Select a medication above to begin.
leucovorin
generic
Adult Dosing .
Dosage forms: TAB: 5 mg, 10 mg, 15 mg, 25 mg; INJ: 10 mg per mL, 20 mg per mL
colorectal CA
- [combo w/ fluorouracil 370 mg/m^2/day]
- Dose: 200 mg/m^2/dose IV x1 on days 1-5 of 28-day cycle; Info: give x2 cycles, then cont. 28-day cycles or extend to 35-day cycles; dosing protocols may vary; see pkg insert for 5-FU dose adjustments based on toxicity
- [combo w/ fluorouracil 425 mg/m^2/day]
- Dose: 20 mg/m^2/dose IV x1 on days 1-5 of 28-day cycle; Info: give x2 cycles, then cont. 28-day cycles or extend to 35-day cycles; dosing protocols may vary; see pkg insert for 5-FU dose adjustments based on toxicity
leucovorin rescue, high-dose methotrexate
- [normal methotrexate elimination]
- Dose: 15 mg PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level approx. 10 micromolar at 24h, 1 micromolar at 48h, and <0.2 micromolar at 72h after methotrexate start; may incr. to 14 doses w/ subsequent cycles if abnormal methotrexate elimination but not severe enough to require adjustments below
- [delayed late methotrexate elimination]
- Dose: 15 mg PO/IM/IV q6h; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level >0.2 micromolar at 72h and >0.05 micromolar at 96h after methotrexate start
- [delayed early methotrexate elimination and/or acute renal injury]
- Dose: 150 mg IV q3h until methotrexate level <1 micromolar, then 15 mg IV q3h; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level >50 micromolar at 24h or >5 micromolar at 48h OR if SCr incr. 100% from baseline at 24h after methotrexate start; use in combo w/ hydration and urinary alkalinization
leucovorin rescue, methotrexate overdose
- [10 mg/m^2/dose PO/IM/IV q6h]
- Start: ASAP after overdose and w/in 24h if delayed methotrexate elimination; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.01 micromolar; incr. dose to 100 mg/m^2/dose IV q3h if SCr incr. 50% from baseline at 24h OR if methotrexate level >5 micromolar at 24h or >0.9 micromolar at 48h
folate antagonist overdose
- [pemetrexed]
- Dose: 50 mg/m^2/dose IV q6h x8 days; Start: 100 mg/m^2/dose IV x1
- [pyrimethamine, trimethoprim]
- Dose: 5-15 mg PO/IM/IV qd until hematopoiesis restored
megaloblastic anemia, folate deficiency-associated
- [<1 mg IM/IV qd]
- Max: 1 mg/day
folate deficiency prevention, pyrimethamine-induced (off-label)
- [PCP or toxoplasmosis prophylaxis use]
- Dose: 25 mg PO qwk
- [toxoplasmosis treatment or maintenance use]
- Dose: 10-25 mg PO qd
- [cystoisosporiasis treatment or maintenance use]
- Dose: 5-25 mg PO qd
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: TAB: 5 mg, 10 mg, 15 mg, 25 mg; INJ: 10 mg per mL, 20 mg per mL
leucovorin rescue, high-dose methotrexate
- [normal methotrexate elimination]
- Dose: 10 mg/m^2/dose PO/IM/IV q6h x10 doses; Start: 24h after methotrexate start; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level approx. 10 micromolar at 24h, 1 micromolar at 48h, and <0.2 micromolar at 72h after methotrexate start; may incr. to 14 doses w/ subsequent cycles if abnormal methotrexate elimination but not severe enough to require adjustments below
- [delayed late methotrexate elimination]
- Dose: 10 mg/m^2/dose PO/IM/IV q6h; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level >0.2 micromolar at 72h and >0.05 micromolar at 96h after methotrexate start
- [delayed early methotrexate elimination and/or acute renal injury]
- Dose: 100 mg/m^2/dose IV q3h until methotrexate level <1 micromolar, then 10 mg/m^2/dose IV q3h; Info: cont. until methotrexate level <0.05 micromolar; use this regimen if methotrexate level >50 micromolar at 24h or >5 micromolar at 48h OR if SCr incr. 100% from baseline at 24h after methotrexate start; use in combo w/ hydration and urinary alkalinization
leucovorin rescue, methotrexate overdose
- [10 mg/m^2/dose PO/IM/IV q6h]
- Start: ASAP after overdose and w/in 24h if delayed methotrexate elimination; Max: 25 mg/dose PO, may give higher doses IM/IV; Info: cont. until methotrexate level <0.01 micromolar; incr. dose to 100 mg/m^2/dose IV q3h if SCr incr. 50% from baseline at 24h OR if methotrexate level >5 micromolar at 24h or >0.9 micromolar at 48h
folate antagonist overdose
- [pyrimethamine, trimethoprim]
- Dose: 5-15 mg PO/IM/IV qd until hematopoiesis restored
megaloblastic anemia, folate deficiency-associated
- [<1 mg IM/IV qd]
- Max: 1 mg/day
folate deficiency prevention, pyrimethamine-induced (off-label)
- [toxoplasmosis prophylaxis or suppression use]
- Dose: 5 mg PO q3 days
- [congenital toxoplasmosis treatment use]
- Dose: 10 mg PO/IM w/ each pyrimethamine dose
- [acquired toxoplasmosis treatment use]
- Dose: 10-25 mg PO qd
- [cystoisosporiasis use]
- Dose: 5-15 mg PO qd
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]