Folistar 5 mg Tablet

Active form of folic acid used for:

• Methotrexate rescue (after high-dose methotrexate) and treatment of methotrexate overdose/toxicity
• With 5-fluorouracil in colorectal cancer chemotherapy (specialist)
• Megaloblastic anaemia due to folate deficiency when oral folic acid is unsuitable
• Prevention of toxicity from pyrimethamine/trimethoprim in some infections

Methotrexate rescue (specialist): usually 15 mg (about 10 mg/m²) every 6 hours by mouth/IV/IM, starting 24 hours after methotrexate, guided by methotrexate blood levels.

Folate-deficiency anaemia: 15 mg daily by mouth.

With pyrimethamine: 5–15 mg daily.

Chemotherapy with 5-FU: per oncology protocol.

• Never give intrathecally. Do not give more than 160 mg/min IV (calcium content).

• Pernicious anaemia or vitamin B12 deficiency anaemia (may correct the blood picture while nerve damage progresses)
• Allergy to folinic acid
• Intrathecal use

Uncommon: allergic reactions (rash, itching, fever), nausea, insomnia, agitation with high doses.

With 5-FU: increased 5-FU toxicity — diarrhoea, mouth ulcers, low blood counts.

Rare: seizures (in epilepsy patients), anaphylaxis (injection).

• Check B12 before treating anaemia.
• Epilepsy on phenytoin/phenobarbital: may reduce their effect and increase seizures.
• Do not give at the same time as low-dose methotrexate for arthritis unless advised (folic acid is usually used instead).

May be used in pregnancy and breastfeeding when needed.

• Phenobarbital, phenytoin, primidone (reduced effect — seizure risk)
• 5-Fluorouracil, capecitabine (toxicity increased)
• Methotrexate, trimethoprim, pyrimethamine (antidote effect)

No specific toxicity; may reduce the anti-cancer effect of methotrexate if given too early or too much.

Store below 25–30°C, protected from light.