Leucovorin: profile and news






Pro-Pharmaceuticals to Present Abstract & Poster at Mass ...  Mar 2, 2006
The full trial is expected to have up to 800 patients in 60 centers and consist of four arms: Irinotecan, leucovorin and 5-FU (FOLFIRI) with and without DAVANAT ... - Genetic Engineering News,

Patients Prefer Xeloda® Over 5-FU for Colon Cancer Cancer  Feb 14, 2006
Researchers from Scotland have reported that patients with colorectal cancer who have received treatment with 5-FU/leucovorin or Xeloda (capecitabine) prefer ... - Cancer Consultants (press release),

ADVENTRX CoFactor Phase IIb Trial Surpasses 50% Enrollment ...  Feb 14, 2006
...toxicities. Patients are being randomized to one of two arms containing either CoFactor or leucovorin, each in combination with 5-FU. ... - PR Newswire (press release),

Chemotherapy Given Directly to Liver Improves Survival for ...  Feb 27, 2006
...research began in 1996, before chemotherapy drugs such as irinotecan and oxaliplatin were available, both sets of patients received fluorouracil and leucovorin ... - AScribe

Recruitment Temporarily Suspended In An International Phase III ...  Feb 20, 2006
In the pivotal Phase III study, the addition of Avastin to chemotherapy (irinotecan/5-fluorouracil/leucovorin) significantly extended survival by, on average ... - Medical News Today (press release),

Avastin May Cause Leukoencephalopathy Syndrome  Mar 2, 2006
...of a 52-year-old woman with hypertension and metastatic rectal adenocarcinoma who had three cycles of chemotherapy with fluorouracil, leucovorin and oxaliplatin ... - Medscape (subscription)

Recruitment Temporarily Suspended in an International Phase III ...  Feb 12, 2006
The XELOX regimen consists of capecitabine and oxaliplatin and the FOLFOX regimen consists of oxaliplatin, 5-FU and leucovorin. ... - PR Newswire (press release),

CoFactor™ (5,10-methylenetetrahydrofolate) May Enhance Activity ...  Feb 3, 2006
...leucovorin (Folinic acid) is frequently used as a modulator of 5-FU. ... Comments: CoFactor may or may not represent an improvement over leucovorin. ... - Cancer Consultants (press release),

Oxaliplatin Safely Stopped with FOLFOX Regimen for Colorectal ...  Feb 21, 2006
NEW YORK FEB 20, 2006 (Reuters Health) - Treatment with oxaliplatin, a key component of the leucovorin/fluorouracil regimen (FOLFOX) used for metastatic ... - Cancerpage.com,

Xaliproden Reduces Occurrence Of Severe Peripheral Sensory ...  Feb 23, 2006
The trial randomized 649 patients treated with the FOLFOX4 schedule (5-fluorouracil/leucovorin/oxaliplatin) for first-line metastatic colorectal cancer. ... - Medical News Today (press release),

Cancer Drug Trial on Hold  Feb 13, 2006
In one arm of the study, they tested Avastin in combination with FOLFOX chemotherapy treatment (a regimen consisting of oxaliplatin, 5-FU, and leucovorin). ... - Red Herring,

Genentech stops colon-cancer study  Feb 13, 2006
...the higher event rate was seen -- are taking capecitabine and oxaliplatin, while the Folfox patients are being given oxaliplatin, 5-FU and leucovorin, the firm ... - United Press International

Genentech/Roche: trial delay won't choke Avastin's growth  Feb 13, 2006
...colorectal cancer patients, who will be given adjuvant treatment following surgery as one of three regimens: the FOLFOX regimen (oxaliplatin, leucovorin and 5 ... - Pharmaceutical Business Review

Study Sets Treatment Standard for Elderly With Colon Cancer  Feb 10, 2006
...colorectal cancer of the chemotherapy regimen known as FOLFOX4, a combination of the standard anticancer drugs 5-fluorouracil (5-FU), leucovorin and the new ... - DG News

Colon cancer chemotherapies OK for elderly  Feb 10, 2006
...against colorectal cancer of the chemotherapy regimen known as FOLFOX4, a combination of the standard anti-cancer drugs 5-fluorouracil, leucovorin and the new ... - United Press International

Pro-Pharmaceuticals Announces $10 Million Financing  Feb 15, 2006
The Company has been conducting clinical and pre-clinical studies with 5-FU, leucovorin, irinotecan, doxorubicin, oxaliplatin, paclitaxel, cisplatin, and ... - Genetic Engineering News,

Roche halts enrollment in Avastin trial  Feb 13, 2006
...compared to those receiving a regimen of Avastin and the standard chemotherapy combination Folfox (oxaliplatin, 5-fluorouracil, leucovorin), or Folfox alone. ... - Pharma Times (subscription),

CoFactor™ Plus 5-FU Provides Large Response in Metastatic ...  Feb 1, 2006
...other therapeutic agents. The agent leucovorin is used in combination with 5-FU to enhance its anticancer activity. Researchers are ... - Cancer Consultants (press release),

Xaliproden May Reduce Side Effect Caused by Eloxatin® in ...  Feb 6, 2006
...included 749 patients with metastatic colorectal cancer who were being treated with the chemotherapy combination FOLFOX (5-fluorouracil, Eloxatin, leucovorin). ... - Cancer Consultants (press release),

Patients Prefer Xeloda® to 5-Flurouracil in Treatment of ...  Feb 15, 2006
A randomized cross-over trial comparing patient preference for oral capecitabine and 5-fluorouracil/leucovorin regimens in patients with advanced colorectal ... - Cancer Consultants (press release),

Xaliproden May Reduce Side Effect Caused by Eloxatin® in ...  Feb 2, 2006
...has spread to distant sites in the body) who were being treated with the chemotherapy combination referred to as FOLFOX (5-fluorouracil, Eloxatin, leucovorin). ... - Cancer Consultants (press release),


Other information


Indication
Used to treat osteosarcoma (after high dose methotrexate therapy), to diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosages of folic acid antagonists, and to treat megaloblastic anemias due to folic acid deficiency. Also used in combination with 5-fluorouracil to prolong survival in the palliative treatment of patients with advanced colorectal cancer.

Pharmacology
Leucovorin is one of several active, chemically reduced derivatives of folic acid. It is useful as an antidote to drugs which act as folic acid antagonists. Leucovorin is a mixture of the diastereoisomers of the 5-formyl derivative of tetrahydrofolic acid (THF). The biologically active compound of the mixture is the (-)-l-isomer, known as Citrovorum factor or (-)-folinic acid. Leucovorin does not require reduction by the enzyme dihydrofolate reductase in order to participate in reactions utilizing folates as a source of “one-carbon” moieties. Administration of leucovorin can counteract the therapeutic and toxic effects of folic acid antagonists such as methotrexate, which act by inhibiting dihydrofolate reductase. Leucovorin has also been used to enhance the activity of fluorouracil.

Mechanism Of Action
As leucovorin is a derivative of folic acid, it can be used to increase levels of folic acid under conditions favoring folic acid inhibition (following treatment of folic acid antagonists such as methotrexate). Leucovorin enhances the activity of fluorouracil by stabilizing the bond of the active metabolite (5-FdUMP) to the enzyme thymidylate synthetase.

Drug Category
Hematinics; Antihypertensive Agents; Methotrexate Antidote; Unclassified Therapeutic Agents (92:00.00);

Brand Names/Synonyms
Acide Folinique; C03479; Calcium Citrovorum Factor; Calcium Folinate; Citrovorum Factor; Folinic Acid; Folinic Acid Calcium Salt; Folinic Acid-Sf; Folinic Acid-Sf, Calcium Salt; Folinic Acidcalcium Salt Usp27; L-Leucovorin; Leucal; Leucovorin Calcium; Leucovorin Calcium Preservative Free; Leucovorin Folinic Acid; Leucovorin [Usan]; Wellcovorin

Dosage Forms
LIQUID; POWDER FOR SOLUTION; SOLUTION; TABLET

Absorption
Following oral administration, leucovorin is rapidly absorbed. The apparent bioavailability of leucovorin was 97% for 25 mg, 75% for 50 mg, and 37% for 100 mg.

Interactions
Interactions for Leucovorin:

Folic acid in large amounts may counteract the antiepileptic effect of phenobarbital, phenytoin and primidone, and increase the frequency of seizures in susceptible pediatric patients.

Preliminary animal and human studies have shown that small quantities of systemically administered leucovorin enter the CSF primarily as 5-methyltetrahydro-folate and, in humans, remain 1 to 3 orders of magnitude lower than the usual methotrexate concentrations following intrathecal administration. However, high doses of leucovorin may reduce the efficacy of intrathecally administered methotrexate.

Leucovorin may enhance the toxicity of 5-fluorouracil.



Chemical IUPAC Name
2-[4-[(2-amino-5-formyl-4-oxo-5,6,7,8-tetrahydro-1H-pteridin-6-yl)methylamino]benzoyl]aminopentanedioicacid

Chemical Formula
C20H23N7O7

Half Life
6.2 hours

Drug Type
Approved Drug

# Accession No
APRD00698

CAS Registry Number
1492-18-8

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