Folinic acid

Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. 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. It is taken by mouth, injection into a muscle, or injection into a vein.

Folinic acid
Clinical data
PronunciationLeucovorin /ˌljkˈvɔːrɪn/
Trade namesMany
Other namescitrovorum factor, 5-formyltetrahydrofolate
AHFS/Drugs.comMonograph
MedlinePlusa608038
License data
Pregnancy
category
  • AU: A
Routes of
administration
Intravenous, IM, by mouth
ATC code
Legal status
Legal status
  • US: ℞-only
Pharmacokinetic data
BioavailabilityDose dependent
Protein binding~15%
Elimination half-life6.2 hours
ExcretionKidney
Identifiers
  • (2S)-2-{[4-[(2-amino-5-formyl-4-oxo-5,6,7,8-
    tetrahydro-1H-pteridin-6-yl)methylamino]
    benzoyl]amino}pentanedioic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.328
Chemical and physical data
FormulaC20H23N7O7
Molar mass473.446 g·mol−1
3D model (JSmol)
Melting point245 °C (473 °F) decomp
Solubility in water~0.3 mg/mL (20 °C)
SMILES
  • O=C(O)[C@@H](NC(=O)c1ccc(cc1)NCC3N(/C2=C(/N/C(=N\C2=O)N)NC3)C=O)CCC(=O)O
  • InChI=1S/C20H23N7O7/c21-20-25-16-15(18(32)26-20)27(9-28)12(8-23-16)7-22-11-3-1-10(2-4-11)17(31)24-13(19(33)34)5-6-14(29)30/h1-4,9,12-13,22H,5-8H2,(H,24,31)(H,29,30)(H,33,34)(H4,21,23,25,26,32)/t12?,13-/m0/s1 Y
  • Key:VVIAGPKUTFNRDU-ABLWVSNPSA-N Y
 NY (what is this?)  (verify)

Side effects may include trouble sleeping, allergic reactions, or fever. Use in pregnancy or breastfeeding is generally regarded as safe. When used for anemia it is recommended that pernicious anemia as a cause be ruled out first. Folinic acid is a form of folic acid that does not require activation by dihydrofolate reductase to be useful to the body.

Folinic acid was first made in 1945. It is on the World Health Organization's List of Essential Medicines.

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