Drug reference

Folinic acid

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1014, 1015

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prevention of methotrexate-induced adverse effects ▶BY INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: 15 mg every 6 hours for 24 hours, to be started usually 12–24 hours after start of methotrexate infusion, dose may be continued by mouth, consult local treatment protocol for further information Suspected methotrexate overdosage ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Initial dose equal to or exceeding dose of methotrexate, to be given at a maximum rate of 160 mg/minute, consult poisons information centres for advice on continuing management Adjunct to fluorouracil in colorectal cancer ▶BY SLOW INTRAVENOUS INJECTION ▶Adult: (consult product literature) SODIOFOLIN ® As an antidote to methotrexate ▶BY INTRAVENOUS INFUSION, OR BY INTRAVENOUS INJECTION ▶Adult: (consult product literature) Adjunct to fluorouracil in colorectal cancer ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)

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Contra Indications

Intrathecal injection

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Cautions

Avoid simultaneous administration of methotrexate. not indicated for pernicious anaemia or other megaloblastic anaemias caused by vitamin B12 deﬁciency

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National Funding Access Decisions

NICE decisions ▶Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer (December 2010) NICE TA212 Bevacizumab in combination with oxaliplatin and either ﬂuorouracil plus folinic acid or capecitabine is not recommended for the treatment of metastatic colorectal cancer. www.nice.org.uk/guidance/ta212

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Safety

Interactions

→Appendix 1: folates

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Side Effects

GENERAL SIDE-EFFECTS ▶Uncommon Fever ▶Rare or very rare Agitation (with high doses). depression (with high doses). epilepsy exacerbated. gastrointestinal disorder (with high doses). insomnia (with high doses) SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intravenous use Bone marrow failure. dehydration. diarrhoea. mucositis. nausea. oral disorders. skin reactions. vomiting ▶Rare or very rare ▶With intramuscular use Urticaria ▶With intravenous use Sensitisation ▶Frequency not known ▶With intravenous use Hyperammonaemia

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Pregnancy

Not known to be harmful; beneﬁt outweighs risk.

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Breast Feeding

Presence in milk unknown but beneﬁt outweighs risk.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Folinic acid (Non-proprietary) Folinic acid (as Calcium folinate) 7.5 mg per 1 ml Calcium folinate 15mg/2ml solution for injection ampoules | 5 ampoule P £39.00 DT = £39.00 | 5 ampoule P £39.00 DT = £39.00 (Hospital only) Folinic acid (as Calcium folinate) 10 mg per 1 ml Calcium folinate 350mg/35ml solution for injection vials | 10 vial P £1,277.60 (Hospital only) Calcium folinate 50mg/5ml solution for injection vials | 1 vial P £20.00 (Hospital only) Calcium folinate 300mg/30ml solution for injection vials | 1 vial P £100.00 (Hospital only) Calcium folinate 100mg/10ml solution for injection vials | 1 vial P £37.50 (Hospital only) | 10 vial P £404.50 (Hospital only) ▶Sodiofolin (medac UK) Folinic acid (as Disodium folinate) 50 mg per 1 ml Sodiofolin 400mg/8ml solution for injection vials | 1 vial P £126.25 (Hospital only) Sodiofolin 100mg/2ml solution for injection vials | 1 vial P £35.09 (Hospital only)

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Dose text by age group

Adult

15 mg every 6 hours for 24 hours, to be started

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Initial dose equal to or exceeding dose of

First-line fragment. Read the complete Indications and Dose section above.

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Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Folinic acid

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1014, 1015

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 1014

Contra Indications

Intrathecal injection

PDF page 1014

Cautions

Avoid simultaneous administration of methotrexate. not indicated for pernicious anaemia or other megaloblastic anaemias caused by vitamin B12 deﬁciency

PDF page 1014

National Funding Access Decisions

PDF page 1015

Safety

Interactions

→Appendix 1: folates

PDF page 1014

Side Effects

PDF pages 1014, 1015

Pregnancy

Not known to be harmful; beneﬁt outweighs risk.

PDF page 1015

Breast Feeding

Presence in milk unknown but beneﬁt outweighs risk.

PDF page 1015

Dose and formulations

Medicinal Forms

PDF page 1015

Dose text by age group

Adult

15 mg every 6 hours for 24 hours, to be started

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

Initial dose equal to or exceeding dose of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1014

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.