Pricing
Prices are indicative MRP and may vary by pharmacy. Trend compares against the last recorded price.
All price changes →More from Folicid
Other strengths and forms by Techno Drugs Ltd., Satipara, Narshingdi
Indications & Uses
Folistar is used to counteract the immediate toxic effects of folic acid antagonists such as methotrexate, and is central to calcium folinate rescue, a treatment technique in which calcium folinate is given alongside folic acid antagonists like methotrexate to minimise systemic toxicity. It is also used to treat megaloblastic anaemias arising from sprue, nutritional deficiency, pregnancy, infancy, liver disease and malabsorption syndrome.
Pharmacology
Calcium Folinate Hydrate is the calcium salt of folinic acid, the 5-formyl derivative of tetrahydrofolic acid. It is a metabolite and active form of folic acid that acts as a cofactor for 1-carbon transfer reactions in the biosynthesis of purines and pyrimidines needed for nucleic acids. In patients with folic acid deficiency, impaired thymidylate synthesis is thought to underlie the defective DNA synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemias. Because it converts readily to other tetrahydrofolic acid derivatives, folinate is a potent antidote for both the hematopoietic and reticuloendothelial toxic effects of folic acid antagonists such as methotrexate, pyrimethamine, and trimethoprim. In some cancers, folinate is thought to enter and "rescue" normal cells from the toxic effects of folic acid antagonists in preference to tumour cells, owing to differences in membrane transport mechanisms; this principle underlies high-dose methotrexate therapy with "folinate rescue."
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Folinic Acid rescue should begin as soon as possible after an inadvertent overdose and within 24 hours of methotrexate administration when there is delayed excretion. There are no fixed guidelines regarding the dose of methotrexate that triggers an automatic subsequent Folinic Acid administration, since tolerance to this folate antagonist depends on various factors. The dose of methotrexate varies, but folinate rescue is necessary when methotrexate is given at doses exceeding 500 mg/m2 and should be considered at doses of 100 mg to 500 mg/m2. Folinic Acid rescue treatment should commence approximately 24 hours after the start of the methotrexate infusion. Dosage regimens vary depending on the dose of methotrexate given. In general, Folinic Acid should be given at a dose of 15 mg (approximately 10 mg/m2) every 6 hours for 10 doses.
The recommended dose of Folinic Acid to counter hematologic toxicity from folic acid antagonists with less affinity for mammalian dihydrofolate reductase than methotrexate, such as trimethoprim and pyrimethamine, is substantially lower, and 5 mg to 15 mg of Folinic Acid per day has been recommended.
Neutralising the immediate toxic effects of folic acid antagonists: if overdose of methotrexate is suspected, the dose of Folinic Acid should be equal to or greater than the dose of methotrexate and should be given within one hour of the methotrexate administration.
Megaloblastic anaemia (folate deficiency): 5 mg to 15 mg of Folinic Acid per day.
Use in children and adolescents: the safety and efficacy of folinic acid in children and adolescents have not been established.
Side Effects
Common side effects of Folistar include mucositis, stomatitis, leukopenia and/or diarrhea, which can limit the dose used.
Cautions & Contraindications
Warnings & Precautions
Folistar should only be used together with methotrexate or 5-FU under the direct supervision of a clinician who is experienced in the use of cancer chemotherapeutic agents. When treating inadvertent overdosage of a folic acid antagonist, folinate should be given as soon as possible, since if more than 4 hours pass before treatment begins, it may no longer be effective. In general, Folistar should not be given at the same time as folic acid antagonists such as methotrexate to abort clinical toxicity, because doing so may nullify the therapeutic effect of the antagonist. However, when Folistar is given concurrently with folate antagonists such as pyrimethamine and trimethoprim, it does not inhibit their antibacterial activity. Ensuring the prompt excretion of methotrexate is an important part of Folistar Rescue Therapy. This involves alkalinising the urine so that the urinary pH is greater than 7.0 before the methotrexate infusion, which increases the solubility of methotrexate and its metabolites, and maintaining a urine output of 1800 to 2000 cc/m2 every 24 hours through increased oral or intravenous fluids on days 2, 3 and 4 following methotrexate therapy. Plasma methotrexate concentration, BUN and creatinine should be measured on days 2, 3 and 4, and these measures should continue until the plasma methotrexate level falls below 10 to the power of minus 7 molar.
Contraindications
Folinic Acid should not be used by anyone with a known hypersensitivity to calcium folinate or to any other ingredient in this product. It is also unsuitable for pernicious anaemia or other forms of megaloblastic anaemia caused by vitamin B12 deficiency. Patients with rare hereditary conditions such as galactose intolerance, lapp lactase deficiency, or glucose-galactose malabsorption should avoid calcium folinate tablets.
Pregnancy & Breastfeeding
Pregnancy & Breastfeeding
There haven't been adequate, well-controlled studies of folinic acid in pregnant women, so it should be used during pregnancy only if the expected benefit outweighs the possible risk to the baby. It also isn't known whether the drug passes into breast milk. Since many medicines do pass into breast milk, calcium folinate should be given to a breastfeeding mother with caution.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
No problems have been reported in patients who received much more calcium folinate than the recommended dose. Still, too much calcium folinate can cancel out the chemotherapy effect of folic acid antagonists. There is no specific antidote for a calcium folinate overdose. If an overdose happens, the patient should be given appropriate supportive care.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Folinic Acid below 30°C and away from light. Keep it out of the reach of children.
Drug Interactions
Common questions about Folicid 10 mg/ml
What is Folicid 10 mg/ml IM/IV Injection?
Folicid 10 mg/ml IM/IV Injection is a medicine that contains Folinic Acid. It is made by Techno Drugs Ltd., Satipara, Narshingdi. It belongs to the Supportive Care Therapy group of medicines.
What is Folicid used for?
Folistar is used to counteract the immediate toxic effects of folic acid antagonists such as methotrexate, and is central to calcium folinate rescue, a treatment technique in which calcium folinate is given alongside folic acid antagonists like methotrexate to minimise systemic toxicity. It is also used to treat megaloblastic anaemias arising from sprue, nutritional deficiency, pregnancy, infancy, liver disease and malabsorption syndrome.
What are the side effects of Folicid?
Common side effects of Folistar include mucositis, stomatitis, leukopenia and/or diarrhea, which can limit the dose used.
Can I take Folicid during pregnancy or while breastfeeding?
Pregnancy & Breastfeeding There haven't been adequate, well-controlled studies of folinic acid in pregnant women, so it should be used during pregnancy only if the expected benefit outweighs the possible risk to the baby. It also isn't known whether the drug passes into breast milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Folicid?
No problems have been reported in patients who received much more calcium folinate than the recommended dose. Still, too much calcium folinate can cancel out the chemotherapy effect of folic acid antagonists. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Folicid?
Store Folinic Acid below 30°C and away from light. Keep it out of the reach of children.
Can I take other medicines with Folicid?
Some medicines can interact with Folinic Acid, for example: Phenobarbitone, Primidone, Phenytoin, Oxaliplatin. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Folicid?
Folicid is a prescription (Rx) medicine. Take it as your doctor advises.