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Randomized trial of surgery versus surgery followed by adjuvant hepatic arterial infusion with 5-fluorouracil and folinic acid for liver metastases of colorectal cancer.
If signs of folate deficiency develop, pyrimethamine should be discontinued and folinic acid should be given until hematopoiesis is restored (see above).
Rescue treatments of IT MTX overdose may include cerebrospinal fluid (CSF) exchange, ventricular washout, folinic acid rescue, and the investigational agent carboxypeptidase G2, an enzyme that rapidly hydrolyzes MTX into inactive metabolites (5-9) There are only a few reports of patients with IT MTX overdose in the literature, and the management has not been uniform.
Investigators at Arkansas Children's Hospital Research Institute treated 40 autistic children for three months with methylcobalamin (a form of vitamin B12 that is active in the central nervous system) and folinic acid, which has vitamin activity equivalent to folic acid.
Because the patient could not tolerate high dose of trimetoprim-sulfamethoxazole and developed leukopenia and skin rash despite the concomitant use of folinic acid, it has been replaced with moxifloxacine, the most effective fluoroquinolone against Stenotrophomonas maltophilia.
2) Concomitant use of either folic acid or folinic acid (high doses of folinic acid being an exception) with methotrexate has no impact on the therapeutic efficacy of methotrexate in multiple clinical trials and meta-analyses.
Despite a "lack of evidence for its continuous use" (9), HDMTX remains a key component of most protocols for childhood ALL and NHL; however, the MTX dose, the timing of administration, and folinic acid rescue are being increasingly discussed (2, 8, 10, 11).
Those with breast cancer were treated with doxorubicin, mitoxantrone, or paclitaxel, and patients with gastrointestinal tract tumors received 5 fluorouracil (5-FU) and folinic acid.
That patient then was readmitted and given a course of methotrexate and folinic acid.
It is believed that Eloxatin, used with 5-fluorouracil (5FU) and folinic acid (FA), offers a potential cure for patients with early stage bowel cancer.
CYRAMZA (ramucirumab injection 10 mg/mL solution) is now also indicated in combination with FOLFIRI (irinotecan, folinic acid, and 5-fluorouracil) chemotherapy for the treatment of patients with metastatic colorectal cancer (mCRC) with disease progression on or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine.
Children with folate receptor autoantibodies were treated with oral folinic acid (leucovorin calcium; 2 mg/kg of body weight per day; maximum, 50 mg per day).