Cafol 100 mg (1vial)

Manufacturer	Graton Pharma
Active Ingredients	Calcium Folinate (Leucovorin Calcium)
Medicine Strength	100mg per Vial
Number Per Pack	Typically 1 Vial
Requires Prescription?	Yes (Oncologist/Specialist Prescription)
Generics	Calcium Folinate, Leucovorin Calcium

Cafol 100mg Ingredients and Usage

The active ingredient is Calcium Folinate, a tetrahydrofolic acid derivative that serves as an active form of folate in the body. The 100mg tablet is designed for oral administration as part of comprehensive cancer treatment protocols. Cafol is clinically indicated for:

• Methotrexate Rescue: Prevention and treatment of methotrexate toxicity in high-dose methotrexate therapy.
• Combination Chemotherapy: Used with fluorouracil (5-FU) to enhance its antitumor activity in colorectal cancer treatment.
• Folate Antagonist Overdose: Treatment of overdosage of folic acid antagonists like trimethoprim and pyrimethamine.
• Megaloblastic Anemia: Treatment of folate deficiency when folic acid cannot be used.

How Does Cafol Work?

Calcium Folinate works through several mechanisms to counteract folate antagonist toxicity and enhance chemotherapy efficacy:

1. Bypasses Dihydrofolate Reductase Inhibition: As a reduced folate, it bypasses the block created by methotrexate at the dihydrofolate reductase enzyme level.
2. Restores Normal Folate Metabolism: Provides the active form of folate necessary for DNA synthesis and cellular replication.
3. Enhances Fluorouracil Activity: Stabilizes the binding of fluorouracil metabolite to thymidylate synthase, increasing cytotoxic effect on cancer cells.
4. Protects Normal Cells: Rescues normal cells from the toxic effects of folate antagonists while maintaining antitumor activity.

Cafol 100mg Side Effects and Warnings

Cafol is generally well-tolerated, but some patients may experience gastrointestinal disturbances, allergic reactions, or neurological symptoms. Side effects are usually mild and transient.

Serious Warnings and Precautions:

1. Timing of Administration: Critical importance of proper timing when used for methotrexate rescue - must not be administered concurrently with methotrexate as it may interfere with antitumor activity.
2. Dosage Calculation: Dose must be carefully calculated based on methotrexate levels and renal function when used for rescue therapy.
3. Seizure Risk: May lower seizure threshold, particularly in patients with pre-existing seizure disorders or when given in high doses.
4. Vitamin B12 Deficiency: May mask hematological signs of vitamin B12 deficiency (pernicious anemia) while neurological damage progresses.
5. Drug Interactions: May decrease the efficacy of phenytoin, phenobarbital, and primidone. Monitor anticonvulsant levels closely.

Cafol 100mg Storage Conditions

Cafol Tablets should be stored under appropriate conditions to maintain stability and efficacy:

• Store at controlled room temperature between 15°C and 30°C (59°F and 86°F).
• Keep in original packaging protected from light and moisture.
• Keep out of reach of children.
• Do not use after the expiration date printed on the packaging.
• Protect from excessive heat and humidity.