Levoleucovorin 1

Generic Name: levoleucovorin (LEE voe LOO koe VOE rin)Brand Names: Fusilev

What is Levoleucovorin 1 (levoleucovorin)?

Levoleucovorin is used to treat or prevent toxic effects of methotrexate in people who have received methotrexate to treat bone cancer.

Levoleucovorin is also used to treat or prevent toxic effects of methotrexate in people whose bodies do not eliminate methotrexate properly after the drug is metabolized.

Levoleucovorin may also be used to treat toxic effects of an accidental overdose of methotrexate.

Levoleucovorin should not be used to treat anemia that is caused by a lack of vitamin B12.

Levoleucovorin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Levoleucovorin 1 (levoleucovorin)?You should not receive this medication if you are allergic to levoleucovorin or to folic acid or folinic acid. If possible, before you receive levoleucovorin, tell your doctor if you have kidney or liver disease, or if you are dehydrated.

Tell your doctor if you are taking sulfa drugs, seizure medication, a cancer medication called fluorouracil (5FU), or a multivitamin or mineral supplement than contains folic acid.

In an emergency situation, it may not be possible before you are treated to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for you afterward knows that you have received this medication.

What should I discuss with my healthcare provider before I receive Levoleucovorin 1 (levoleucovorin)?You should not receive this medication if you are allergic to levoleucovorin or to folic acid or folinic acid.

If possible, before you receive levoleucovorin, tell your doctor if you have:

• kidney disease;
• liver disease; or

• if you are dehydrated.

FDA pregnancy category C. It is not known whether levoleucovorin is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether levoleucovorin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible to tell your caregivers that you are pregnant or breast-feeding before you are treated with levoleucovorin. However, make sure any doctor caring for your pregnancy or your baby knows that you have received the medication.

How is levoleucovorin given?

Levoleucovorin is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and can take up to 4 hours to complete.

Levoleucovorin is usually given every 6 hours for 10 doses. You will most likely receive your first dose 24 hours after the start of your methotrexate infusion, or as soon as possible within the first 24 hours after accidental overdose.

After treatment with levoleucovorin, you will be watched to make sure the medication has been effective and you no longer have any effects of methotrexate.

To be sure this medication is not causing harmful effects, your blood will need to be tested at least once daily for a short period of time while you are receiving levoleucovorin. This will help your doctor determine if your dose needs to be adjusted.

What happens if I miss a dose?

Since this medication is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a levoleucovorin overdose are not known.

What should I avoid while receiving Levoleucovorin 1 (levoleucovorin)?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Levoleucovorin 1 (levoleucovorin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have a serious side effect such as:

• white patches or sores inside your mouth or on your lips;

• urinating more or less than usual;

• numbness or tingling;

• fever, chills;

• confusion; or

• trouble breathing.

Less serious side effects may include:

• nausea, vomiting, diarrhea;

• stomach pain, upset stomach;

• mild skin rash; or

• white patches or sores inside your mouth or on your lips.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Levoleucovorin 1 (levoleucovorin)?

The following drugs can interact with levoleucovorin. Tell your doctor if you are using any of these:

• fluorouracil (5-FU, Adrucil, Efudex, Carac, Fluoroplex);

• sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);

• seizure medication such as phenobarbital (Solfoton), phenytoin (Dilantin), or primidone (Mysoline); or

• a multivitamin or mineral supplement than contains folic acid.

This list is not complete and there may be other drugs that can interact with levoleucovorin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about levoleucovorin.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.01. Revision Date: 11/04/2009 2:25:05 PM.