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Folinic acid (Leucovorin) is an active coenzyme form and does not need to be reduced by DHF Rase before it can act. Methotrexate is a DHF Rase inhibitor; its toxicity is not counteracted by folic acid but antagonised by folinic acid.


Antidote for methotrexate & folic acid antagonists.


Dose equal to antagonist given: to be given within 1 hr. Usually ineffective if given after 3 hrs.


ernicious anaemia and megaloblastic anaemia secondary to the lack of vit B12.

Special Precautions

Undiagnosed megaloblastic anaemia, folate dependent tumors. Paediatrics: Use with caution. Pregnancy: Safety not established. Lactation: Saferty not established. Elderly: May cause severe G.I. disturbances and other adverse effects.

Side Effects

Allergic sensitization, nausea, pyrexia, vomiting, urticaria, anaphylactic reactions.

Drug Interactions

Enhances cytotoxic effect of fluorouracil. Reduces methotrexate toxicity. Phenobarbitone, phenytoin, primidone counteracts the antiepileptic effects.

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