Before taking Leucovorin, tell your healthcare provider about your complete medical history, any allergies you have, and all prescription medications, over-the-counter medicines, vitamins, and herbal supplements you are taking. This information helps your healthcare provider determine whether Leucovorin is appropriate for you and whether any special precautions are needed during treatment.
Allergic Reactions
Do not take Leucovorin if you have had an allergic reaction to:
- Leucovorin (calcium folinate)
- Levoleucovorin
- Folic acid
- Folinic acid
- Any of the ingredients in the medication
Tell your healthcare provider or pharmacist if you have a history of medication allergies or other severe allergic reactions. Seek immediate medical attention if you develop symptoms of an allergic reaction, such as a rash, itching, swelling of the face or throat, severe dizziness, or difficulty breathing.
Increased Toxicity When Used With Fluorouracil
Leucovorin is sometimes given together with fluorouracil (5-FU) to improve the effectiveness of cancer treatment. However, this combination can also increase the risk of serious side effects because Leucovorin enhances the effects of fluorouracil.
Older adults may be especially sensitive to this combination and have a higher risk of developing severe or life-threatening complications, including:
- Severe diarrhea
- Enterocolitis (inflammation of the intestines)
- Dehydration
- Fever
- Granulocytopenia (a significant decrease in certain infection-fighting white blood cells)
Contact your healthcare provider immediately if you experience severe diarrhea, persistent vomiting, fever, signs of dehydration, or symptoms of infection while receiving Leucovorin with fluorouracil.
Vitamin B12 Deficiency
Tell your healthcare provider if you have anemia caused by vitamin B12 deficiency, such as pernicious anemia, before taking Leucovorin.
Although Leucovorin can improve some blood test results associated with folate deficiency, it does not treat vitamin B12 deficiency and may mask the blood-related signs of the condition while allowing nerve damage to continue. Your healthcare provider may perform additional testing to ensure you receive the appropriate treatment.
Pregnancy
If you are pregnant, planning to become pregnant, or think you may be pregnant, discuss the potential benefits and risks of Leucovorin with your healthcare provider before starting treatment.
Leucovorin is often used as part of chemotherapy treatment or to reduce the toxic effects of methotrexate. Your healthcare provider will carefully weigh the expected benefits against any potential risks to you and your developing baby before recommending treatment during pregnancy.
Timing Is Critical After Methotrexate Overdose
Leucovorin is used as a rescue medication following high-dose methotrexate therapy and is also the standard treatment for accidental methotrexate overdose.
For Leucovorin to be most effective, it must be administered as soon as possible after excessive exposure to methotrexate or other folic acid antagonists. Delaying treatment reduces Leucovorin’s ability to protect healthy cells from methotrexate toxicity, increasing the risk of serious complications such as bone marrow suppression, severe mouth sores, and damage to the digestive tract.
Always follow your healthcare provider’s instructions carefully regarding the timing and dosing of Leucovorin, especially when it is prescribed as part of methotrexate treatment.
Ongoing Monitoring
Depending on why you are taking Leucovorin, your healthcare provider may monitor your blood cell counts, kidney function, liver function, and response to treatment throughout therapy. Attend all scheduled follow-up appointments so your healthcare provider can ensure the medication is working safely and effectively.
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