Calcium Folinate Injection

• Also Known As: Leucovorin Calcium Injection

• Type: Folate (Vitamin B9) derivative / Rescue agent

• Form: Injectable solution (usually given intravenously or intramuscularly)

How It Works

• Calcium folinate is the active, reduced form of folic acid.

• It bypasses the steps required to activate folic acid in the body, providing ready-to-use folate for cells.

• This helps rescue normal cells from the toxic effects of drugs like methotrexate, which block folate metabolism.

• Also enhances the effects of some chemotherapy drugs (like 5-fluorouracil) when used together.

Common Uses

• Leucovorin Rescue:

  • Given after high-dose methotrexate therapy to protect healthy cells and prevent severe toxicity

• Enhancement of Chemotherapy:

  • Combined with 5-fluorouracil (5-FU) to improve its cancer-fighting effect (commonly used in colorectal cancer)

• Treatment of Folate Deficiency:

  • Especially when rapid correction is needed or oral therapy isn’t possible

• Antidote for Certain Poisonings:

  • Used in methanol or trimethoprim overdose (as directed by a doctor)

Advantages

• Life-saving in preventing severe bone marrow and gastrointestinal toxicity from methotrexate

• Can boost the effectiveness of chemotherapy when used in combination

• Works quickly when given intravenously

Possible Side Effects

• Usually well tolerated

• Rare side effects may include:

  • Allergic reactions (rash, itching)

  • Fever or chills

  • Nausea, vomiting, diarrhea

  • Seizures (very rare, usually with very high doses)

Precautions

• Must be given at the correct time and dose after methotrexate therapy — timing is critical for effectiveness

• Dose may need to be adjusted based on blood methotrexate levels

• Should be used cautiously in patients with seizure disorders (may increase risk of seizures)

• Always administered under supervision of trained medical staff