucovorin as the calcium salt of -[4-[[(2-amino-5-formyl-1,4,5,6,7,8-hexahydro-4-oxo-6-pteridinyl)methyl] amino]benzoyl]--glutamic acid. This is equivalent to either 5.4 mg, 10.8 mg, 16.21 mg or 27.01 mg of anhydrous leucovorin calcium USP, respectively. In addition, each tablet contains the following : colloidal silicon dioxide, croscarmellose sodium, D&C yellow #10 (15 mg and 25 mg), magnesium stearate, microcrystalline cellulose, povidone and pregelatinized starch.
  • Leucovorin is a water soluble form of reduced folate in the folate group; it is useful as an antidote to drugs which act as folic acid antagonists. These tablets are intended for oral administration only.
  • The structural formula of leucovorin calcium is:
  • CHCaNO M.W. 511.51
  • Leucovorin is a racemic mixture of the diastereoisomers of the 5-formyl derivative of tetrahydrofolic acid. The biologically active compound of the mixture is the (-)--isomer, known as , or (-)-folinic acid. Leucovorin does require reduction by the enzyme dihydrofolate reductase in order to participate in reactions utilizing folates as a source of u201cone-carbonu201d moieties. Following oral administration, leucovorin is rapidly absorbed and enters the general body pool of reduced folates. The increase in plasma and serum folate activity (determined microbiologically with ) seen after oral administration of leucovorin is predominantly due to 5-methyltetrahydrofolate.
  • Twenty normal men were given a single, oral 15 mg dose (7.5 mg/m) of leucovorin calcium and serum folate concentrations were assayed with . Mean values observed (u00b1 one standard error) were:
  • a) Time to peak serum folate concentration: 1.72 u00b1 0.08 hours,
  • b) Peak serum folate concentration achieved: 268 u00b1 18 ng/mL,
  • c) Serum folate half-disappearance time: 3.5 hours.
  • Oral tablets yielded areas under the serum folate concentration-time curves (AUCs) that were 12% greater than equal amounts of leucovorin given intramuscularly and equal to the same amounts given intravenously.
  • Oral absorption of leucovorin is saturable at doses above 25 mg. The apparent bioavailability of leucovorin was 97% for 25 mg, 75% for 50 mg and 37% for 100 mg.
  • Leucovorin is indicated to diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosages of folic acid antagonists.
  • Leucovorin is improper therapy for pernicious anemia and other megaloblastic anemias secondary to the lack of vitamin B. A hematologic remission may occur while neurologic manifestations continue to progress.
  • In the treatment of accidental overdosage of folic acid antagonists, leucovorin should be administered as promptly as possible. As the time interval between antifolate administration (e.g., methotrexate) and leucovorin rescue increases, leucovorinu2019s effectiveness in counteracting hematologic toxicity decreases.
  • Monitoring of the serum methotrexate concentration is essential in determining the optimal dose and duration of treatment with leucovorin.
  • Delayed methotrexate excretion may be caused by a third space fluid accumulation (i.e., ascites, pleural effusion), renal insufficiency, or inadequate hydration. Under such circumstances, higher doses of leucovorin or prolonged administration may be indicated. Doses higher than those recommended for oral use must be given intravenously.
  • Leucovorin may enhance the toxicity of fluorouracil. Deaths from severe enterocolitis, diarrhea, and dehydration have been reported in elderly patients receiving weekly leucovorin and fluorouracil. Concomitant granulocytopenia and fever were present in some but not all of the patients.
  • The concomitant use of leucovorin with trimethoprim-sulfamethoxazole for the acute treatment of pneumonia in patients with HIV infection was associated with increased rates of treatment failure and mortality in a placebo-controlled study.
  • No data
  • Allergic sensitization, including anaphylactoid reactions and urticaria, has been reported following the administration of both oral and parenteral leucovorin.
  • Excessive amounts of leucovorin may nullify the chemotherapeutic effect of folic acid antagonists.
  • Leucovorin calcium tablets are intended for oral administration. Because absorption is saturable, oral administration of doses greater than 25 mg is not recommended.
  • Leucovorin rescue should begin as soon as possible after an inadvertent overdosage and within 24 hours of methotrexate administration when there is delayed excretion (see ). Leucovorin 15 mg (10 mg/m) should be administered IM, IV, or PO every 6 hours until the serum methotrexate level is less than 10 M. In the presence of gastrointestinal toxicity, nausea, or vomiting, leucovorin should be administered parenterally.
  • Serum creatinine and methotrexate levels should be determined at 24-hour intervals. If the 24-hour serum creatinine has increased 50% over baseline or if the 24-hour methotrexate level is greater than 5 x 10 M or the 48-hour level is greater than 9 x 10 M, the dose of leucovorin should be increased to 150 mg (100 mg/m) IV every 3 hours until the methotrexate level is less than 10 M. Doses greater than 25 mg should be given parenterally (see ).
  • Hydration (3 L/d) and urinary alkalinization with sodium bicarbonate should be employed concomitantly. The bicarbonate dose should be adjusted to maintain the urine pH at 7.0 or greater.
  • The recommended dose of leucovorin to counteract hematologic toxicity from folic acid antagonists with less affinity for mammalian dihydrofolate reductase than methotrexate (i.e., trimethoprim, pyrimethamine) is substantially less, and 5 to 15 mg of leucovorin per day has been recommended by some investigators.
  • Patients who experience delayed early methotrexate elimination are likely to develop reversible non-oliguric renal failure. In addition to appropriate leucovorin therapy, these patients require continuing hydration and urinary alkalinization, and close monitoring of fluid and electrolyte status, until the serum methotrexate level has fallen below 0.05 micromolar and the renal failure has resolved.
  • Some patients will have abnormalities in methotrexate elimination or renal function following methotrexate administration, which are significant but less severe. These abnormalities may or may not be associated with significant clinical toxicity. If significant clinical toxicity is observed, leucovorin rescue should be extended for an additional 24 hours (total 14 doses over 84 hours) in subsequent courses of therapy. The possibility that the patient is taking other medications which interact with methotrexate (e.g., medications which may interfere with methotrexate elimination or binding to serum albumin) should always be reconsidered when laboratory abnormalities or clinical toxicities are observed.
  • Leucovorin Calcium Tablets USP
  • 5 mg tablets are supplied as an off-white, round, slightly biconvex tablet; scored on one side and product identification u201c54 293u201d debossed on the other side.
  • NDC 0054-8496-19: 5x10 Unit-Dose
  • NDC 0054-4496-13: Bottle of 30 Tablets
  • NDC 0054-4496-25: Bottle of 100 Tablets
  • 10 mg tablets are supplied as an off-white, round, slightly biconvex tablet; scored on one side and product identification u201c54 942u201d debossed on the other side.
  • NDC 0054-4497-05: Bottle of 12 Tablets
  • NDC 0054-4497-10: Bottle of 24 Tablets
  • 15 mg tablets are supplied as an yellow, round, slightly biconvex tablet; scored on one side and product identification u201c54 650u201d debossed on the other side.
  • NDC 0054-4498-10: Bottle of 24 Tablets
  • 25 mg tablets are supplied as an yellow, round, slightly biconvex tablet; scored on one side and product identification u201c54 013u201d debossed on the other side.
  • NDC 0054-4499-11: Bottle of 25 Tablets
  • Store at 20u00b0 to 25u00b0C (68u00b0 to 77u00b0F). [See USP Controlled Room Temperature.]
  • Protect From Light and Moisture.
  • References
  • Distr. by: Eatontown, NJ 07724
  • Revised March 2016
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