Key points

  • We recommend to consult your poison centre with the use of this antidote.
  • For methotrexate poisoning, the dose of leucovorin should equal the dose of methotrexate ingested or injected, if known, and administered early, within 4 hours of intake.
  • Use the IV route only and never use the intrathecal route.
  • Folinic acid or leucovorin, the biologically active forms of folic acid, must be used for reversing toxicity due to dihydrofolate reductase inhibitors (methotrexate).
  • Folic acid, can be used interchangeably with folinic acid or leucovorin only in cases of methanol poisoning.
  • Folic acid or leucovorin facilitates the conversion of formates (toxic) resulting from the metabolism of methanol.
  • Leucovorin contains calcium: rapid intravenous administration can result in complications.

Last updated : 2021-08-31