Folinic acid

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Calcium folinate; disodium salt; Folinic acid; Sodium folinate

Definition
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Metabolically active form of folic acid (vitamin from the vitamin B complex).

Indication
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Substitution therapy in patients undergoing methotrexate or cotrimoxazole therapy with pronounced megalocytic anaemia (folic acid has no effect in this indication because the enzymes that convert folic acid into the metabolically active form of folinic acid are inhibited).

Dosage and method of use
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  • For folic acid deficiency: 5- max. 15 mg/day p.o. or i.v.
  • As a comedication in methotrexate therapy, see below Table 1.

Undesirable effects
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Allergic reactions, bronchospasm, dyspnoea, CNS disorders, gastrointestinal disorders.

Interactions
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See Table 2.

Contraindication
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Megaloblastic anemia due to isolated vitamin B12 deficiency.

Preparations
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Leucovorin (folic acid), Oncofolic, Vorina

Note(s)
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S.a. Methotrexate regarding the simultaneous administration of folic acid during MTX therapy.

Literature
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  1. Weatherhead SC et al (2007) An open-label, dose-ranging study of methotrexate for moderate-to-severe adult atopic eczema. Br J Dermatol 156: 346-351

Tables
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Dosage of folinic acid as a function of MTX level

Methotrexate serum levels [M]

Folinic acid per 6 hours [mg]

5 x 10-5

20

1 x 10-6

100

2 x 10-6

200

> 2 x 10-6

proportional rise


Interactions of folinic acid

Fluorouracil

Fluorouracil effect ↑

Methotrexate

MTX Effect ↓

Primidone

Folinic acid levels ↓

Pyrimethamine

Pyrimethamine effect ↓

Outgoing links (2)

Cotrimoxazole; Methotrexate;

Authors

Last updated on: 29.10.2020