Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Calcium folinate 10 mg/ml solution for injection/infusion
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Calcium folinate hydrate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
How to take it
Calcium folinate This medicine may be given by injection or infusion (drip) into a vein, or as an injection into a muscle. If it is given by infusion this medicine will be diluted first.
You should not be given Calcium folinate together with certain anticancer drugs if you are pregnant or breast-feeding (your doctor will know Your doctor will determine the correct which these are). dose of this medicine for you and how often it must be given. It will depend This medicine must not be injected upon the medical condition which is into the spine (intrathecally). being treated, your body surface area and any other treatment you may be Warnings and precautions receiving. Talk to your doctor or nurse before If you are given more Calcium you are given this medicine if: − you have kidney disorders (you may folinate than you should need a higher dose or need this This medicine will be given to you in medicine for longer period of time); a hospital, under the supervision of − you have epilepsy. a doctor. It is unlikely that you will be given too much or too little. Use of calcium folinate with However, tell your doctor or nurse if fluorouracil you have any concerns. You should not receive this medicine together with fluorouracil if you have If you have any further questions on noticed that your medicine is causing the use of this medicine, ask your problems to your stomach and gut. doctor or nurse. 4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them.
Tell your doctor or nurse immediately if you experience: a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause Your doctor will monitor how well difficulty in swallowing or your liver and/or kidneys are working breathing), and you may feel you and will take regular blood tests to are going to faint. These may be check this. signs of very rare severe allergic at 25 °C followed by 8 minutes of The following information is intended centrifugation. for medical or healthcare professionals Droperidol 2.5 mg/0.5 ml with only: calcium folinate 10 mg/0.5 ml, immediate precipitation when the Incompatibilities medicines were injected sequentially This medicinal product must not be into a Y-site without flushing the mixed with other medicinal products Y-side arm between injections. except those mentioned in section 'Instructions for use, disposal and Fluorouracil other handling' below. Incompatibilities have been reported Calcium folinate must not be mixed between injectable forms of calcium in the same infusion as 5-fluorouracil because a precipitate may form. folinate and injectable forms of Fluorouracil 50 mg/ml with calcium droperidol, 5-fluorouracil, foscarnet folinate 20 mg/ml, with or without and methotrexate. glucose 50 mg/ml (5 %) solution for injection, has been shown to be Droperidol incompatible when mixed in different Droperidol 1.25 mg/0.5 ml with amounts and stored at 4 °C, 23 °C, or calcium folinate 5 mg/0.5 ml, 32 °C in polyvinyl chloride containers. immediate precipitation in direct admixture in syringe for 5 minutes
Place for bleedmarks
In case you should receive calcium folinate and fluorouracil at the same time talk to your doctor or nurse before you are given this medicine if: − you have had radiotherapy; − you have stomach or bowel disorders; − you have an inflammation on the inside of your mouth; − you are elderly; − you feel very weak.
injection. From a microbiological point of view, the diluted product should be used immediately. If not used immediately, in-use storage times and conditions prior to the use are the responsibility of the user and would not normally be longer than 24 hours at 2 to 8 °C, unless dilution has taken place in controlled and validated aseptic conditions.
Chemical and physical in-use stability has been demonstrated for 24 hours at Uncommon (may affect up to 2 to 8 °C after dilution with glucose 1 in 100 people) 50 mg/ml (5 %) solution for injection. fever From a microbiological point of view, unless the method of opening/dilution Rare (may affect up to precludes the risk of microbial 1 in 1 000 people) contamination, the product should be insomnia used immediately. If not used agitation and depression (after high immediately, in-use storage times and doses) conditions are the responsibility of an increase in convulsions (fits) in user. patients with epilepsy gastrointestinal disorders (after high Do not throw away any medicines via doses) wastewater or household waste. Ask your pharmacist how to throw away Combination therapy with medicines you no longer use. These fluorouracil only measures will help protect the If you receive calcium folinate in environment. combination with fluorouracil, it is more likely that you experience the following side effects:
Possible side effects
not listed in this outer cartons. leaflet. You can also report side effects directly via Yellow Card Scheme. Pack sizes: Website: www.mhra.gov.uk/yellowcard 1, 5 or 10 vials of 5 ml or search for MHRA Yellow Card in 1 or 10 vials of 10 ml the Google Play or Apple App Store. 1 or 10 vials of 20 ml By reporting side effects you can help 1 or 10 vials of 30 ml provide more information on the safety 1 or 10 vials of 50 ml of this medicine. 1 or 10 vials of 100 ml
How to store it
Calcium folinate
Not all pack sizes may be marketed.
Marketing authorisation holder and Manufacturer AS KALCEKS Krustpils iela 71E, Rīga, LV-1057, Latvia Do not use this medicine after the expiry date which is stated on the vial Tel.: +371 67083320 and carton after EXP. The expiry date E-mail: [email protected] refers to the last day of that month. This leaflet was last revised in Store in a refrigerator (2 °C ‒ 8 °C). 01/2024 Keep the vial in the outer carton in order to protect from light. Keep this medicine out of the sight and reach of children.
Shelf life after dilution Chemical and physical in-use stability has been demonstrated for 4 days at 25 °C (protected from light) and at 2 to 8 °C after dilution with sodium chloride 9 mg/ml (0.9 %) solution for Foscarnet Foscarnet 24 mg/ml with calcium folinate 20 mg/ml; formation of a cloudy yellow solution reported. Instructions for use, disposal and other handling For single use only. Use immediately after opening the vial. Discard any remaining contents after use. The solution should be inspected visually prior to use. Do not use if there are any visible signs of deterioration (e.g. particles). Only clear solutions free from visible particles should be used. Dilution for intravenous infusion To administer the dose for a given
04.01.2024. MUK/I/10/1
patient, aseptically withdraw the appropriate amount of Calcium folinate 10 mg/ml solution for injection/infusion from the vial, then dilute it with any of compatible solutions mentioned below. For storage conditions and shelf life after dilution, see section 5. For intravenous infusion may be diluted with: − sodium chloride 9 mg/ml (0.9 %) solution for injection; − glucose 50 mg/ml (5 %) solution for injection. Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
Place for bleedmarks
After opening the vial: the product should be used immediately.
Contents of the pack and other information
Very common (may affect more than 1 in 10 people) What Calcium folinate contains − The active substance is folinic acid bone marrow failure (including as calcium folinate hydrate. life-threatening conditions) inflammation of the lining of the intestine and mouth (life-threatening Each ml of solution contains calcium conditions have occurred) folinate hydrate equivalent to 10 mg nausea, vomiting and diarrhoea folinic acid. (with monthly dosing) Each vial with 5 ml solution contains severe diarrhoea and dehydration calcium folinate hydrate equivalent to (with weekly dosing) 50 mg folinic acid. Each vial with 10 ml solution contains calcium folinate hydrate equivalent to Common (may affect up to 100 mg folinic acid. 1 in 10 people) redness and swelling of the palms Each vial with 20 ml solution contains of the hands or the soles of the feet calcium folinate hydrate equivalent to 200 mg folinic acid. which may cause the skin to peel Each vial with 30 ml solution contains (hand-foot syndrome) calcium folinate hydrate equivalent to 300 mg folinic acid. Not known (frequency cannot be Each vial with 50 ml solution contains estimated from the available data) elevated ammonia level in the blood calcium folinate hydrate equivalent to 500 mg folinic acid. Tell your doctor if you experience Each vial with 100 ml solution diarrhoea or an inflammation of the contains calcium folinate hydrate lining of the mouth, as your doctor equivalent to 1000 mg folinic acid. might wish to decrease the dose of Each 1 mg of folinic acid is equivalent fluorouracil until symptoms have to 1.08 mg of calcium folinate. fully disappeared.
reaction (may affect up to 1 in 10,000 people). You may need urgent medical attention reddish flat, target-like or circular patches on the trunk, often with central blisters, skin peeling, ulcers of mouth, throat, nose, genitals and eyes. These serious skin rashes can be preceded by fever and flu-like symptoms (Stevens-Johnson syndrome, toxic epidermal necrolysis) (frequency cannot be estimated from the available data)
Because diarrhoea may be a sign of − The other ingredients are sodium toxicity to the stomach and gut, if you chloride, sodium hydroxide (for pH show these symptoms, you will be adjustment), water for injections. carefully monitored until the symptoms What Calcium folinate looks like and have disappeared completely. These contents of the pack symptoms may be the start of a rapid Clear, colourless or yellowish solution deterioration leading to death. free from visible particles. Your doctor may do tests to check for low levels of calcium in your blood. 5 ml, 10 ml, 20 ml, 30 ml, 50 ml or 100 ml of solution filled in clear glass vials closed with bromobutyl rubber Reporting of side effects If you get any side effects, talk to your stoppers sealed with aluminium doctor or nurse. This includes any flip-off seals. Vials are packed into
Frequently asked questions about Calcium folinate 10 mg/ml solution for injection/infusion
How do I take Calcium folinate 10 mg/ml solution for injection/infusion?
Calcium folinate 10 mg/ml solution for injection/infusion comes as injection containing 10mg/ml. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Calcium folinate 10 mg/ml solution for injection/infusion?
The active substance in Calcium folinate 10 mg/ml solution for injection/infusion is calcium folinate hydrate.
Are there equivalent medicines to Calcium folinate 10 mg/ml solution for injection/infusion?
Medicines with the same active substance, strength and form include: Calcium Folinate 10 mg/ml Injection. They are interchangeable only if your prescriber or pharmacist says so.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Calcium folinate 10 mg/ml solution for injection/infusion, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Calcium folinate 10 mg/ml solution for injection/infusion without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: calcium folinate hydrate
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Calcium folinate is indicated:
− to diminish the toxicity and counteract the action of folic acid antagonists such as methotrexate in cytotoxic therapy and overdose in adults and children. In cytotoxic therapy, this procedure is commonly known as “calcium folinate rescue”;
− in combination with 5-fluorouracil in cytotoxic therapy.
4.2. Posology and method of administration
Posology
Calcium folinate rescue in methotrexate therapy
Since the calcium folinate rescue dosage regimen depends heavily on the posology and method of the intermediate- or high-dose methotrexate administration, the methotrexate protocol will dictate the dosage regimen of calcium folinate rescue. Therefore, it is best to refer to the applied intermediate or high-dose methotrexate protocol for posology and method of administration of calcium folinate.
The following guidelines may serve as an illustration of regimens used in adults, elderly and children:
Calcium folinate rescue has to be performed by parenteral administration in patients with malabsorption syndromes or other gastrointestinal disorders where enteral absorption is not assured. Dosages above 25-50 mg should be given parenterally due to saturable enteral absorption of calcium folinate.
Calcium folinate rescue is necessary when methotrexate is given at doses exceeding 500 mg/m2 body surface and should be considered with doses of 100-500 mg/m2 body surface.
Dosage and duration of calcium folinate rescue primarily depend on the type and dosage of methotrexate therapy, the occurrence of toxicity symptoms, and the individual excretion capacity for methotrexate. As a rule, the first dose of calcium folinate is 15 mg (6-12 mg/m²) to be given 12-24 hours (24 hours at the latest) after the beginning of methotrexate infusion. The same dose is given every 6 hours throughout a period of 72 hours. After several parenteral doses treatment can be switched over to the oral form.
In addition to calcium folinate administration, measures to ensure the prompt excretion of methotrexate (maintenance of high urine output and alkalinisation of urine) are integral parts of the calcium folinate rescue treatment. Renal function should be monitored through daily measurements of serum creatinine.
Forty-eight (48) hours after the start of the methotrexate infusion, the residual methotrexate level should be measured. If the residual methotrexate level is > 0.5 micromol/l, calcium folinate dosages should be adapted according to the following table:
Residual methotrexate blood level 48 hours after the start of the methotrexate administration:
Additional calcium folinate to be administered every 6 hours for 48 hours or until levels of methotrexate are lower than 0.05 micromol/l:
≥ 0.5 micromol/l
15 mg/m²
≥ 1.0 micromol/l
100 mg/m²
≥ 2.0 micromol/l
200 mg/m²
In combination with 5-fluorouracil in cytotoxic therapy
Different regimens and different dosages are used, without any dosage having been proven to be the optimal one.
The following regimens have been used in adults and elderly in the treatment of advanced or metastatic colorectal cancer and are given as examples. There are no data on the use of these combinations in children:
Bimonthly regimen: Calcium folinate 200 mg/m2 by IV infusion over 2 hours, followed by bolus 400 mg/m2 of 5-fluorouracil and 22-hour infusion of 5-fluorouracil (600 mg/m2) for 2 consecutive days, every 2 weeks on days 1 and 2.
Weekly regimen: Calcium folinate 20 mg/m² by bolus IV injection or 200 to 500 mg/m² as IV infusion over a period of 2 hours plus 500 mg/m² 5-fluorouracil as IV bolus injection in the middle or at the end of the calcium folinate infusion.
Monthly regimen: Calcium folinate 20 mg/m² by bolus IV injection or 200 to 500 mg/m² as IV infusion over a period of 2 hours immediately followed by 425 or 370 mg/m² 5-fluorouracil as IV bolus injection during five consecutive days.
For the combination therapy with 5-fluorouracil, modification of the 5-fluorouracil dosage and the treatment-free interval may be necessary depending on patient condition, clinical response and dose limiting toxicity as stated in the product information of 5-fluorouracil. A reduction of calcium folinate dosage is not required.
The number of repeat cycles used is at the discretion of the clinician.
Antidote to the folic acid antagonists trimetrexate, trimethoprim, and pyrimethamine
Trimetrexate toxicity:
• Prevention: Calcium folinate should be administered every day during treatment with trimetrexate and for 72 hours after the last dose of trimetrexate. Calcium folinate can be administered either by the intravenous route at a dose of 20 mg/m² for 5 to 10 minutes every 6 hours for a total daily dose of 80 mg/m², or by oral route with four doses of 20 mg/m2 administered at equal time intervals. Daily doses of calcium folinate should be adjusted depending on the haematological toxicity of trimetrexate.
• Overdosage (possibly occurring with trimetrexate doses above 90 mg/m2 without concomitant administration of calcium folinate): after stopping trimetrexate, calcium folinate 40 mg/m2 IV every 6 hours for 3 days.
Trimethoprim toxicity:
• After stopping trimethoprim, 3-10 mg/day calcium folinate until recovery of a normal blood count.
Pyrimethamine toxicity:
• In case of high dose pyrimethamine or prolonged treatment with low doses, calcium folinate 5 to 50 mg/day should be simultaneously administered, based on the results of the peripheral blood counts.
Method of administration
For intravenous or intramuscular use.
In the case of intravenous administration, no more than 160 mg of calcium folinate should be injected per minute due to the calcium content of the solution.
For intravenous infusion, Calcium folinate may be diluted before use. For instructions on dilution of the medicinal product before administration, see section 6.6.
4.3. Contraindications
Hypersensitivity to the active substance, or to any of the excipients listed in section 6.1.
Pernicious anaemia or other anaemias due to vitamin B12 deficiency.
Regarding the use of calcium folinate with methotrexate or 5-fluorouracil during pregnancy and lactation, see section 4.6 and the Summaries of Product Characteristics (SmPCs) for methotrexate- and 5-fluorouracil-containing medicinal products.
4.4. Special warnings and precautions for use
Calcium folinate should only be given by intramuscular or intravenous injection and must not be administered intrathecally. When calcium folinate has been administered intrathecally following intrathecal overdose of methotrexate, death has been reported.
General
Calcium folinate should be used with methotrexate or 5-fluorouracil only under the direct supervision of a clinician experienced in the use of cancer chemotherapeutic agents.
Calcium folinate treatment may mask pernicious anaemia and other anaemias resulting from vitamin B12 deficiency.
Many cytotoxic medicinal products – direct or indirect DNA synthesis inhibitors – lead to macrocytosis (hydroxycarbamide, cytarabine, mercaptopurine, tioguanine). Such macrocytosis should not be treated with calcium folinate.
In epileptic patients treated with phenobarbital, phenytoin, primidone, and succinimides there is a risk to increase the frequency of seizures due to a decrease of plasma concentrations of antiepileptic drugs. Clinical monitoring, possibly monitoring of the plasma concentrations and, if necessary, dose adaptation of the antiepileptic drug during calcium folinate administration and after discontinuation is recommended (see section 4.5).
Calcium folinate/5-fluorouracil
Calcium folinate may enhance the toxicity risk of 5-fluorouracil, particularly in elderly or debilitated patients. The most common manifestations are leucopenia, mucositis, stomatitis and/or diarrhoea, which may be dose limiting. When calcium folinate and 5-fluorouracil are used in combination, the 5-fluorouracil dosage has to be reduced more in cases of toxicity than when 5-fluorouracil is used alone.
Combined 5-fluorouracil/calcium folinate treatment should neither be initiated nor maintained in patients with symptoms of gastrointestinal toxicity, regardless of the severity, until all of these symptoms have completely disappeared.
Because diarrhoea may be a sign of gastrointestinal toxicity, patients presenting with diarrhoea must be carefully monitored until the symptoms have disappeared completely, since a rapid clinical deterioration leading to death can occur. If diarrhoea and/or stomatitis occur, it is advisable to reduce the dose of 5-fluorouracil until symptoms have fully disappeared.
Especially the elderly and patients with a low physical performance due to their illness are prone to these toxicities. Therefore, particular care should be taken when treating these patients.
In elderly patients and patients who have undergone preliminary radiotherapy, it is recommended to begin with a reduced dosage of 5-fluorouracil.
Calcium folinate must not be mixed with 5-fluorouracil in the same IV injection or infusion.
Calcium levels should be monitored in patients receiving combined 5-fluorouracil/calcium folinate treatment and calcium supplementation should be provided if calcium levels are low.
Calcium folinate/methotrexate
For specific details on reduction of methotrexate toxicity refer to the SmPC of methotrexate.
Calcium folinate has no effect on non-haematological toxicities of methotrexate such as the nephrotoxicity resulting from methotrexate and/or metabolite precipitation in the kidney. Patients who experience delayed early methotrexate elimination are likely to develop reversible renal failure and all toxicities associated with methotrexate (please refer to the SmPC for methotrexate). The presence of pre-existing- or methotrexate-induced renal insufficiency is potentially associated with delayed excretion of methotrexate and may increase the need for higher doses or more prolonged use of calcium folinate.
Excessive calcium folinate doses must be avoided since this might impair the antitumour activity of methotrexate, especially in CNS tumours where calcium folinate accumulates after repeated courses.
Resistance to methotrexate as a result of decreased membrane transport implies also resistance to calcium folinate rescue as both medicinal products share the same transport system.
An accidental overdose with a folate antagonist, such as methotrexate, should be treated as a medical emergency. As the time interval between methotrexate administration and calcium folinate rescue increases, calcium folinate effectiveness in counteracting toxicity decreases.
The possibility that the patient is taking other medications that interact with methotrexate (e.g. medications which may interfere with methotrexate elimination or binding to serum albumin) should always be considered when laboratory abnormalities or clinical toxicities are observed.
Excipients
This medicinal product contains 3.15 mg sodium per ml of solution, equivalent to 0.16 % of the WHO recommended maximum daily intake of 2 g sodium for an adult.
4.5. Interaction with other medicinal products and other forms of interaction
When calcium folinate is given in conjunction with a folic acid antagonist (e.g. co-trimoxazole, pyrimethamine, other antibiotics with an antifolate effect, methotrexate) the efficacy of the folic acid antagonist may either be reduced or completely neutralised.
Calcium folinate may reduce the effect of antiepileptic medicines: phenobarbital, phenytoin, primidone and succinimides, and may increase the frequency of seizures (a decrease of plasma levels of enzymatic inductor anticonvulsant drugs may be observed because the hepatic metabolism is increased as folates are one of the co-factors) (see section 4.4).
Concomitant administration of calcium folinate with 5-fluorouracil has been shown to enhance the efficacy and toxicity of 5-fluorouracil (see sections 4.2, 4.4 and 4.8).
4.6. Fertility, pregnancy and lactation
Pregnancy
There are no adequate and well-controlled clinical studies conducted in pregnant or breast-feeding women. Animal studies are insufficient with respect to reproductive toxicity (see section 5.3). However, there are no indications that calcium folinate induces harmful effects if administered during pregnancy. During pregnancy, methotrexate should only be administered on strict indications, where the benefits of the drug to the mother should be weighed against possible hazards to the foetus. Should treatment with methotrexate or other folate antagonists take place despite pregnancy, there are no limitations as to the use of calcium folinate to diminish toxicity or counteract the effects.
5-fluorouracil use is generally contraindicated during pregnancy and contraindicated during breast-feeding; this applies also to the combined use of calcium folinate with 5-fluorouracil.
Please refer also to the SmPCs for methotrexate, other folate antagonists and 5-fluorouracil-containing medicinal products.
Breast-feeding
It is not known whether calcium folinate is excreted into human breast milk. Calcium folinate can be used during breast-feeding when considered necessary according to the therapeutic indications.
Fertility
Calcium folinate is an intermediate product in the metabolism of folic acid and occurs naturally in the body. No fertility studies have been conducted with calcium folinate in animals.
4.7. Effects on ability to drive and use machines
There is no evidence that calcium folinate has an effect on the ability to drive or use machines.
4.8. Undesirable effects
The frequencies are defined according to the MedDRA as follows: very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1 000 to < 1/100), rare (≥ 1/10 000 to < 1/1 000), very rare (< 1/10 000), not known (cannot be estimated from the available data).
All therapeutic indications
Immune system disorders
Very rare: allergic reactions including anaphylactoid/anaphylactic reactions, urticaria.
Psychiatric disorders
Rare: insomnia, agitation and depression after high doses.
Nervous system disorders
Rare: increase in the frequency of attacks in patients with epilepsy (see section 4.5).
Gastrointestinal disorders
Rare: gastrointestinal disorders after high doses.
Skin and subcutaneous tissue disorders
Not known: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
In patients receiving folinic acid in combination with other agents known to be associated with these conditions; some cases may be fatal. It cannot be ruled out that folinic acid contributed to the occurrence of SJS/TEN.
General disorders and administration site conditions
Uncommon: fever.
Combination therapy with 5-fluorouracil only
Generally, the safety profile depends on the applied regimen of 5-fluorouracil due to enhancement of the 5-fluorouracil induced toxicities.
Blood and lymphatic system disorders
Very common: bone marrow failure including fatal cases.
Metabolism and nutrition disorders
Not known: hyperammonaemia.
Skin and subcutaneous tissue disorders
Common: palmar-plantar erythrodysesthesia.
General disorders and administration site conditions
Very common: mucositis, including stomatitis and cheilitis. Fatalities have occurred as a result of mucositis.
Monthly regimen
Gastrointestinal disorders
Very common: nausea, vomiting and diarrhoea.
No enhancement of other 5-fluorouracil induced toxicities (e.g. neurotoxicity).
Weekly regimen
Gastrointestinal disorders
Very common: diarrhoea with higher grades of toxicity, and dehydration, resulting in hospital admission for treatment and even death.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
There have been no reported sequelae in patients who have received significantly more calcium folinate than the recommended dosage. However, excessive amounts of calcium folinate may nullify the chemotherapeutic effect of folic acid antagonists.
Should overdosage of the combination of 5-fluorouracil and calcium folinate occur, the overdosage instructions for 5-fluorouracil should be followed.
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Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.