{"entity":{"id":"leucovorin","kind":"drug","name":"Leucovorin (folinic acid)","aka":["Leucovorin Calcium","Folinic acid","Calcium folinate","Levoleucovorin (Fusilev, Khapzory)"],"tldr":"Leucovorin is not a cancer drug in itself: it rescues normal tissue after high-dose methotrexate and, given with fluorouracil, makes that chemotherapy work better, which is why it appears in FOLFOX, FOLFIRI and FOLFIRINOX.","summary":"Leucovorin (folinic acid, calcium folinate) is a form of folate that cells can use without the enzyme methotrexate blocks. Given after high-dose methotrexate it lets normal bone marrow and gut recover while the drug has already acted on the tumour; given with fluorouracil it increases the drug's binding to its target enzyme thymidylate synthase, an effect that underlies every fluorouracil-based bowel, stomach and pancreatic cancer regimen. Levoleucovorin is the active isomer alone at half the dose. It is a generic medicine on the WHO essential medicines list.","status":"established","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Folinic_acid","links":[{"label":"Label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=leucovorin%20calcium"}],"tags":["gap-fill","generic"],"related":[],"cancers":["colorectal","pancreatic","gastric","all-leukemia"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":["dhfr","tyms"],"drugs":["methotrexate","fluorouracil"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"brand":"Wellcovorin / generic","modality":"Reduced folate (rescue agent and chemotherapy modulator)","mechanism":"A reduced folate that bypasses dihydrofolate reductase, rescuing normal cells from methotrexate, and that stabilises the fluorouracil-thymidylate synthase complex to make fluorouracil more effective.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/leucovorin/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"target":[{"id":"dhfr","kind":"target","name":"Dihydrofolate reductase (DHFR)","route":"/targets/dhfr/"},{"id":"tyms","kind":"target","name":"Thymidylate synthase (TYMS)","route":"/targets/tyms/"}],"drug":[{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"methotrexate","kind":"drug","name":"Methotrexate","route":"/drugs/methotrexate/"}]}}