Reduced folate
Folinic acid (calcium folinate)
Brand names: Refolinon, Lederfolin
Adult dose
Dose: Methotrexate rescue: 15mg every 6h until methotrexate <0.05 micromol/L. With 5-FU: per protocol
Route: PO/IV/IM
Frequency: per protocol
Clinical pearls
- Methotrexate rescue (high-dose), accidental overdose, or toxicity
- Potentiates 5-FU; treats trimethoprim-induced megaloblastic anaemia
Contraindications
- Pernicious anaemia or B12 deficiency
Side effects
- Allergic reaction
- GI upset
Interactions
- Phenytoin/phenobarbital (reduced anticonvulsant effect at high doses)
- 5-FU enhanced
Monitoring
- Methotrexate level
- FBC
Reference: BNF; UKHCDO; https://bnf.nice.org.uk/drugs/folinic-acid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
Same specialty