Leucovorin

Folinic acid

Clinical data
Pronunciation	Leucovorin /luːkoʊˈvɔːrɪn/
Trade names	Many
AHFS/Drugs.com	Monograph
Pregnancy category	AU: A US: C (Risk not ruled out)
Routes of administration	intravenous, IM, by mouth
ATC code	V03AF03 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	Dose dependent
Protein binding	~15%
Biological half-life	6.2 hours
Excretion	Urinary
Identifiers
IUPAC name (2S)-2-{[4-[(2-amino-5-formyl-4-oxo-5,6,7,8- tetrahydro-1H-pteridin-6-yl)methylamino] benzoyl]amino}pentanedioic acid
Synonyms	citrovorum factor, 5-formyltetrahydrofolate
CAS Number	1492-18-8 Y
PubChem CID	6006
IUPHAR/BPS	4816
DrugBank	DB00650 N
ChemSpider	5784 Y
UNII	RPR1R4C0P4
ChEMBL	CHEMBL1679 Y
ECHA InfoCard	100.014.621
Chemical and physical data
Formula	C20H23N7O7
Molar mass	473.44 g/mol
3D model (Jmol)	Interactive image
Melting point	245 °C (473 °F) decomp
SMILES O=C(O)[C@@H](NC(=O)c1ccc(cc1)NCC3N(/C2=C(/N/C(=N\C2=O)N)NC3)C=O)CCC(=O)O
InChI InChI=1S/C20H23N7O7/c21-20-25-16-15(18(32)26-20)27(9-28)12(8-23-16)7-22-11-3-1-10(2-4-11)17(31)24-13(19(33)34)5-6-14(29)30/h1-4,9,12-13,22H,5-8H2,(H,24,31)(H,29,30)(H,33,34)(H4,21,23,25,26,32)/t12?,13-/m0/s1 Y Key:VVIAGPKUTFNRDU-ABLWVSNPSA-N Y
NY (what is this?)

Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. It is also used in combination with 5-fluorouracil to treat colorectal cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning. It is taken by mouth, injection into a muscle, or injection into a vein.

Side effects may include trouble sleeping, allergic reactions, or fever. Use in pregnancy or breastfeeding is generally regarded as safe. When used for anemia it is recommended that pernicious anemia as a cause be ruled out first. Folinic acid is a form of folic acid that does not require activation by dihydrofolate reductase to be useful to the body.

Folinic acid was first made in 1945. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In the United Kingdom it costs the NHS about 4.62 pounds per 30 mg vial.

Folinic acid is administered at the appropriate time following methotrexate as part of a total chemotherapeutic plan, where it may "rescue" bone marrow and gastrointestinal mucosa cells from methotrexate. No apparent effect is seen on pre-existing methotrexate-induced nephrotoxicity. Folinic acid can be taken as a pill (orally) or injected into a vein (intravenously) or muscle (intramuscularly).