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Folinex 15mg Tablet
Folinic Acid (Calcium folinate)
- Colorectal Cancer: Used as an adjunct to fluorouracil for chemotherapy treatment.
- Methotrexate Toxicity: Acts as an antidote for the toxicity caused by methotrexate.
- Folate-Deficient Megaloblastic Anaemia: To treat folate deficiency-related anemia.
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✅ Description:
Folinic acid (calcium folinate) enters cells as 5-methyl tetrahydrofolate, providing the necessary cofactor that is blocked by methotrexate.
- It stabilizes the binding of 5-dUMP to thymidylate synthetase and enhances the activity of fluorouracil.
- It neutralizes the toxic effects of methotrexate while increasing the efficacy of fluorouracil.
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✔️ Dosage & Administration
For Adults:
Oral Antidote for Methotrexate Toxicity:
- 15 mg every 6 hours for 10 doses, starting 24 hours after methotrexate infusion.
- Continue until serum methotrexate levels are <0.05 micromolar.
- Can be administered via IM/IV injection as an alternative.
For Folate-Deficient Megaloblastic Anaemia:
- 15 mg daily (oral route).
Adjunct to Fluorouracil in Colorectal Cancer:
- 200 mg/m² Body Surface Area (BSA) via slow IV injection over at least 3 minutes, followed by 370 mg/m² fluorouracil by IV injection.
- Treatment is given for 5 consecutive days and repeated every 28 days for 2 courses.
- Subsequent doses may be repeated every 4-5 weeks if the patient has recovered from the toxic effects.
Intramuscular Folate-Deficient Megaloblastic Anaemia:
- Up to 1 mg/day.
Always follow a healthcare professional’s advice for accurate dosing.
✔️ Side Effects
Common:
- Allergic reactions (e.g., rash, pruritus, erythema, urticaria).
- Nausea, vomiting, fever.
Serious:
- Rare side effects like severe enterocolitis, diarrhea, and dehydration (especially in elderly patients).
✔️ Drug Interactions
- Fluorouracil: Folinic acid may increase toxicity when given with fluorouracil.
- Sulfamethoxazole-Trimethoprim: Folinic acid can reduce its efficacy in treating pneumocystis carinii pneumonia.
- Other Interactions: Be cautious when combined with other medications such as methotrexate, warfarin, anticonvulsants, and antibiotics.
✔️ Contraindications
- Hypersensitivity to folinic acid or any component of the product.
- Pernicious anemia or any other megaloblastic anemia caused by vitamin B12 deficiency.
- Intrathecal or intraventricular administration.
✔️ Precautions
- Undiagnosed Megaloblastic Anaemia: Ensure diagnosis of megaloblastic anemia before use.
- Folate-Dependent Tumors: Exercise caution.
- Pregnancy: Use only if the potential benefit justifies the risk to the fetus.
- Monitor Serum Methotrexate Levels: Essential for determining optimal dose and duration.
- Monitor Electrolytes and Liver Function: Regular testing is advised.
✔️ Storage Conditions
- Store below 30°C.
- Keep away from light and moisture.
- Keep out of reach of children.
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