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Leucovorin is a medication used in the treatment of methotrexate toxicity and chemotherapy regimens. Leucovorin is a folate analog. This activity reviews the indications, action, and contraindications for leucovorin as a valuable agent in the reversal of methotrexate toxicity and as a part of chemotherapy regimens. This activity will highlight the mechanism of action, adverse event profile, and other key factors pertinent to members of the healthcare team in the management of patients on leucovorin therapy. Objectives: Identify the mechanism of action of leucovorin. Describe the potential adverse effects of leucovorin. Review the appropriate monitoring necessary following administration of leucovorin. Outline interprofessional team strategies for improving care coordination and communication to improve outcomes for patients on leucovorin therapy. Access free multiple choice questions on this topic.
When administered along with fluorouracil, the following side effects can occur. Dermatologic: alopecia, dermatitis Gastrointestinal: stomatitis, nausea, diarrhea, vomiting, anorexia Central nervous system: fatigue, malaise
Leucovorin is a useful drug used in the setting of chemotherapy and methotrexate overdose/toxicity. Care of patients undergoing combination chemotherapy with leucovorin can be challenging and requires an interprofessional team of clinicians from different specialties, nurses, and pharmacists. It is useful to know the symptoms of the toxicity of methotrexate. Early recognition of toxicity and early institution of treatment can reduce adverse outcomes. When the clinician initiates leucovorin, they will do well to consult with the pharmacist to ensure proper dosing, the absence of potential interactions, and review the adverse events and corrective actions. Dosing and administration will fall to nursing; they must also be well-informed regarding early signs of adverse reactions and keep the team informed on patient tolerance and therapeutic progress. If any issues become apparent, the nursing staff should promptly involve the pharmacy and the clinicians for corrective action. These interprofessional actions will optimize leucovorin therapy results while minimizing adverse effects. [Level 5]