REVIEW Calcium folinate pentahydrate is the salt of folinic acid, an adjuvant used in chemotherapy involving the drug methotrexate. It is also used in synergistic combination with 5-fluorouracil. Folinic acid is a 5-formyl derivative of tetrahydrofolic acid. It is readily converted to other reduced folic acid derivatives and thus has vitamin activity equivalent to folic acid. However, since it does not require the action of dihydrofolate reductase for its conversion, its function as a vitamin is unaffected by inhibition of this enzyme by drugs such as methotrexate. Folinic acid, therefore, allows for some purine/pyrimidine synthesis to occur in the presence of dihydrofolate reductase inhibition, so that some normal DNA replication and RNA transcription processes can proceed.
REFERENCES
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Mueller, Thomas F.; Moser, Rudolf; Ulmann, Martin Use of folates for producing a preparation suitable for preventing and treating inflammation and diseases associated with inflammation, especially for influencing the inflammation markers CRP and SAA PCT Int. Appl. (2003), WO 2003072096 A1 20030904.
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Bertino JR, Levitt M, McCullough JL, Chabner B. New approaches to chemotherapy with folate antagonists: use of leucovorin rescue and enzymic folate depletion.Ann N Y Acad Sci. 1971 Nov 30;186:486-95.
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Goldman ID, Matherly LH.Biochemical factors in the selectivity of leucovorin rescue: selective inhibition of leucovorin reactivation of dihydrofolate reductase and leucovorin utilization in purine and pyrimidine biosynthesis by methotrexate and dihydrofolate polyglutamates. NCI Monogr. 1987;(5):17-26.
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DeLap RJ.The effect of leucovorin on the therapeutic index of fluorouracil in cancer patients. Yale J Biol Med. 1988 Jan-Feb;61(1):23-34.
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