calcium folinate hydrate at a glance
Medicine class
Reduced folate and detoxifying agent used in anticancer treatment.
Main roles
Folate-antagonist rescue, fluorouracil enhancement and treatment of selected folate-deficiency anaemias.
What is calcium folinate hydrate used for?
Licensed uses represented by the selected products include:
Reducing toxicity and counteracting folate antagonists such as methotrexate in adults and children, including after overdose.
Use with fluorouracil to increase its activity in cytotoxic treatment.
Oral treatment of megaloblastic anaemia associated with folate deficiency.
How does calcium folinate hydrate work?
It supplies folate in a form that bypasses metabolic steps blocked by medicines such as methotrexate, replenishing reduced folate inside cells. With fluorouracil, it increases both anticancer activity and the potential for toxicity.
calcium folinate hydrate preparations and strengths
Tablet
Route: Oral
Strengths: 15 mg
Injection
Route: Parenteral
Strengths: 10 mg/mL
How to take calcium folinate hydrate
Follow the specialist treatment plan exactly because administration must be coordinated with the treatment whose effects calcium folinate is modifying.
Swallow tablets whole with water. The score helps swallowing but does not divide the tablet into equal amounts.
Injection or infusion is prepared and given by a healthcare professional into a vein or muscle.
It must never be injected into the spinal canal.
Parenteral treatment may be needed if vomiting, gastrointestinal toxicity or malabsorption makes oral absorption unreliable.
calcium folinate hydrate side effects
Common or expected effects
- With fluorouracil: mouth inflammation or ulcers, diarrhoea, nausea, vomiting and hand-and-foot skin reactions.
- Many effects during combination treatment arise from increased fluorouracil toxicity rather than calcium folinate alone.
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty, swelling, hives or collapse.
- Severe blistering or peeling skin reactions.
- New seizures or increased seizure frequency, particularly with certain antiseizure medicines.
- Severe diarrhoea, dehydration, extensive mouth inflammation or bone-marrow suppression during fluorouracil treatment.
calcium folinate hydrate in pregnancy
Evidence is limited, so specialist assessment of benefits and risks is required. Calcium folinate should not be withheld when clinically necessary to counteract folate-antagonist toxicity, but restrictions for accompanying treatments still apply.
calcium folinate hydrate while breastfeeding
It is unknown whether calcium folinate passes into breast milk. It may be used when clinically necessary after individual specialist assessment. Fluorouracil-containing treatment is incompatible with breastfeeding.
calcium folinate hydrate interactions
Clinically important interactions include:
Methotrexate and other folate antagonists
Calcium folinate can reduce or neutralise their effects; intended rescue must be carefully timed and supervised.
Fluorouracil and other fluoropyrimidines
It increases therapeutic activity but can intensify gastrointestinal, mucosal, blood and neurological toxicity.
Common questions about calcium folinate hydrate
Answers are fully visible for fast scanning and source review.
Is calcium folinate hydrate the same as folic acid?
No. It supplies folinic acid, a reduced folate that can bypass blockade by folate antagonists. Do not substitute routine folic acid unless directed by a clinician.
Why is it given after methotrexate?
It replenishes reduced folate in healthy cells and limits methotrexate toxicity while specialist monitoring guides rescue.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.