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Contraindications and precautions
This medication is contraindicated by megaloblastic anemia due to vitamin B12 deficiency, including pernicious anemia, because it heals the symptoms of the disease. Without preventing the growth of neurological complications.
Calcium folinate, when administered concurrently with 5- fluorouracil, increases the toxicity and side effects of the second drug and requires regular monitoring of the patient's blood and liver. Pregnancy and breast-feeding should be prescribed with caution.
If the patient is likely to vomit, the use of the injectable form of the drug is preferable.
Calcium folinate has no effect on non-thyroid side effects of monotherapy, such as its hepatic toxicity.
Important drug interactions:
Pharmaceutical: 1) Folic acid reduces the effect of anticonvulsants such as phobarbital, phenytoin and pyrimidone, and calcium folinate may also have similar effects. 2) Calcium folinate increases the effects of 5-FU, especially digestive problems. 3) Calcium folinate inhibits the effects of folic acid antagonists, such as methotrexate.
Laboratory: No case has been reported.
side effects
Rarely, allergies or symptoms such as rash, itching, erythema and shortness of bronchitis can rarely follow the administration of the injection form of that fever.
Consumption in pregnancy and lactation
It is not known whether calcium folinate damps the fetus. Use only if necessary. It is not known whether calcium folinate is given to the mother's breast, so be prescribed cautiously to breast-feeding mothers.
Poisoning and treatment
High levels of calcium folinate reduce the effect of folic acid antagonists, such as paclitaxel or trimethoprim.
Medical attention - nursing
1) When treating methotrexate poisoning, it is best to determine the concentration of methotrexate to select the appropriate amount of calcium folinate. 2) If a patient suffering from methotrexate poisoning, ascites, fluid accumulation in the lung, renal failure or dehydration, more or prolonged calcium folinate concentrations are required. 3) Do not inject intravenously due to the calcium content found in calcium folinate solution at speeds exceeding 160 mg / min. 4) Patients should receive calcium folinate in the treatment of folic acid antagonists (methotrexate, perimethine or trimethoprim). The more the drug is delivered to the patient later, the less impact it will have. 5) In some calcium folinate products, there is benzyl alcohol, which can cause problems, such as gasping syndrome, especially in premature babies. 6) Drug, especially the diluted form, protect it from heat and light. 7) Be careful about the condition of the kidneys and possible signs of allergy. 8) If the disease is due to anemia, but the cause is unknown, calcium folinate should be used to treat it because it may be a patient with pernious anemia and hematologic manifestations of calcium folinate will improve the anemia, but neurological complications It continues to stretch and thus the patient may have severe neurological complications. 9) The use of this drug with fluorouracil should be cautious, especially if the patient is elderly. 10) If calcium folinate is used as an oral solution prepared from the powder, since it contains 21-23 percent alcohol for aromatherapy, if calcium folinate concentrations are higher than the recommended amount It should be noted that the patient does not suffer from alcohol-related complications in these oral solutions. 11) If calcium folinate is used to counteract the toxic effects of methotrexate, the plasma level of methotrexate should be measured and the calcium folinate should be used and the duration of treatment should be determined. In this case, creatinine clearance should be measured before calcium folinate therapy, and urine pH should be checked every 6 hours before and after treatment. Serum creatinine levels should also be measured daily. This will be immediately detected in case of kidney impairment. 12) In order to prepare this drug for injection, every 5 mg of calcium folinate in the vial should be added to 5 cc bactetravascular injectable water containing benzyl alcohol. The solution obtained in this way should be used within 7 days. If the preparation is to be injected with distilled water, the solution should be used promptly. 13. The calcium folinate solution with 100 to 500 cc can be diluted from most existing injectable serums (such as 5% dextrose). 14) For intravenous administration of the drug, the diluted solution should be injected intravenously in the form of a volume of 15 to 60 minutes, depending on its size.
Patient education - family
1) If you have any symptoms of hypersensitivity such as pruritus, hives and rash, if you are taking this medication, you should inform your doctor immediately. 2) The patient should avoid excessive intake of the drug and take the prescribed medicine at a given time. 3) If the patient forgets to take the drug one time, you should refrain from using it after reminders and discuss the matter with your doctor.
Maintenance
Calcium folinate should be kept out of the light and stored at room temperature.
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