Folinic Acid Rescue for Vincristine Toxicity

Abstract

Inadvertent vincristine sulfate overdosage was treated with folinic acid. The sequence of development of the signs and symptoms associated with known vincristine toxicity was accentuated; however, the duration of these toxicities was markedly compressed in time when compared with previous reports. The known pharmacologic and biologic activities of vincristine sulfate and presumed mechanism of counteractivity of folinic acid is presented.

Errors involving pediatric patients receiving chemotherapy: A literature review

“…It has been postulated that it works by overcoming a vinca alkaloidmediated block of dihydrofolate reductase, or by the restoring cellular capacity to synthesize RNA and proteins [20,29]. Furthermore, there has not been any controlled trial demonstrating its effectiveness in reducing toxicities associated with vinca alkaloids.…”

“…Folinic acid was used as rescue therapy in 10 cases (20)(21)(22)(23)(24)28,29,38] and was reported to have reduced the duration of neurotoxicities, or toxicity to bone marrow, in 6 [20,21,23,24,29]. The dosage, except for one of those six cases, was greater than 2 mg/kg/day.…”

Clinical Activity of Folinic Acid in Patients with Chronic Fatigue Syndrome

“…Folinic acid was previously shown to be an effective agent for treatment of patients with a deficiency of dihydropteridine reductase (DHPR) and presumed CNS folate deficiency [47]. It is also effective in treatment of severe neuropathy and fatigue caused by the chemotherapeutic drugs vincristine [48], vinblastine [49], and methotrexate [50,51]. The observed activity of folinic acid in patients with CFS may provide the foundation for a new standard of care for this frequently debilitating condition.…”

Development of a Policy and Procedure for Accidental Chemotherapy Overdose

“…Leucovorin (Grush & Morgan, 1979;Thomas et al, 1982;Viketal., 1985) 10-15 mg/m2 every three hours for the duration of 24 doses LFT, cardiac function, neurologic function or seizures, bone marrow function, and SIADH Sincalide (Jackson et al, 1982) 0.01 mcg/kg per hour continuous infusion in 250-1,000 ml D5W. Continue until ileus is resolved.…”