Levoleucovorin (Intravenous)

Levoleucovorin is administered to patients who are suffering harmful effects from treatment with methotrexate and overdose of other medications.

Overview

Levoleucovorin is an injected antidote that is given to treat patients who are suffering from harmful effects from the use of other medications. It can be used in the treatment of overdose of certain medication, but is most commonly used to prevent and treat the harmful effects of methotrexate treatment. This aggressive cancer medication is used in high doses in patients suffering from bone cancer and Levoleucovorin is used to reduce some of the harmful side effects that this use causes.

Levoleucovorin can also be used in conjunction with 5-fluorouracil to relieve and prevent some of the symptoms of cancer of the colon and rectum that has already spread in the body.

This medication should only be used under the direct supervision of a doctor and is usually administered in a hospital or cancer clinic. It is provided as Fusilev in the form of a solution or a powder for solution.

Condition treated

  • Overdose of certain medications
  • Methotrexate, symptoms of

Type Of Medicine

  • Antidote

Side Effects

In addition to the desired effects of Levoleucovorin, other unwanted side effects can also occur. While not all side effects may occur in any one patient, medical attention may need to be sought in some cases.

You should inform your doctor or nurse immediately if you experience any of the following side effects from treatment:

Occurring more commonly:

  • Wheezing
  • Watery or bloody diarrhea
  • Unusual tiredness or weakness
  • Tightness in the chest
  • Stomach cramps, tenderness or pain
  • Shortness of breath
  • Lack or loss of strength
  • General feeling of discomfort
  • General feeling of illness
  • Fever
  • Difficult or labored breathing
  • Decrease in urine output
  • Decrease in urine-concentration
  • Cloudy urine

Frequency of incidence not known:

  • Shivering
  • Feeling unusually cold

Other side effects can also occur that would not normally require that you seek medical attention for treatment. In some cases these side effects may become bothersome or may be ongoing. In this case you can seek advice from your healthcare professional about how to alleviate them:

Occurring more commonly:

  • Weight loss
  • Vomiting
  • Swelling or inflammation of the mouth
  • Stomach discomfort or upset
  • Stabbing pain
  • Sensation of pins and needles
  • Nausea
  • Mood or mental changes
  • Loss of appetite
  • Indigestion
  • Heartburn
  • Hair loss or thinning of the hair
  • Diarrhea
  • Decreased appetite
  • Cracked, dry, or scaly skin
  • Change in taste
  • Burning, numbness, tingling or pain of hands, arms, feet or legs
  • Blistering
  • Crusting of the skin
  • Irritation
  • Itching
  • Reddening of the skin
  • Swelling of the skin
  • Belching
  • Bad, unusual, or unpleasant (after) taste
  • Acid or sour stomach

Frequency of incidence not known:

  • Rash

Other side effects from the use of Levoleucovorin can also occur that have not been listed herein. If you experience any other side effects then you should contact your doctor for advice on how best to alleviate them and any other action to take.

Dosage

This medication should only ever be administered by a trained health professional and should only be given under the direct supervision of a doctor. Levoleucovorin is administered directly into the veins by needle.

When treating inadvertent overdose the treatment is usually 7.5mg of Levoleucovorin given intravenously every 6 hours until the levels have reduced.

When treating patients who are receiving methotrexate the usual dose is 7.5mg for 10 doses that begin after methotrexate treatment begins.

Interactions

Medications can interact with one another in the body and can cause serious medical conditions to develop. While Levoleucovorin is intended for use with some other medications, it should not be used with others. In some cases medications may stop one another from working if used together or may increase the occurrence of side effects. To avoid any drug interactions you must inform your doctor of all medications that you are taking before you begin use of Levoleucovorin. This is especially important if you are taking any of the following:

The use of these medications is not normally recommended with use of Levoleucovorin. In some cases, however, both medications may be the best treatment for you. If you are prescribed both medications then changes may be made to the dose and frequency of use:

  • Tegafur
  • Fluorouracil
  • Doxifluridine
  • Capecitabine

Levoleucovorin may also interact with other medications not listed herein. Ensure that your doctor knows of everything you are taking whether it was prescribed, purchased over the counter or otherwise obtained.

Other medical problems from which you suffer can also affect your use of Levoleucovorin. Some medical conditions may be worsened by use of Levoleucovorin so you must inform your doctor of all conditions from which you suffer. This is particularly important if you suffer from any of the following conditions

  • Ascites
  • Dehydration
  • Severe kidney disease
  • Pleural effusion
  • Blood problems

Other medical conditions not listed herein may also impact your use of Levoleucovorin. Ensure you share your full medical history with your doctor.

Warnings

Before you begin treatment with Levoleucovorin it is important that you understand the risks of use and have considered this in relation to the good that it will do. The decision to use this medication should be taken with your doctor having ensured that you have considered the following aspects together:

Allergies ' You must tell your doctor of all allergies that you suffer whether they are allergies to foods, dyes, preservatives or any other substances. It is particularly important that you inform your doctor if you have ever reacted badly to any medications in the past. Allergies may prohibit your use of this treatment in some cases.

Pediatric ' This medication has been tested to the age of 6+ in children. Below this age the safety and efficiency of use is unknown. You should discuss the options with your doctor before use in children.

Geriatric ' While no specific tests have been carried out on the geriatric population, no age related limitations have been reported. Geriatric patients may, however, be more likely to be suffering from other medical conditions that may prohibit use of this medication. Caution should be used.

Pregnancy ' Inform your doctor if you are pregnant before you use this treatment. While this medication has only a category C risk it is commonly used with other medications that can be more harmful to an unborn baby. You should discuss present and future pregnancy with your doctor before undergoing treatment.

Breastfeeding ' The risks of breastfeeding during use are unknown. Some of the medications commonly used in conjunction with this treatment are known to be harmful to babies, however. Discuss breastfeeding with your doctor before beginning use.

Your doctor will need to monitor you during your use of this treatment and during other concurrent treatments. You will need to remain in hospital or in a cancer clinic during this treatment and you will be regularly given blood and urine tests. These tests will enable the doctor to determine the dose to give you and when to cease treatment. It will also enable them to check for unwanted side effects that could occur.

You should not take any other medications with this treatment unless you have discussed this use with your doctor. If you are told to take other medications with Levoleucovorin then you should do so exactly as you have been instructed to and should not make any changes to dose or frequency of use. Do not miss doses of this medication.

Storage

Before the vials have been reconstituted they can be stored at 25°C. Vials must always remain within 15-30°C.

Once reconstituted the medication can be stored for 12-24 hours at room temperature before it needs to be disposed of.

Storage times may vary so read the medication label.

This medication and all other medications must always be kept out of the reach of children.

Summary

Levoleucovorin is an antidote treatment that is used to relieve the effects of other medications on the body. It is used following overdosage of certain medications and is used to prevent harmful side effects from occurring from the use of certain cancer treatments. Commonly it is used to prevent the harmful effects of methotrexate on the body. It is also used to relieve and prevent the symptoms of advanced metastatic colon and rectum cancers.

This medication should only ever be administered in a hospital or cancer clinic under the direct supervision of the doctor. It is safe for use on children aged 6+ and in adults and elderly patients.

Before you begin use of this medication it is vital that you understand the risks of use and are aware of the potential side effects. Ensure that you have discussed everything here with your doctor before use of Levoleucovorin.

Do not use this medication when pregnant. Discuss the use of this treatment with your doctor if there is a chance you may be pregnant or may become pregnant.