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Overview

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This medicine contains an important and useful components, as it consists of
Folinic Acid (Calcium Folinate) (as anhydrous)is available in the market in concentration

Name

Folinic Acid

Precaution

Undiagnosed megaloblastic anaemia, folate dependent tumors; pregnancy. Monitor calcium levels in patients receiving combined 5-Fluorouracil/Folinic acid treatment. To be given parenterally in the presence of GI toxicity, nausea or vomiting. Monitor serum levels of methotrexate to determine the optimal dose and duration of folinic acid admin. Monitor CBC, electrolytes and liver function tests before and regularly during treatment.

Indication

Colorectal cancer, Methotrexate toxicity, Megaloblastic anaemia

Contra indication

Hypersensitivity, pernicious anaemia and other megaloblastic anaemias secondary to vit B12-deficiency, intrathecal and intraventricular admin.

Side Effect

Allergic sensitisation, rash, pruritus, eythema, urticaria, nausea, vomiting, pyrexia.

Pregnancy Category ID

Mode of Action

Calcium folinate enters the cells as 5-methyl tetrahydrofolate and supplies the cofactor blocked by methotrexate. It stabilises the binding of 5-dUMP and thrymidylate synthetase, enhances flourouracil activity and neutralises the effects of folic acid antagonists such as methotrexate but increases those of 5-fluorouracil.

Interaction

Fluorouracil: Folinic acid may increase the toxicity associated with fluorouracil if the two are administered together. Some adverse effects that have occurred, particularly in elderly patients, include severe enterocolitis, diarrhea, and dehydration. Sulfamethoxazole-trimethoprim: A potential drug interaction exists with concomitant use of sulfamethoxazole-trimethoprim and folinic acid. Folinic acid has been shown to decrease the efficacy of sulfamethoxazole-trimethoprim in the treatment of pneumocystis carinii, a common cause of pneumonia in AIDs patients