Description
Leucovorin injection is used as a rescue after high-dose methotrexate treatment. This medicine is also used to lessen the toxic effects of methotrexate in patients who cannot eliminate methotrexate properly from their bodies. It is also used to lessen the toxic effects of folic acid antagonists or dihydrofolate reductase (DHFR) inhibitors after an overdose.
Leucovorin injection is used to treat megaloblastic anemia caused by folic acid deficiency in patients who cannot receive medicines by mouth. This medicine is also used together with fluorouracil to treat metastatic (cancer that has spread) colon or rectal cancer.
This medicine is to be given only by or under the immediate supervision of your doctor.
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of leucovorin injection in children as rescue after high-dose methotrexate treatment and to lessen the toxic effects of folic acid antagonists or dihydrofolate reductase (DHFR) inhibitors after an overdose. Safety and efficacy have been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of leucovorin injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving this medicine.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Capecitabine
- Doxifluridine
- Fluorouracil
- Glucarpidase
- Sulfamethoxazole
- Tegafur
- Trimethoprim
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Hypercalcemia (high calcium in the blood) or
- Kidney disease—Use with caution. May make these conditions worse.
Proper Use
A doctor or other trained health professional will give you or your child this medicine in a hospital. This medicine is given as a shot into a muscle or into your vein.
This medicine should be given at least 2 hours before or 2 hours after receiving glucarpidase.
Precautions
It is very important that your doctor check your progress closely while you are receiving this medicine to make sure it is working properly. Blood and urine tests may be needed to check for unwanted effects.
This medicine may cause a serious allergic reaction called anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
- Black, tarry stools
- bleeding gums
- blood in urine or stools
- chest pain
- chills
- cough
- fever
- painful or difficult urination
- pinpoint red spots on the skin
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
- trouble breathing
- unusual bleeding or bruising
- unusual tiredness or weakness
Incidence not known
- Chest tightness
- difficulty swallowing
- dizziness
- fast heartbeat
- hives, itching, skin rash
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Constipation
- diarrhea
- loss of appetite
- loss or thinning of the hair
- nausea
- swelling or inflammation of the mouth
- unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
- vomiting
- weight loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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