What Is Leucovorin (Folinic Acid)?

Leucovorin, also known as Folinic Acid, is an active form of folate (a type of B vitamin) used as a medication to enhance or rescue cells from the toxic effects of certain chemotherapy drugs, particularly methotrexate. It acts as a precursor to active folate metabolites and can bypass metabolic blocks caused by folate antagonists. Additionally, Leucovorin is employed in treatment regimens for Cerebral Folate Deficiency. The high dosage of Folinic Acid increases cerebral folate activity, even in the presence of inactive folate receptors.

Differences Between Leucovorin and Folate Supplements

While folate can be sourced as a nutritional supplement, there are two significant differences to note. Firstly, most folate supplements contain Pteroyl Glutamate, which is an inactive form of folate that must be converted to the active form. Secondly, the typical dose of folate in a supplement is much lower than that in Leucovorin (0.4 mg compared to 15 mg).

Availability of Leucovorin in Hong Kong

Another complication is that, here in Hong Kong, Leucovorin is not available; instead, we use the generic Calcium Folinate 15 mg tablet. Low doses of Folinic Acid and MTHF, the active forms of folate, are readily available from supplement outlets such as iHerb.

Consultation with a Healthcare Professional

Before starting treatment with Leucovorin or Calcium Folinate, it's essential to consult a healthcare professional. Personalised advice on health conditions, potential medication interactions, and the correct dosages can be provided. This ensures safe and effective management of folate-related therapies and chemotherapy.

Dr Tim Trodd

Family Medicine, Functional Medicine, General Practice

MBBS (London)
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What Is Cerebral Folate Deficiency? Understanding This Neurological Disorder

References

Frye, R.E., Sequeira, J.M. and Quadros, E.V. (2018) 'Leucovorin improves verbal communication in children with autism and language impairment: A randomised double-blind placebo-controlled trial', Molecular Psychiatry, 23(1), pp. 247–256. Available at: https://doi.org/10.1038/mp.2017.40
Herbert, V. (2001) 'Folic acid and vitamin B12', in Shils, M.E. and Shike, M. (eds.) Modern Nutrition in Health and Disease. 10th edn. Philadelphia: Lea & Febiger, pp. 402–414.
Desai, A., Sequeira, J.M. and Quadros, E.V. (2016) 'The metabolic basis for developmental disorders due to defective folate transport', Biochimie, 126, pp. 31–42. Available at: https://doi.org/10.1016/j.biochi.2016.01.012
Steinfeld, R., Grapp, M., Kraetzner, R. et al. (2009) 'Folate receptor alpha defect causes cerebral folate transport deficiency: A treatable neurodegenerative disorder associated with disturbed myelin metabolism', American Journal of Human Genetics, 85(3), pp. 354–363. Available at: https://doi.org/10.1016/j.ajhg.2009.07.003
Matherly, L.H. and Goldman, D.L. (2003) 'Membrane transport of folates', Vitamins and Hormones, 66, pp. 403–456. Available at: https://doi.org/10.1016/S0083-6729(03)66015-6