calcium folinate at a glance
Medicine class
Reduced folate and antidote to folate antagonists
Main roles
Methotrexate rescue and treatment of folate-deficiency megaloblastic anaemia
Important ingredient
The tablets described here contain lactose
What is calcium folinate used for?
The tablet product described here is licensed for:
Reducing or counteracting toxicity from folate-antagonist treatment such as methotrexate.
Treating megaloblastic anaemia caused by folate deficiency. It must not be used for anaemia caused by vitamin B12 deficiency.
How does calcium folinate work?
Calcium folinate supplies folate in a form that bypasses the enzyme blocked by methotrexate. It replenishes reduced folates in healthy cells, supports normal DNA production and may compete with methotrexate at its enzyme target.
How to take calcium folinate
Swallow the tablets with a glass of water.
The product described here is an oral, scored, uncoated tablet.
Tell the prescriber if you have an intolerance to lactose or certain sugars.
calcium folinate side effects
Common or expected effects
- With fluorouracil: diarrhoea and a sore or inflamed mouth.
- With fluorouracil: reduced white blood cells or platelets, potentially causing infection, bruising or bleeding.
- Fever has occasionally been reported after injectable calcium folinate.
Get urgent medical advice
- A severe allergic reaction, including breathing difficulty, facial or lip swelling, hives or widespread itching.
- Severe or persistent diarrhoea, mouth inflammation, unexplained bleeding or signs of infection during fluorouracil treatment require prompt clinical assessment.
calcium folinate in pregnancy
Evidence specifically studying calcium folinate during pregnancy is limited. It may be used when clinically necessary to reduce folate-antagonist toxicity, but methotrexate and fluorouracil have important pregnancy risks. Specialist assessment is required.
calcium folinate while breastfeeding
It is unknown whether calcium folinate passes into breast milk. It may be used when clinically necessary, but breastfeeding may be unsuitable because of accompanying treatment; fluorouracil is contraindicated while breastfeeding. Discuss feeding with the specialist team.
calcium folinate interactions
The treatment team should know about all prescribed, non-prescribed and complementary medicines. Important interactions include:
Methotrexate and other folate antagonists
Incorrect timing may reduce or cancel their intended therapeutic effect.
Fluorouracil
Calcium folinate can increase toxicity, particularly diarrhoea, mouth inflammation and blood-cell suppression.
Phenytoin, phenobarbital or primidone
Their antiseizure effect may be reduced, potentially increasing seizure frequency.
Chloramphenicol
It may reduce the blood-cell response to folate treatment in people with folate deficiency.
Common questions about calcium folinate
Answers are fully visible for fast scanning and source review.
Is calcium folinate the same as folic acid?
No. It is a reduced, active folate derivative that can bypass the metabolic step blocked by methotrexate.
Why is it given after methotrexate?
It replenishes reduced folates in healthy cells and helps counteract methotrexate toxicity.
Can it cancel methotrexate's effect?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.