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Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. [2] [3] It is also used in combination with 5-fluorouracil to treat colorectal cancer and pancreatic cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning.
Both high-folate diets and supplemental folic acid may help reduce the toxic side-effects of low-dose methotrexate without decreasing its effectiveness. [ 8 ] [ 9 ] Anyone taking low-dose methotrexate for the health problems listed above should consult with a physician about the need for a folic acid supplement.
Patients are recommended to take folic acid and vitamin B 12 supplement even if levels are normal when they are on pemetrexed therapy. [15] [2] (In clinical trials for mesothelioma, folic acid and B12 supplementation reduced the frequency of adverse events.)
The Common Terminology Criteria for Adverse Events (CTCAE), [1] formerly called the Common Toxicity Criteria (CTC or NCI-CTC), are a set of criteria for the standardized classification of adverse events of drugs and treatment used in cancer therapy. The CTCAE system is a product of the US National Cancer Institute (NCI).
For many biologics (e.g., monoclonal antibodies), injection site reactions are the most common adverse effect of the drug, and have been reported to have an incidence rate of 0.5–40%. [2] In trials of subcutaneous administration of oligonucleotides, between 22 and 100% of subjects developed reactions depending on the oligonucleotide. [6]
[3] [4] It is given by injection into a muscle or vein, [2] by pill or sublingually. Side effects are generally few. [2] They may include diarrhea, feeling sick, hot flushes, itchiness, low blood potassium, allergic reactions, and high blood pressure. [2] Normal doses are considered safe in pregnancy. [5]
Nearly 8 in 1,000 adults aged 65 years or older experienced one of the four most common ADEs (steroids, antibiotics, opiates/narcotics, and anticoagulants) during hospitalization. [42] A study showed that 48% of patients had an adverse drug reaction to at least one drug, and pharmacist involvement helps to pick up adverse drug reactions. [44]
They are given by injection. [2] Common side effects may include joint pain, rash, vomiting, and headache. [4] Serious side effects may include heart attacks, stroke, increased cancer growth, or pure red cell aplasia. [2] It is unclear if use is safe during pregnancy. [5] [6] They work similar to naturally occurring erythropoietin. [1]