Wellcovorin

Leucovorin (loo-koe-VOR-in) is used as an antidote to the harmful effects of methotrexate (a cancer medicine) that is given in high doses. It is used also to prevent or treat certain kinds of anemia. Leucovorin acts the same way in the body as folic acid, which may be low in these patients.

Leucovorin is also used along with fluorouracil (a cancer medicine) to treat cancer of the colon (bowel).

Leucovorin is available only with a prescription and is to be given only by or under the supervision of your doctor. It is available in the following dosage forms:

                      In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For leucovorin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to leucovorin. Also tell your health care professional if you are allergic to any other substance, such as foods, sulfites or other preservatives, or dyes.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals.

Breast-feeding—It is not known whether leucovorin passes into the breast milk. However, it has not been reported to cause problems in nursing babies.

Children—In children with seizures, leucovorin may increase the number of seizures that occur.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of leucovorin in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of leucovorin. If you are taking leucovorin as an antidote to methotrexate, make sure you tell your doctor if you have any other medical problems, especially:

Kidney disease—Levels of methotrexate may be increased because of its slower removal from the body, so the dose of leucovorin may not be enough to block the unwanted effects of methotrexate

Nausea and vomiting—Not enough leucovorin may be absorbed into the body to block the unwanted effects of methotrexate

                                 It is very important that you take leucovorin exactly as directed , especially when it is being taken to counteract the harmful effects of cancer medicine. Do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night . For example, if you are to take 4 doses a day, the doses should be spaced about 6 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Do not stop taking leucovorin without checking with your doctor . It is very important that you get exactly the right amount.

Dosing—The dose of leucovorin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of leucovorin. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets or doses of injection that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking leucovorin .

For use as an antidote to methotrexate:

For oral (tablets) or injection dosage forms:

Adults, teenagers, and children—Dose is based on body size and must be determined by your doctor.

For use as an antidote to other medicines:

For oral (tablets) or injection dosage forms:

Adults, teenagers, and children—Dose may range from 0.4 milligrams (mg) to 15 mg a day and must be determined by your doctor.

For certain kinds of anemia:

For oral (tablets) or injection dosage forms:

Adults, teenagers, and children—Up to 1 mg a day.

For colon cancer:

For injection dosage forms:

Adults and teenagers—Dose is based on body size and must be determined by your doctor.

Children—Dose must be determined by your doctor.

Missed dose—If you miss a dose of leucovorin or if you vomit shortly after taking a dose, check with your doctor right away . Your doctor may want you to take extra leucovorin to make up for what you missed. Do not take more medicine on your own, however, since it is very important that you receive just the right dose at the right time.

Storage—To store this medicine:

Keep out of the reach of children.

Store away from heat and direct light.

Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.

Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

                           Along with its needed effects, a medicine may cause some unwanted effects. Leucovorin usually does not cause any side effects.

However, check with your doctor immediately if any of the following side effects occur shortly after you receive this medicine:

Rare

Skin rash, hives, or itching; wheezing

Check with your doctor as soon as possible if the following side effect occurs:

Rare—reported with use in treatment of cancer

Convulsions (seizures)

                        

Radiogardase

Prussian blue was originally developed as a dye for use in paints and ink. It is used in medicine to help speed up the body's elimination of certain metals or chemical elements. It works by binding to the metals in the digestive tract to keep the body from absorbing them.

Prussian blue is used to treat people who have been contaminated with radioactive cesium or thallium, or non-radioactive thallium.

Prussian blue may also be used for other purposes not listed in this medication guide.

                        Before you take Prussian blue, tell your doctor if you have a digestive disorder, chronic constipation, a blockage in your stomach or intestines, a heart rhythm disorder; or an electrolyte imbalance.

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Prussian blue is usually taken 3 times per day for at least 30 days.

Prussian blue may work best if you take it with food. After you are treated with Prussian blue, your urine and stools will contain the radioactive materials that the medication has helped the body eliminate. Avoid handling any clean-up of your stools or urine without wearing latex rubber gloves. If another person is handling your stools or urine, they should wear gloves, eye protection, and a mask to cover the nose and mouth. Prussian blue may cause your stools to appear blue in color. This is a normal side effect of Prussian blue, and should not be cause for alarm.

Although Prussian blue helps the body quickly eliminate a radioactive element, this medication will not treat any symptoms of radiation exposure. You will be given other medications to treat complications of radiation exposure, such as bone marrow suppression or severe infection.

While taking Prussian blue, tell your caregivers at once if you have a serious side effect such as severe constipation or stomach pain.

Prussian blue may bind with other medications and could possibly make them less effective. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors.

                           Before you take Prussian blue, tell your doctor if you are allergic to any drugs, or if you have:

      a digestive disorder;

      chronic constipation;

      a blockage in your stomach or intestines;

      a heart rhythm disorder; or

      an electrolyte imbalance.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Prussian blue.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant before you are treated with Prussian blue. It is not known whether Prussian blue passes into breast milk or if it could harm a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby. Exposure to radiation could cause a man to have low sperm counts up to several years later. Talk with your doctor if you have concerns about how radiation may affect your fertility.

                           Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Prussian blue may work best if you take it with food.

Prussian blue is usually taken 3 times per day for at least 30 days. You may need to take several capsules at one time to get the correct dose.

If you are unable to swallow large number of capsules, you may open the capsules and sprinkle the medicine into a small amount of liquid or bland food to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Opening a Prussian blue capsule and mixing the medicine with liquid or food may cause a blue discoloration inside your mouth. After you are treated with Prussian blue, your urine and stools will contain the radioactive materials that the medication has helped the body eliminate.

Use a toilet rather than a urinal and sit on the toilet while urinating. Flush the toilet 3 times with the lid down after use.

Always wash your hands after using the bathroom. Avoid handling any clean-up of your stools or urine without wearing latex rubber gloves. If another person is handling your stools or urine, they should wear gloves, eye protection, and a mask to cover the nose and mouth.

When cleaning any spills of bodily fluid, use only disposable cleaning cloths that can be flushed down a toilet. Ask your doctor or health department how to dispose of any bodily fluid spills that cannot be flushed down a toilet.

Wash any soiled clothing separately from the laundry of other people in your home.

Prussian blue may cause your stools to appear blue in color. This is a normal side effect of Prussian blue, and should not be cause for alarm.

Although Prussian blue helps the body quickly eliminate a radioactive element, this medication will not treat any symptoms of radiation exposure. You will be given other medications to treat complications of radiation exposure, such as bone marrow suppression or severe infection.

To be sure this medication is helping your condition, the radiation levels in your urine and stools will need to be checked often. This will help your doctor determine how long to treat you with Prussian blue. Do not miss any scheduled appointments.

Store Prussian blue capsules in the dark at room temperature.

                           Prussian blue may bind with other medications and could possibly make them less effective.

Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.