Name of Drug Generic Name: leucovorin Trade Name: Leucovorin Calcium Welcovorin

Classification of Drug Pharmacologic Class: Water soluble vitamin

Mechanism of Action Counteracts therapeutic and toxic effects of folic acid antagonists; may enhance therapeutic and toxic effects of fluoropyrimidines used in cancer therapy. Also supplements folic acid in folic acid deficiency.

Indication Leucovorin rescue after highdose methotrexate therapy To reduce toxicity and counteract effects of impaired methotrexate elimination or inadvertent overdose of folic acid antagonist Advanced colorectal cancer Megaloblastic anemia secondary to folic acid deficiency

Contraindications Contraindicated in: Hypersensitivity Preparations containing benzyl alcohol should not be used in neonates Use Cautiously in: Undiagnosed anemia (may mask the progression of pernicious anemia) OB: Lactation: Safety not established but has been used safely to treat megaloblastic anemia in pregnancy Drug-Drug Interaction May anticonvulsant effect of barbiturates , phenytoin , or primidone

Side Effects Hemat: thrombocytosis (intraarterial methotrexate only). Misc: allergic reactions (rash, urticaria, wheezing).

Nursing Responsibilities Before: 1.Perform handwashing 2.Prepare right dosage of drug 3.Do not use benzyl alcohol solutions when giving drug to premature infants 4.Begin leucovorin rescue within 24 hr of methotrexate administration 5.Arrange for fluid loading & uterine alkalinization During: 1. Verify clients identity 2. Explain the benefits of drugs and side effects 3. Administer drug at the correct site 4. Do not exceed the recommended dosage. 5. Observe strict asepsis After: 1. Thank patient for her cooperation. 2. Provide health education about drug being administered. 3. Keep supportive equipment and emergency drugs in case of allergic response 4. Monitor vital signs 5. Advise patient to report any unsual or undesired sensation. Source: http://www.rxlist.com/le ucovorin-drug.htm

Maximum Dose: 100mg Minimum Dose: 10mg Availability: Tablets : 5, 15, 25 mg Injection 3mg / mL Powder for injection : 50, 100, 350 mg/ vial Patients Dosage:

Therapeutic: antidote to folic acid antagonist, antianemic, antineoplastic adjunct

Absorption: Well absorbed (38%) following PO administration. Bioavailability decreases with larger doses. Oral absorption is saturated at doses >25 mg Distribution: Widely distributed. Concentrates in the CNS and liver Metabolism : Heptaic; T : unknown

Pregnancy Risk Category: C

Excretion : Urine and feces

Route Oral IM IV

Onset 30 mins Rapid Immediat e

Peak 2-.4 hrs 52 mins 10 mins

Duratio n 3-6 hrs 3-6-hrs 3-6 hrs

Patients Indication:

Concurrent use with trimethoprim/sulfametho xazole may result in anti-infective efficacy and poor therapeutic outcome when used to treat Pneumocystis jirovecii pneumonia in HIV patients May therapeutic effects and toxicity of fluorouracil ; therapy may be combined for this purpose

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