Advanced CRC Bimthly regimen: Folinic acid 200 mg/m
2 IV infusion over 2 hr, followed by 5-FU 400 mg/m
2 IV bolus & 22-hr infusion of 5-FU 600 mg/m
2 for 2 consecutive days every 2 wk on days 1 & 2. Wkly regimen: Folinic acid 20 mg/m
2 IV bolus inj or 200-500 mg/m
2 as IV infusion over 2 hr + IV bolus inj of 5-FU 500 mg/m
2 in the middle or end of folinic acid infusion. Mthly regimen: Folinic acid 20 mg/m
2 IV bolus inj or 200-500 mg/m
2 as IV infusion over 2 hr immediately followed by IV bolus inj of 425 or 370 mg/m
2 5-FU during 5 consecutive days.
Folinic acid rescue after chemotherapy w/ MTX >500 mg/m2 Start rescue therapy w/in 24 hr of MTX administration. Dosage schedule: 10 mg/m
2 parenterally followed by 10 mg/m
2 orally (if there is adequate GI function) every 6 hr until serum MTX conc has declined to <10
-8 M.
Antidote to MTX toxicity 75 mg IV infusion w/in 12 hr followed by 12 mg IM every 6 hr for 4 doses. When ave MTX doses appear to have an adverse effect: 6-12 mg IM every 6 hr for 4 doses.
Antidote to trimetrexate toxicity 20 mg/m
2 every 6 hr. Total daily dose: 80 mg/m
2. Folinic acid should be given daily during trimetrexate treatment either orally or IV over 5-10 min & should be continued for at least 72 hr after the last trimetrexate dose. Recommended course: 21 days trimetrexate therapy & 24 days folinic acid.
Overdosage w/ trimetrexate >90 mg/m2 w/o folinic acid administration 40 mg/m
2 IV every 6 hr for 3 days.
Antidote to pyrimethamine toxicity 3-9 mg/day IM for 3 days.
Antidote to trimethoprim toxicity 3-10 mg/day.
Megaloblastic anemia due to folate deficient 1 mg IM daily.
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