Description
What is Calcium Folinate?
Calcium Folinate is the calcium salt of folinic acid, an active form of folic acid. It belongs to a category of medications known as detoxifying agents. Folinic acid plays a crucial role in DNA synthesis and repair, and its administration counteracts the toxic effects of folic acid antagonists.
Uses of Calcium Folinate
Calcium Folinate serves several key purposes in medical treatment:
| Use | Description |
|---|---|
| Reducing Harmful Effects of Anticancer Drugs | Calcium Folinate helps to mitigate the toxic effects of certain anticancer drugs like methotrexate. This process, known as “Calcium Folinate Rescue,” protects healthy cells while allowing chemotherapy to target cancer cells more effectively. |
| Treating Overdose of Folic Acid Antagonists | In cases of overdose with folic acid antagonists such as methotrexate, Calcium Folinate restores normal folic acid levels and prevents severe side effects. |
| Enhancing the Effectiveness of Fluorouracil | When used with fluorouracil, a chemotherapy drug, Calcium Folinate enhances the efficacy of the treatment, leading to improved outcomes in cancer therapy. |
Dosage
The dosage of Calcium Folinate depends on the condition being treated and the patient’s response to the medication. Typical dosages include:
| Condition | Dosage |
|---|---|
| Methotrexate Rescue | 6-12 mg/m², administered 2-4 hours after the start of methotrexate infusion; repeated every 3-6 hours for up to 72 hours. |
| Enhancing Fluorouracil Effectiveness | 20 mg/m² administered every 6 hours for 5 to 10 minutes, with a total daily dose of 80 mg/m². |
| Treating Overdose of Folic Acid Antagonists | Dosage and frequency depend on the severity of the overdose and patient condition. |
Administration
Calcium Folinate can be given intravenously or intramuscularly. The choice of administration route and dosage adjustments are based on the patient’s medical condition and treatment protocol.
Side Effects
| Type | Side Effects |
|---|---|
| Common | Nausea, vomiting, diarrhea, fatigue |
| Serious | Allergic reactions (rash, itching, swelling, difficulty breathing), seizures, increased risk of infection |
If serious side effects occur, immediate medical attention is necessary.
Precautions
Pregnancy and Breastfeeding
Calcium Folinate is generally considered safe when used alone during pregnancy. However, it should not be used in combination with fluorouracil during pregnancy or breastfeeding due to potential risks to the baby.
Drug Interactions
Calcium Folinate may interact with other medications, including:
- Folic Acid Antagonists: Such as co-trimoxazole and pyrimethamine.
- Anticancer Medications: Like fluorouracil.
- Antiepileptic Drugs: Such as phenobarbital, phenytoin, and primidone.
It is crucial to inform healthcare providers about all medications being taken to avoid potential interactions.
Availability in Tablet Form
Calcium Folinate is also available in tablet form, typically used to prevent and treat the adverse effects of folic acid antagonists like methotrexate. Tablet strengths generally include 5 mg, 15 mg, and 25 mg.
Recommended Dosage Guidelines
For Methotrexate Rescue
- Intravenous (IV) or Intramuscular (IM) Injection: 6-12 mg/m², administered 2-4 hours after the start of methotrexate infusion; repeated every 3-6 hours for up to 72 hours.
For Enhancing Fluorouracil Effectiveness
- Intravenous (IV) Injection: 20 mg/m² every 6 hours for 5 to 10 minutes, totaling 80 mg/m² daily.
For Treating Overdose of Folic Acid Antagonists
- Intravenous (IV) or Intramuscular (IM) Injection: Dosage and frequency are adjusted based on overdose severity and patient condition.
For Oral Administration
- Tablets: 15 mg (1 tablet) every 6 hours for 48 hours following certain anticancer treatments.
These guidelines are general, and the exact dosage should be personalized by a healthcare professional.
Maximum Recommended Duration of Treatment
For Methotrexate Rescue
- Duration: Typically administered every 6 hours for 72 hours. If significant toxicity is observed, the treatment may be extended for an additional 24 hours.
For Enhancing Fluorouracil Effectiveness
- Duration: Usually repeated every 2 weeks for 6 to 12 cycles.
For Treating Overdose of Folic Acid Antagonists
- Duration: Depends on overdose severity and patient condition. Adhere to healthcare provider instructions.
Monitoring Requirements During Treatment
Monitoring during Calcium Folinate treatment is essential for effectiveness and safety:
| Aspect | Monitoring Requirement |
|---|---|
| Serum Methotrexate Levels | Regular monitoring of serum methotrexate concentration to determine optimal Calcium Folinate dosage and duration. |
| Renal Function | Daily measurements of serum creatinine levels to ensure methotrexate excretion and maintain urine alkalinization. |
| Blood Levels | Monitor residual methotrexate levels at intervals (e.g., 48 hours post-administration) to adjust Calcium Folinate dosage. |
| General Health and Side Effects | Regular check-ups to monitor for side effects such as allergic reactions or increased infection risk. |
Interaction with Other Supplements or Vitamins
Calcium Folinate can generally be taken with other supplements or vitamins, but attention should be given to potential interactions:
- Iron or Zinc Supplements: These should be taken several hours apart from calcium supplements to avoid interaction.
- Tetracycline Antibiotics: Should also be taken several hours apart from calcium.
- Levothyroxine: For hypothyroidism, should be taken several hours before or after calcium to prevent interactions.
Vitamin D
Adequate vitamin D is important as it enhances calcium absorption.
General Advice
Consult with a healthcare provider before starting new supplements to ensure safety and appropriateness.
Administration with or without Food
Calcium Folinate can be taken with or without food. However, taking it with food may reduce the risk of gastrointestinal side effects:
- With Food: Helps minimize potential nausea or stomach discomfort.
- On an Empty Stomach: Effective, but follow specific instructions for other medications to avoid interactions.
Always consult with your healthcare provider for personalized advice based on your health needs and other medications you may be taking.
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