Uses
Anti-anemic (folate deficiency); antidote (to folic acid
antagonists).
brand name
Wellcovorin (GlaxoSmithKline).
Clinical Use
Folinic acid rescue
Enhancement of 5-fluorouracil cytotoxicity in
advanced colorectal cancer
Folate deficiency
Drug interactions
Potentially hazardous interactions with other drugs
Should not be administered simultaneously with a
folic acid antagonist as this may nullify the effect of
the antagonist.
Cytotoxics: avoid with panitumumab and raltitrexed.
Metabolism
Folinic acid is a racemate where the L-form (L-5-
formyl-tetrahydrofolate, L-5-formyl-THF), is the active
enantiomer. The major metabolic product of folinic acid
is 5-methyl-tetrahydrofolic acid (5-methyl-THF) which
is predominantly produced in the liver and intestinal
mucosa.
80-90% with the urine (5- and 10-formyltetrahydrofolates
inactive metabolites), 5-8% with the
faeces.
