Pharmacological FOLI
Folinic acid
Folinic acid, also known as 5-formyl tetrahydrofolic acid or leucovorin, is a vital medication used in various cancer treatments and as an antidote for folic acid antagonists like methotrexate.
As a natural and biologically active form of folate, folinic acid enhances the efficacy of chemotherapy agents such as 5-fluorouracil (5-FU) and mitigates the toxic effects of methotrexate. It is particularly crucial in treating colorectal cancer, where it improves patient outcomes when combined with 5-FU. Additionally, folinic acid is used to counteract methotrexate toxicity and to treat folate-deficiency-associated megaloblastic anemia.
While its FDA-approved uses include treating colorectal cancer and megaloblastic anemia, folinic acid also has several off-label applications. These include potential use in treating breast cancer, various non-Hodgkin lymphomas, and as a prophylactic measure for certain infections. It may also help reduce homocysteine levels in patients with hyperhomocysteinemia and protect against bone marrow suppression due to nitrous oxide exposure.
Folinic acid functions by bypassing the need for dihydrofolate reductase, thus rescuing cells from the toxic effects of folic acid antagonists and enhancing the impact of fluoropyrimidines like 5-FU. This action supports critical metabolic processes, including DNA synthesis and repair, by stabilizing enzyme-inhibitor complexes involved in these pathways.
Number of meta-analyses
- Preschool (0-5): no meta-analysis
- School-age (6-12): 4 meta-analyses
- Adolescents (13-17): no meta-analysis
- Adults (18+): no meta-analysis
One meta-analysis per outcome and age group, shown in the Intervention explorer.
See its evidence