Fusilev

Adult Dosing .

Dosage forms:  INJ

levoleucovorin rescue, high-dose methotrexate

[normal methotrexate elimination]

Dose: 7.5 mg IV q6h x10 doses; Start: 24h after methotrexate start; 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; use in combo w/ hydration and urinary alkalinization

[delayed late methotrexate elimination]

Dose: 7.5 mg IV q6h; 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; use in combo w/ hydration and urinary alkalinization

[delayed early methotrexate elimination and/or acute renal injury]

Dose: 75 mg IV q3h until methotrexate level <1 micromolar, then 7.5 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

levoleucovorin rescue, methotrexate overdose

[7.5 mg IV q6h]

Start: ASAP after overdose and w/in 24h if delayed methotrexate elimination; Info: cont. until methotrexate level <0.01 micromolar; incr. dose to 50 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; use in combo w/ hydration and urinary alkalinization

colorectal CA

[combo w/ fluorouracil 370 mg/m^2/day]

Dose: 100 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: 10 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

renal dosing

[not defined]

renal impairment: not defined

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

levoleucovorin rescue, high-dose methotrexate

[normal methotrexate elimination, 6 yo and older]

Dose: 5 mg/m^2/dose IV q6h x10 doses; Start: 24h after methotrexate start; 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; use in combo w/ hydration and urinary alkalinization

[delayed late methotrexate elimination, 6 yo and older]

Dose: 5 mg/m^2/dose IV q6h; 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; use in combo w/ hydration and urinary alkalinization

[delayed early methotrexate elimination and/or acute renal injury, 6 yo and older]

Dose: 50 mg/m^2/dose IV q3h until methotrexate level <1 micromolar, then 5 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

levoleucovorin rescue, methotrexate overdose

[6 yo and older]

Dose: 5 mg/m^2/dose IV q6h; Start: ASAP after overdose and w/in 24h if delayed methotrexate elimination; Info: cont. until methotrexate level <0.01 micromolar; incr. dose to 50 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; use in combo w/ hydration and urinary alkalinization

renal dosing

[not defined]

renal impairment: not defined

HD/PD: not defined

hepatic dosing

[not defined]