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Therapeutic class: Vitamer Pharmacologic class: Reduced folic acid derivative Use\ Indications 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. There is no apparent effect on preexisting methotrexate-induced nephrotoxicity. Pharmacological Effects Folinic acid is a 5-formyl derivative of tetrahydrofolic acid. It is readily converted to other reduced folic acid derivatives (e.g., tetrahydrofolate), and, thus, has vitamin activity that is equivalent to that of folic acid. Adverse Reactions Leucovorin in combination with fluorouracil: leukopenia, nausea, vomiting, diarrhea, stomatitis, lethargy/malaise/fatigue, alopecia, dermatitis, anorexia. Precautions/Warnings/Contraindication Folinic acid should not be administered intrathecally. This may produce severe adverse effects or even death Pernicious anemia or other megaloblastic anemias secondary to lack of vitamin B12; such use may obscure diagnosis of pernicious anemia by alleviating hematologic manifestations while allowing neurologic complications to progress. Interactions: Anticonvulsants, Fluorouracil, Glucarpidase, Co-trimoxazole Dosing Adults and children: Not more than 25mg dose is recommended Brand Names Parenteral: Kunyrin 15mg, 50mg Leucovorin 15mg Tablet: Kunyrin 15mg Tablet.