calcium folinate injection - Calcium Leucovorin (15mg) medicine

Calcium Leucovorin 15mg Tablet: Complete Guide

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🏭 Fresenius Kabi India Pvt Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 23, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for approved indications.
Reviewed by
SaathiMed Expert Panel | Sep 23, 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or swelling of the face, lips, or throat.
  • Severe skin rash, hives, or blistering.
  • Seizures or convulsions.
  • Severe abdominal pain or persistent vomiting.
  • Blood in vomit or stool.
  • Irregular heartbeat or palpitations.
  • Unusual bleeding or bruising.
  • Yellowing of the skin or eyes (jaundice).

If experiencing severe symptoms, call emergency services immediately.

What is calcium folinate injection used for?

Calcium leucovorin 15 mg tablet is used as a rescue agent after high-dose methotrexate therapy, to treat folate deficiency caused by certain medicines, and in combination with 5-fluorouracil for colorectal cancer. It works by replenishing active folate pools in the body.

  • Generic Name: Calcium Leucovorin
  • Manufacturer: Fresenius Kabi India Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 calcium folinate injection के बारे में (Hindi Summary)

उपयोग: यह दवा कैल्शियम ल्यूकोवोरिन 15 मिलीग्राम टैबलेट के रूप में उपलब्ध है और इसका उपयोग मुख्य रूप से मेथोट्रेक्सेट की उच्च खुराक के बाद बचाव चिकित्सा के लिए किया जाता है। यह कैंसर रोगियों में मेथोट्रेक्सेट के कारण होने वाले विषाक्त प्रभावों को कम करने में मदद करती है। इसके अलावा, यह कुछ दवाओं के कारण होने वाली फोलेट की कमी के इलाज में और कोलोरेक्टल कैंसर के इलाज में 5-फ्लोरोयूरासिल के साथ मिलकर उपयोग की जाती है। यह दवा शरीर में सक्रिय फोलेट के स्तर को बढ़ाकर काम करती है, जो डीएनए संश्लेषण और कोशिका विभाजन के लिए आवश्यक है। इस दवा का उपयोग केवल डॉक्टर की सलाह पर ही करना चाहिए।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में मतली, उल्टी, पेट में असुविधा, दस्त और थकान शामिल हो सकते हैं। कुछ रोगियों में एलर्जी प्रतिक्रियाएं जैसे त्वचा पर चकत्ते, खुजली या पित्ती हो सकती है। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन गंभीर एलर्जी प्रतिक्रिया (एनाफिलेक्सिस) हो सकती है, जिसके लिए तत्काल चिकित्सा सहायता की आवश्यकता होती है। अन्य गंभीर प्रभावों में दौरे पड़ना और इलेक्ट्रोलाइट असंतुलन शामिल हो सकते हैं। किसी भी असामान्य लक्षण को तुरंत डॉक्टर को बताएं।

सुरक्षा सलाह: यह दवा केवल योग्य स्वास्थ्य पेशेवर की देखरेख में ही लेनी चाहिए। बिना डॉक्टर की सलाह के खुराक न बदलें और न ही स्वयं दवा लें। अपने डॉक्टर को अन्य सभी दवाओं, सप्लीमेंट्स और हर्बल उत्पादों के बारे में बताएं। यदि आप गर्भवती हैं, गर्भवती होने की योजना बना रही हैं या स्तनपान करा रही हैं, तो इस दवा का उपयोग करने से पहले डॉक्टर से सलाह लें। इस दवा को लेते समय शराब का सेवन न करें। बच्चों की पहुंच से दूर रखें और लेबल पर दिए निर्देशों के अनुसार ही भंडारण करें। एक्सपायरी डेट के बाद दवा का उपयोग न करें। यदि सांस लेने में कठिनाई, चेहरे, होंठ या गले में सूजन जैसे एलर्जी के लक्षण दिखें, तो तुरंत आपातकालीन चिकित्सा सहायता लें।

💡 Did You Know? The first generic medicine was introduced in India in 1970 after the Patents Act was amended.

💊 calcium folinate injection Uses & Benefits

[{"condition":"Methotrexate rescue therapy","description":"This medicine is used to rescue normal cells after high-dose methotrexate treatment, reducing toxicity while maintaining anti-cancer efficacy.","evidence":"Well-established"},{"condition":"Folate deficiency due to certain medications","description":"It is used to treat folate deficiency caused by drugs like trimethoprim, pyrimethamine, or phenytoin.","evidence":"Well-established"},{"condition":"Colorectal cancer (in combination with 5-fluorouracil)","description":"This medicine enhances the effectiveness of 5-fluorouracil in palliative treatment of colorectal cancer.","evidence":"Well-established"},{"condition":"Toxicity from folic acid antagonists","description":"It is used as an antidote for overdose or toxicity from folic acid antagonists such as methotrexate.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Prevention of neural tube defects","description":"Sometimes used off-label in women with a history of neural tube defects, but folic acid is the standard.","evidence":"Limited"},{"condition":"Enhancement of chemotherapy in other cancers","description":"Occasionally used off-label in other cancers to modulate chemotherapy, but evidence is limited.","evidence":"Limited"}]

Primary treatment for: Methotrexate toxicity rescue

Also treats: Folate deficiency, Colorectal cancer, Toxicity from folic acid antagonists

📋 Drug Information

Generic Name(s)Calcium Leucovorin
Brand NameAdcov 50mg Injection
ManufacturerFresenius Kabi India Pvt Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassBLOOD RELATED
Action ClassCytoprotective agents- methotrexate
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container.
Shelf LifeTypically 24 months from the date of manufacture, but check the expiry date on the package.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always take this medicine exactly as prescribed by your oncologist or specialist.
2
Timing is critical when using this medicine for methotrexate rescue; follow the schedule precisely.
3
Take with food if you experience nausea or stomach upset.
4
Stay well hydrated while taking this medicine.
5
Avoid alcohol consumption as it may increase the risk of liver problems.
6
Inform your doctor immediately if you experience any signs of allergic reaction.
7
Do not share this medicine with others, even if they have similar symptoms.
8
Keep all follow-up appointments for monitoring blood tests.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Methotrexate toxicity
This medicine is commonly prescribed for this.
Likely Use
Folate deficiency
This medicine is used to treat this condition.
Likely Use
Fever
This medicine is not a primary fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionCalcium leucovorin is rapidly absorbed from the gastrointestinal tract after oral administration. Peak plasma levels are achieved within 1 to 2 hours. The bioavailability is high, though it may be saturable at higher doses.
DistributionLeucovorin is widely distributed in body tissues, including the liver, kidneys, and central nervous system. It crosses the blood-brain barrier to some extent. It is also distributed into breast milk.
Protein BindingCalcium leucovorin is approximately 15% bound to plasma proteins.
MetabolismLeucovorin is metabolized in the liver and intestinal mucosa to its active metabolite, 5-methyltetrahydrofolate (5-MTHF), and other folate derivatives. It undergoes enterohepatic circulation.
Half-LifeThe elimination half-life of leucovorin is approximately 3 to 6 hours, but it may be prolonged in patients with renal impairment.
ExcretionLeucovorin and its metabolites are primarily excreted in the urine (about 80-90%) and to a lesser extent in the feces. Renal clearance is an important route of elimination.
BioavailabilityThe oral bioavailability of leucovorin is high, approximately 90% or more, but it may be reduced at higher doses due to saturable absorption.
Onset of ActionThe onset of action is rapid, with effects on folate pools occurring within 1 to 2 hours after oral administration.
Peak Plasma TimePeak plasma concentrations are reached approximately 1 to 2 hours after oral administration.
Duration of ActionThe duration of action depends on the dose and indication. For methotrexate rescue, leucovorin is typically given every 6 hours for several doses, and its effects last until folate pools are restored.

How It Works

Calcium leucovorin is a reduced form of folic acid that bypasses the dihydrofolate reductase (DHFR) enzyme to directly supply active folate cofactors. It enters cells via the reduced folate carrier and is converted to tetrahydrofolate (THF) and other folate derivatives. These cofactors are essential for thymidylate synthesis and purine synthesis, which are required for DNA and RNA production. In methotrexate rescue, leucovorin replenishes the folate pools that methotrexate depletes, thereby rescuing normal cells from methotrexate-induced toxicity. In combination with 5-fluorouracil, leucovorin stabilizes the binding of 5-fluorouracil to thymidylate synthase, enhancing its inhibition and anti-tumor effect.

Mechanism Steps

1
Cellular uptake: Calcium leucovorin is transported into cells via the reduced folate carrier (RFC) and possibly other transporters.
2
Conversion to active folates: Inside cells, leucovorin is converted to tetrahydrofolate (THF) and then to 5,10-methylenetetrahydrofolate, which are active cofactors.
3
Restoration of folate pools: These active folates replenish the pools depleted by methotrexate, allowing normal DNA and RNA synthesis to resume.
4
Enhancement of 5-fluorouracil: In combination with 5-fluorouracil, leucovorin forms a stable ternary complex with thymidylate synthase, increasing its inhibition.

💡 How to Take calcium folinate injection

Strength: Calcium Leucovorin 15 mg immediate-release tablet.

1Take this medicine exactly as prescribed by your doctor.
2Swallow the tablet whole with a glass of water.
3You may take it with or without food, but taking it with food may reduce stomach upset.
4Do not crush, chew, or break the tablet unless instructed by your doctor.
5If you miss a dose, follow the missed dose instructions.
6Do not take more than the prescribed dose.

Dosage Information

Adult DosageThe dose of this medicine is highly individualized and depends on the specific indication, such as methotrexate rescue, folate deficiency, or combination chemotherapy. It is typically prescribed by a specialist and must be taken exactly as directed. Do not adjust the dose without consulting your doctor. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may have reduced renal function, which can affect the elimination of leucovorin. Dose adjustment may be necessary based on renal function. Consult a doctor for individualized dosing.
Renal ImpairmentIn patients with renal impairment, the elimination of leucovorin may be prolonged. Dose reduction or extended intervals may be required. Consult a doctor for specific dosing recommendations.
Hepatic ImpairmentNo specific dose adjustment is established for hepatic impairment. Use with caution and monitor liver function.
Maximum Daily DoseThe maximum daily dose varies by indication and is determined by the prescribing clinician. Do not exceed the prescribed dose.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset and nausea.
Alcohol
Avoid
May increase risk of liver problems and worsen folate deficiency.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of calcium folinate injection

✅ Common Side Effects

Nausea (Common (5-10%))
Take with food to reduce nausea. If it persists, consult your doctor.
Vomiting (Common (5-10%))
Stay hydrated and inform your doctor if vomiting is severe or persistent.
Abdominal discomfort (Common (5-10%))
Take with meals. If pain is severe, seek medical advice.
Diarrhea (Common (5-10%))
Drink plenty of fluids. Consult doctor if diarrhea is severe or bloody.
Fatigue (Common (5-10%))
Rest and maintain hydration. If fatigue interferes with daily activities, consult your doctor.

🚨 Serious Side Effects

Severe allergic reaction (anaphylaxis) (Rare (<0.1%))
Seek emergency medical help immediately if you experience difficulty breathing, swelling of face, lips, or throat, or severe rash.
Seizures (Rare (<0.1%))
Call emergency services if seizures occur. This may be more common in patients with a history of seizures.
Severe electrolyte imbalance (Rare (<0.1%))
Report symptoms like muscle cramps, weakness, or irregular heartbeat to your doctor immediately.

⚠️ Rare Side Effects

Fever
Monitor temperature and consult doctor if fever persists.
Chills
Keep warm and inform your doctor if chills are accompanied by fever.
Skin rash
Discontinue use and consult a doctor if rash develops.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Methotrexate Major
5-Fluorouracil Major
Trimethoprim Major
Pyrimethamine Major
Phenytoin Moderate
Sulfasalazine Moderate
Antacids Minor

🚨 Major Interactions

  • Methotrexate
  • 5-Fluorouracil
  • Trimethoprim
  • Pyrimethamine

⚡ Moderate Interactions

  • Phenytoin
  • Sulfasalazine

🍷 Alcohol Interaction

Alcohol may increase the risk of liver problems and can worsen folate deficiency. It is advisable to avoid alcohol while taking this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to leucovorin or any component of the tablet.","Pernicious anemia or other megaloblastic anemias due to vitamin B12 deficiency, as leucovorin may mask hematologic signs.","Use in patients with known folate-sensitive conditions without medical supervision."]

⚠️ Warnings & Precautions

["This medicine should only be used under the supervision of a qualified healthcare professional.","Do not use for the treatment of anemia without confirming the cause, as it may mask vitamin B12 deficiency.","Caution in patients with renal impairment; dose adjustment may be required.","Caution in patients with a history of seizures; leucovorin may lower seizure threshold.","Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding.","Avoid alcohol consumption while taking this medicine.","Keep out of reach of children.","Do not exceed the prescribed dose."]

🤱 Lactation Safety

Leucovorin is excreted in breast milk. Consult your doctor before breastfeeding while taking this medicine. It is generally considered compatible with breastfeeding when used as prescribed.

💊 Overdose Management

Overdose of leucovorin is unlikely to cause serious toxicity due to its low toxicity profile. However, if a large overdose is taken, seek medical attention. Treatment is supportive and symptomatic. In case of accidental overdose, contact a poison control center or emergency room immediately.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up. Consult your doctor if you are unsure.

Additional Safety Advice

General Safety

This medicine should only be taken under the supervision of a qualified healthcare professional. Do not self-medicate or adjust the dose without consulting your doctor. Inform your doctor about all other medicines, supplements, and herbal products you are taking, as interactions may occur. If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits with your doctor before using this medicine. Avoid alcohol consumption while taking this medicine, as it may increase the risk of liver problems. Keep this medicine out of reach of children and store it as directed on the label. Do not use this medicine after the expiry date. If you experience any signs of an allergic reaction, such as difficulty breathing, swelling of the face, lips, or throat, seek emergency medical help immediately.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may have reduced renal function, which can affect the elimination of this medicine. Dose adjustment may be necessary. Regular monitoring of renal function is advised.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor before taking this medicine. It should only be used if clearly needed and prescribed by a doctor.

🏥 Post-Surgery Considerations

This medicine is not typically associated with post-surgery complications. However, inform your surgeon and anesthesiologist about all medicines you are taking before surgery.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine before any dental procedure. No specific precautions are usually needed, but it is important for your healthcare provider to know.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy diet rich in fruits and vegetables.
🥗
Stay well hydrated throughout the day.
😴
Avoid alcohol consumption.
💧
Get adequate rest and sleep.
🧘
Follow your doctor's advice regarding follow-up appointments and blood tests.
🌞
Inform your doctor about any other medicines or supplements you are taking.

🏋️ Exercise Considerations

This medicine is unlikely to affect your ability to exercise, but if you feel tired or unwell, avoid strenuous activities. Consult your doctor before starting any new exercise regimen.

🥗 Diet Recommendations

Include folate-rich foods like leafy greens, legumes, and citrus fruits.
Avoid alcohol.
Stay hydrated.
Eat small, frequent meals if you experience nausea.

💼 Impact on Daily Work & Life

This medicine is unlikely to affect your ability to work or drive. However, if you experience side effects like fatigue or dizziness, avoid driving or operating heavy machinery until you feel better.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor. Stopping abruptly may lead to recurrence of the condition being treated or other complications. Your doctor will determine the appropriate duration of treatment.

📅 Long-Term Use Effects

Long-term use of this medicine is generally safe when taken as prescribed. However, it may mask vitamin B12 deficiency, so monitoring is important. Regular blood tests may be needed to check folate levels and overall health. When used in chemotherapy, long-term effects are related to the underlying cancer treatment rather than leucovorin itself.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Folic acid supplementation

For folate deficiency, folic acid may be used, but it is not a substitute for leucovorin in rescue therapy.

Evidence: Well-established
Levofolinate

The active isomer of leucovorin, used in some chemotherapy regimens.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific interactions with vaccines are established. However, if you are undergoing chemotherapy, consult your doctor about the timing of vaccinations.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid loss. Store at room temperature and protect from extreme heat or cold. If crossing time zones, consult your doctor about adjusting the dosing schedule, especially if on a strict rescue protocol. Check customs regulations for carrying prescription medicines.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 58-year-old man undergoing high-dose methotrexate therapy for lymphoma.
He was prescribed this medicine as part of his rescue protocol. He took it exactly as scheduled, every 6 hours for several doses. He experienced mild nausea but no serious side effects. His methotrexate levels decreased appropriately, and he recovered without significant toxicity.
💡 Lesson: Adhering to the rescue schedule is crucial to prevent methotrexate toxicity and ensure successful treatment.
👤 A 45-year-old woman with colorectal cancer receiving 5-fluorouracil and leucovorin combination chemotherapy.
She experienced moderate diarrhea and fatigue during treatment but managed with dietary changes and hydration. Her tumor showed good response to therapy. She emphasized the importance of reporting side effects to her doctor promptly.
💡 Lesson: Close monitoring and prompt reporting of side effects help manage chemotherapy toxicity effectively.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 1 to 2 hours after oral administration, but its effects depend on the indication and are often part of a treatment protocol.

Q: Can I take this medicine without food?

A: Yes, it can be taken with or without food, but taking it with food may reduce stomach upset.

Q: Is this medicine safe during pregnancy?

A: It should only be used during pregnancy if prescribed by a doctor. The risks and benefits must be weighed.

Q: What should I do if I miss a dose?

A: Take it as soon as you remember if less than half the dosing interval has passed. Otherwise, skip the missed dose and continue with your regular schedule. Do not double dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for calcium folinate injection

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: Calcium leucovorin is a vitamin supplement that anyone can take.
    Fact: It is a prescription medicine used for specific medical conditions and should not be taken without medical supervision.
  • Myth: Leucovorin can be taken at any time relative to methotrexate.
    Fact: Timing is critical; leucovorin must be given at the correct interval after methotrexate to rescue normal cells without reducing anti-tumor efficacy.
  • Myth: Leucovorin is the same as folic acid.
    Fact: Leucovorin is a reduced form of folate that bypasses the DHFR enzyme, while folic acid requires activation by DHFR.

🔄 Alternative Options

Generic Alternatives

  • Calcium Leucovorin 15 mg tablet (various manufacturers)

Brand Alternatives

  • Biovorin 15 tablet

📊 Comparison with Similar Medicines

[{"medicine":"Calcium Leucovorin","active_ingredient":"Calcium Leucovorin","strength":"15 mg","dosage_form":"Tablet","route":"Oral","primary_use":"Methotrexate rescue, folate deficiency"},{"medicine":"Folic Acid","active_ingredient":"Folic Acid","strength":"5 mg","dosage_form":"Tablet","route":"Oral","primary_use":"Folate deficiency, pregnancy supplementation"}]

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