Diferencia entre revisiones de «Leucovorin»
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric)) |
(Restore original dosing content alongside dynamic SMW tables) |
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| Línea 6: | Línea 6: | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Fluorouracil adjuvant treatment, adv. colorectal CA | |||
**high dose: 200mg/m^2 IV QD x5 days | |||
**low dose: 20mg/m^2 IV QD x5 days | |||
*Leucovorin rescue, high-dose [[methotrexate]] | |||
**normal methotrexate elimination: 15mg PO/IM/IV q6h x10 doses | |||
**delayed late methotrexate elimination: 15mg PO/IM/IV q6h; Max: 25mg/dose PO, May give higher doses IM/IV | |||
*Delayed early methotrexate elimination and/or acute renal injury: 150mg IV q3h until methotrexate level <1 micromolar, then 15mg IV q3h | |||
*Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h | |||
*Folate antagonist overdose | |||
**pemetrexed: 50mg/m^2 IV q6h x8 days; Start: 100mg/m^2 IV x1 | |||
**pyrimethamine, trimethoprim: 5-15mg PO/IM/IV QD until hematopoiesis restored | |||
*Megaloblastic anemia, folate-deficient: <1mg IM/IV QD | |||
**Max: 1mg/day | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Adult]] | {{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Adult]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Leucovorin rescue, high-dose methotrexate | |||
**normal methotrexate elimination: 10mg/m^2 PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25mg/dose PO | |||
**delayed late methotrexate elimination: 10mg/m^2 PO/IM/IV q6h; Max: 25mg/dose PO | |||
**delayed early methotrexate elimination and/or acute renal injury: 100mg/m^2 IV q3h until methotrexate level <1 micromolar, then 10mg/m^2 IV q3 | |||
*Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h | |||
*Folate antagonist overdose: 5-15mg PO/IM/IV QD until hematopoiesis restored | |||
*Megaloblastic anemia, folate-deficient: <1mg IM/IV QD | |||
**Max: 1mg/day | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Pediatric]] | {{#ask: [[Has DrugName::Leucovorin]] [[Has Population::Pediatric]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
Revisión del 02:37 20 mar 2026
Administration
- Type: Antidote; Chemotherapy Modulating Agent; Rescue Agent (Chemotherapy)
- Dosage Forms: 5,10,15,25
- Routes of Administration: IV, IM
- Common Trade Names: Lederle Leucovorin
Adult Dosing
- Fluorouracil adjuvant treatment, adv. colorectal CA
- high dose: 200mg/m^2 IV QD x5 days
- low dose: 20mg/m^2 IV QD x5 days
- Leucovorin rescue, high-dose methotrexate
- normal methotrexate elimination: 15mg PO/IM/IV q6h x10 doses
- delayed late methotrexate elimination: 15mg PO/IM/IV q6h; Max: 25mg/dose PO, May give higher doses IM/IV
- Delayed early methotrexate elimination and/or acute renal injury: 150mg IV q3h until methotrexate level <1 micromolar, then 15mg IV q3h
- Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
- Folate antagonist overdose
- pemetrexed: 50mg/m^2 IV q6h x8 days; Start: 100mg/m^2 IV x1
- pyrimethamine, trimethoprim: 5-15mg PO/IM/IV QD until hematopoiesis restored
- Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
- Max: 1mg/day
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Toxoplasmosis | 10mg PO q24hrs | Immunocompetent adjunct |
| Toxoplasmosis | 25mg PO q24hrs | Immunosuppressed adjunct |
Pediatric Dosing
- Leucovorin rescue, high-dose methotrexate
- normal methotrexate elimination: 10mg/m^2 PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25mg/dose PO
- delayed late methotrexate elimination: 10mg/m^2 PO/IM/IV q6h; Max: 25mg/dose PO
- delayed early methotrexate elimination and/or acute renal injury: 100mg/m^2 IV q3h until methotrexate level <1 micromolar, then 10mg/m^2 IV q3
- Leucovorin rescue, methotrexate overdose: 10mg/m^2 PO/IM/IV q6h
- Folate antagonist overdose: 5-15mg PO/IM/IV QD until hematopoiesis restored
- Megaloblastic anemia, folate-deficient: <1mg IM/IV QD
- Max: 1mg/day
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Toxoplasmosis | 10mg PO 3x/week | Congenital/Pediatric adjunct |
Special Populations
- Pregnancy Risk Factor: C
- Breast Feeding: Leucovorin is a form of folic acid and is present in breast milk which may be beneficial to the newborn.
Renal Dosing
- Not defined
Hepatic Dosing
- Not defined
Contraindications
- Allergy to class/drug
- intrathecal administration
- caution if pernicious anemia
- caution if megaloblastic anemia, vitamin B12 deficient
- caution if vitamin B-12 deficiency
Adverse Reactions
Serious
- anaphylactoid reaction
- seizures
- syncope
Common
- urticaria
- nausea/vomiting (IV use)
Pharmacology
- Half-life: 6hr
- Metabolism: liver, GI, CYP450
- Excretion: Urine
Mechanism of Action
Comments
See Also
References
<Epocrates, UpToDate>