Ferplex-Fol is a form of folic acid Folic acid helps your body produce
Ferplex-Fol is a form of folic acid Folic acid helps your body produce

Calcium Folinate (Ferplex-Fol) is a form of folic acid. Folic acid helps your body produce and maintain new cells, and also helps prevent changes to DNA that may lead to cancer. Folic acid is present in many foods such as dried beans, peas, oranges, spinach, and others.
Calcium Folinate (Ferplex-Fol) is used to reduce the side effects of large doses or accidental overdose of medications that can reduce the effects of folic acid in the body. This includes methotrexate (Rheumatrex), pyrimethamine (Daraprim), trimethoprim (Trimpex, Proloprim), and others.
Calcium Folinate (Ferplex-Fol) may also be used for purposes not listed in Calcium Folinate (Ferplex-Fol) guide.

Calcium Folinate (Ferplex-Fol) side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Calcium Folinate (Ferplex-Fol) dosing

Usual Adult Dose for Colorectal Cancer:

200 mg/m2, by slow IV injection, followed by 5-fluorouracil (the manufacturer product information should be consulted), once a day for 5 days
OR
20 mg/m2, IV, followed by 5-fluorouracil (the manufacturer product information should be consulted), once a day for 5 days
Comments:
-Do not be mix in the same infusion as 5-fluorouracil; a precipitate may form.
-May repeat 5 day treatment course at 4 week (28 day) intervals for 2 courses, then repeat at 4 to 5 week (28 to 35 day) intervals provided the patient is completely recovered from toxicities of the prior course.
Use: For use in combination with 5-fluorouracil to prolong survival in the palliative treatment of patients with advanced colorectal cancer.

Usual Adult Dose for Methotrexate Rescue:

Calcium Folinate (Ferplex-Fol) Rescue:
15 mg (approximately 10 mg/m2), orally, IV, or IM, every 6 hours for 10 doses; start 24 hours after beginning of methotrexate infusion (based on a methotrexate dose of 12 to 15 g/m2 IV over 4 hours)
Impaired Methotrexate Elimination or Inadvertent Overdosage:
10 mg/m2 orally, IV, or IM, every 6 hours until methotrexate level is less than 10(-8) mol
Comments:
-Determine serum creatinine and methotrexate levels at least once a day.
-Continue Calcium Folinate (Ferplex-Fol), hydration, and urinary alkalization until methotrexate levels are below 5 x 10(-8) mol.
-Give parenterally if gastrointestinal toxicity, nausea, or vomiting are present.
Uses: Calcium Folinate (Ferplex-Fol) rescue after high dose methotrexate therapy; diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosages.

Usual Adult Dose for Methotrexate Overdosage:

Calcium Folinate Rescue:
15 mg (approximately 10 mg/m2), orally, IV, or IM, every 6 hours for 10 doses; start 24 hours after beginning of methotrexate infusion (based on a methotrexate dose of 12 to 15 g/m2 IV over 4 hours)
Impaired Methotrexate Elimination or Inadvertent Overdosage:
10 mg/m2 orally, IV, or IM, every 6 hours until methotrexate level is less than 10(-8) mol
Comments:
-Determine serum creatinine and methotrexate levels at least once a day.
-Continue Calcium Folinate (Ferplex-Fol), hydration, and urinary alkalization until methotrexate levels are below 5 x 10(-8) mol.
-Give parenterally if gastrointestinal toxicity, nausea, or vomiting are present.
Uses: Calcium Folinate (Ferplex-Fol) rescue after high dose methotrexate therapy; diminish the toxicity and counteract the effects of impaired methotrexate elimination and of inadvertent overdosages.

Usual Adult Dose for Megaloblastic Anemia:

Up to 1 mg, IV or IM, once a day
Comments:
-There is no evidence that doses above 1 mg daily have greater efficacy; additionally, urinary folate loss becomes roughly logarithmic as the amount administered exceeds 1 mg.
Use: Treatment of megaloblastic anemias due to folic acid deficiency when oral therapy is not feasible

Usual Adult Dose for Folic Acid Antagonist Overdose:

5 to 15 mg orally once a day
Use: Diminish the toxicity and counteract the effects of inadvertent overdosages of folic acid antagonists.

Usual Adult Dose for Pneumocystis Pneumonia:

Treatment of pneumocystis pneumonia is not is not a labeled indication.
20 mg/m2 or 0.5 mg/kg, IV or orally, every 6 hours, continued for 3 days after last trimetrexate dose
Comments:
-Use in combination with trimetrexate.
Use: Treatment of pneumocystis pneumonia in HIV infected patients

Usual Adult Dose for Pneumocystis Pneumonia Prophylaxis:

Prophylaxis of pneumocystis pneumonia is not a labeled indication.
25 mg, orally, once a week, in combination with dapsone and pyrimethamine
Comments:
-Prophylaxis in HIV infected patients usually begins when the CD4+ count is less than 200 cells/mm or for a history of oropharyngeal candidiasis.
-Prophylaxis is usually discontinued when CD4+ count is 200 cells/mm or higher for 3 months.
Use: Pneumocystis pneumonia prophylaxis in immunocompromised patients

Usual Adult Dose for Toxoplasmosis:

Use in the treatment of toxoplasmosis is not a labeled indication.
Ocular toxoplasmosis:
5 to 25 mg orally, IV, or IM, with each dose of pyrimethamine
Acute/primary treatment of toxoplasma encephalitis in AIDS patients:
Standard dose: 10 to 20 mg, orally, IM, or IV, once a day, during and for 1 week after pyrimethamine treatment
Maximum dose: 50 mg once a day
Use: Toxoplasmosis treatment

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