Leucovorin Dosing Recommendations

Colorectal Cancer Chemotherapy Regimens

• The National Comprehensive Cancer Network recommends leucovorin 400 mg/m² IV over 2 hours on day 1 for mFOLFOX6 and FOLFIRI regimens, repeated every 2 weeks 1, 2, 3, 4, 5, 6
• The National Comprehensive Cancer Network suggests that this dose applies whether leucovorin is used alone or combined with bevacizumab, cetuximab, or panitumumab 1
• The National Comprehensive Cancer Network notes that levoleucovorin dose is 200 mg/m², which equals 400 mg/m² of standard leucovorin 7, 1, 2, 3, 4, 5, 8, 6

Methotrexate Rescue Dosing

Key Clinical Considerations

• The National Comprehensive Cancer Network advises to never confuse leucovorin with levoleucovorin, as the active isomer requires half the dose 7, 1, 2, 3, 4, 5, 8, 6
• The National Comprehensive Cancer Network recommends limiting chemotherapy orders to 24-hour units to minimize medication errors 7, 2, 3, 4, 5, 8, 6
• The National Comprehensive Cancer Network suggests that intravenous administration is preferred for chemotherapy protocols 1
• Oral leucovorin (10-20 mg three times weekly) is appropriate for long-term supplementation with chronic methotrexate therapy, according to Praxis Medical Insights 9