Folidel 5
Form: Tablet
Strength: 5mg
Generic Name: Folinic Acid
Company: Delta Pharma Limited
MRP:৳ 9.0 (Strip=10)
Per Piece: ৳ 0.90
Is Antibiotic: No
Indications
Folidel 5 is used to neutralize the toxic effects of folic acid blockers, such as methotrexate. Folidel 5 is also used in a treatment method called “calcium folinate rescue” to reduce the toxicity from folic acid blockers. Additionally, Folidel 5 is used to treat megaloblastic anemia caused by conditions like sprue, nutritional deficiencies, pregnancy, infancy, liver disease, and malabsorption syndromes.
Pharmacology
This preparation is calcium folinate hydrate, which is a calcium salt of folinic acid, a form of folic acid. Folidel 5 is involved in reactions that help build nucleic acids (DNA and RNA). Folic acid deficiency leads to poor DNA production, causing megaloblastic anemia. Because calcium folinate can turn into other forms of tetrahydrofolic acid, Folidel 5 acts as a powerful antidote to the toxic effects of folic acid blockers like methotrexate. Folidel 5 also helps protect normal cells from the damage caused by these blockers in certain cancers, which is why Folidel 5 is used in high-dose methotrexate therapy.
Dosage & Administration
Calcium Folinate Rescue: Start the rescue treatment as soon as possible after methotrexate overdose, ideally within 24 hours. The dose of methotrexate influences the amount of calcium folinate needed, but for doses over 500 mg/m2, a dose of 15 mg (around 10 mg/m2) every 6 hours for 10 doses is usually recommended.
Neutralizing Toxic Effects: If methotrexate overdose is suspected, calcium folinate should be given in the same amount or more than the methotrexate dose, within one hour of methotrexate administration.
Megaloblastic Anemia: 5 mg to 15 mg of calcium folinate per day can be used for treating folate deficiency.
Use in Children: The safety and effectiveness of calcium folinate in children and adolescents have not been established.
Interaction
Taking large amounts of folinate may reduce the effectiveness of antiepileptic drugs like phenobarbitone, phenytoin, and primidone, possibly increasing the risk of seizures. Caution is needed when calcium folinate is taken with fluoropyrimidine drugs, as this has been linked to seizures and fainting.
Contraindications
Folidel 5 is contraindicated in patients who are allergic to calcium folinate or any of its components. Folidel 5 should not be used in cases of pernicious anemia or any megaloblastic anemia caused by vitamin B12 deficiency. Patients with rare hereditary issues such as galactose intolerance, lactase deficiency, or glucose-galactose malabsorption should avoid calcium folinate.
Side Effects
The most common side effects are mouth ulcers, inflammation of the mouth, low white blood cell count, and diarrhea. These side effects may limit the dosage.
Pregnancy & Lactation
There are no well-controlled studies on the use of calcium folinate during pregnancy. Folidel 5 should only be used if the benefits outweigh the risks. Folidel 5 is not known if calcium folinate passes into breast milk, so caution is advised when administering Folidel 5 to breastfeeding mothers.
Precautions & Warnings
Calcium folinate should only be used with methotrexate or 5-FU under the supervision of a healthcare professional experienced in cancer treatment. In cases of accidental overdose with folic acid antagonists, calcium folinate should be given as soon as possible, ideally within 4 hours. Folidel 5 is generally not recommended to give calcium folinate with folic acid antagonists like methotrexate for treating toxicity, as this may reduce the effect of the antagonist. However, Folidel 5 can be used with certain folate antagonists like pyrimethamine and trimethoprim without affecting their antibacterial properties.
Overdose Effects
There have been no reported harmful effects from taking more calcium folinate than recommended. However, taking too much may cancel out the effects of folic acid blockers. There is no specific antidote for calcium folinate overdose, and treatment would involve providing appropriate supportive care.
Therapeutic Class
Supportive Care Therapy
Storage Conditions
Store below 30°C, away from light, and keep out of reach of children.
Similar Brands of Folinic Acid (Tablet – 5mg)
| Brand Name | Form | Strength | Company | MRP (৳) |
|---|---|---|---|---|
| Foly | Tablet | 5mg | Drug International Ltd. | 9.0 |