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Levoleucovorin Brand Names- Fusilev | KHAPZORY
What is Levoleucovorin
Levoleucovorin is approved by the FDA as rescue therapy following high-dose methotrexate (12 grams/m2 IV over 4 hours) treatment in patients with osteosarcoma and to reduce toxicity associated with inadvertent folic acid antagonist overdose or impaired methotrexate elimination.
The Fusilev and Khapzory brands are also approved for the palliative treatment of advanced metastatic colorectal cancer, in combination with 5-fluorouracil.
Levoleucovorin is the levo isomeric form of racemic (d,l)-leucovorin and the pharmacologically active isomer of 5-formyl tetrahydrofolic acid (folinic acid).
Levoleucovorin does not require reduction by the enzyme dihydrofolate reductase; it forms 5-methyltetrahydrofolate (5-MTHF), a reduced (active) folate.
Levoleucovorin counteracts the toxic effects of folic acid antagonists such as methotrexate and is used to ameliorate the hematologic toxicity associated with high-dose methotrexate therapy or other folic acid antagonist overdose.
Levoleucovorin also enhances the therapeutic and toxic effects of fluoropyrimidines, such as 5-fluorouracil.
Indications
- colorectal cancer
- methotrexate toxicity prophylaxis
For methotrexate toxicity prophylaxis
as rescue therapy following the administration of high-dose methotrexate (12 grams/m2 IV over 4 hours) in patients with osteosarcoma
NOTE: The FDA has designated levoleucovorin as an orphan drug for use in conjunction with high-dose methotrexate in the treatment of osteosarcoma.
Side Effects
- abdominal pain
- abdominal pain
- alopecia
- alopecia
- anorexia
- anorexia
- asthenia
- asthenia
- atopic dermatitis
- atopic dermatitis
- chills
- confusion
- diarrhea
- diarrhea
- dysgeusia
- dyspepsia
- dyspnea
- fatigue
- fatigue
- fever
- malaise
- malaise
- nausea
- nausea
- peripheral neuropathy
- pruritus
- rash
- seizures
- stomatitis
- stomatitis
- syncope
- typhlitis
- vomiting
- vomiting
Monitoring Parameters
- serum creatinine
Contraindications
- breast-feeding
- children
- dehydration
- diarrhea
- folic acid hypersensitivity
- geriatric
- pernicious anemia
- pregnancy
- renal disease
- renal impairment
- seizure disorder
- vitamin B12 deficiency megaloblastic anemia
Levoleucovorin is contraindicated in patients with a history of folic acid hypersensitivity or folinic acid hypersensitivity.
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Amobarbital
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Butabarbital
- Capecitabine
- Floxuridine
- Fluorouracil, 5-FU
- Fosphenytoin
- Glucarpidase
- Mephobarbital
- Methohexital
- Pentobarbital
- Phenobarbital
- Phenytoin
- Primidone
- Secobarbital
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Thiopental
- Trimethoprim
- Trimetrexate
