Leucovorin: uses, dosing, side effects & brands
Leucovorin is a folate analog sold in the U.S. under 3 brand and generic names, for megaloblastic anemia, folic acid deficiency and drug-related side effects and adverse reactions. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Folate Analog
- Treats (across its forms)
- Megaloblastic Anemia, Folic Acid Deficiency and Drug-Related Side Effects and Adverse Reactions
- Available as
- Injectable · Solution · Tablet
- Sold as
- 3 products — Wellcovorin, Leucovorin Calcium and Vykoura
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- about $59 for a 30-count supply — not your price
How Vykoura is dosed
From the FDA label for Vykoura (application NDA220406). Other leucovorin products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
VYKOURA is indicated for intravenous or intramuscular administration. Do not administer intrathecally. ( 2.1 ) Rescue After High-Dose Methotrexate Therapy : Rescue recommendations are based on methotrexate dose of 12 to 15 grams/m 2 administered by intravenous infusion over 4 hours. Initiate rescue at a dose of 15 mg (approximately 10 mg/m 2 ) every 6 hours beginning 24 hours after the beginning of methotrexate infusion. ( 2.2 ) Continue until the methotrexate level is below 0.05 micromolar (5 x 10 -8 M). Adjust dose, if necessary, based on methotrexate elimination. ( 2.2 ) Reducing the Toxicity of Methotrexate in Patients with Impaired Methotrexate Elimination or Following an Overdosage of Folic Acid Antagonists or DHFR Inhibitors : Start as soon as possible after methotrexate overdosage or within 24 hours of delayed methotrexate elimination. ( 2.3 ) Administer VYKOURA 10 mg/m 2 intravenously or intramuscularly every 6 hours until methotrexate level is less than 0.01 micromolar (1 x 10 -8 M). ( 2.3 ) Metastatic Colorectal Cancer in Combination with Fluorouracil : 20 mg/m 2 to 500 mg/m 2 based on specific combination regimen. Administer VYKOURA before fluorouracil. ( 2.4 ) Do not mix VYKOURA with other drugs or administer other drugs through the same intravenous line. ( 2.4 ). Megaloblastic Anemia Due to Folic Acid Deficiency: Up to 1 mg/day administered intravenously until…
Everything below is the FDA label for Vykoura (injectable). Leucovorin is also sold as solution and tablet, and those are different medicines to take — follow the label for the one you were prescribed.
Vykoura side effects
The following clinically significant adverse reactions are described elsewhere in the labeling: Hypersensitivity [see Warnings and Precautions (5.1) ] Hypercalcemia [see Warnings and Precautions (5.2) ] The most common adverse reactions (≥20%) in patients receiving high-dose methotrexate therapy with leucovorin rescue are stomatitis and vomiting. ( 6.1 ) The most common adverse reactions (>50%) in patients receiving leucovorin in combination with fluorouracil for metastatic colorectal cancer are stomatitis, diarrhea, and nausea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Avyxa Pharma, LLC at 1-888-520-0954 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. Table 2 summarizes significant adverse events occurring in 316 patients treated with the leucovorin/5-fluorouracil combinations compared against 70 patients treated with 5-fluorouracil alone for advanced colorectal carcinoma. These data are taken from the Mayo/NCCTG large multicenter prospective trial evaluating the efficacy and safety of the combination regimen. Table 2: Percentage of Patients Treated with…
Who shouldn’t take Vykoura
VYKOURA is contraindicated in patients who have had a severe hypersensitivity reaction to leucovorin (folinic acid), levoleucovorin, or folic acid [see Warnings and Precautions (5.1) ]. Reactions have included anaphylactic reactions. VYKOURA is contraindicated in patients who have had a severe hypersensitivity reaction to leucovorin (folinic acid), levoleucovorin, or folic acid. ( 4 )
Vykoura drug interactions
7.1 Effects of Other Drugs on VYKOURA Glucarpidase Administer VYKOURA at least 2 hours before or 2 hours after the glucarpidase dose when administering concomitantly. Glucarpidase can decrease leucovorin concentrations, which may decrease the effect of leucovorin rescue. 7.2 Effects of VYKOURA on Other Drugs Certain Antiepileptic Drugs Increase monitoring for seizure activity in patients taking certain concomitant antiepileptic drugs. Folic acid in high doses may reduce the effectiveness of certain antiepileptic drugs (e.g., phenobarbital, phenytoin, and primidone) and thereby increase the frequency of seizures. It is not known whether folinic acid, including VYKOURA, has the same effects; however, both folic and folinic acids, including VYKOURA share some common metabolic pathways. Trimethoprim-Sulfamethoxazole Avoid concomitant use of VYKOURA with trimethoprim-sulfamethoxazole . The effectiveness of trimethoprim-sulfamethoxazole can be decreased if used concomitantly with VYKOURA which was associated with increased rates of treatment failure and mortality in patients with HIV infection who receive trimethoprim-sulfamethoxazole for the acute treatment of Pneumocystis jirovecii pneumonia.
Every leucovorin product we track (3)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 70/100 | Prescription | Injectable | Generic | $59 | View → | |
| 2 | Not yet rated | Prescription | Injectable | Generic | $59 | View → | |
| 3 | Not yet rated | Prescription | Injectable | Generic | $59 | View → |
What leucovorin pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
| Imprint | Strength | Colour | Shape | Maker |
|---|---|---|---|---|
| b;484 | 5 mg | white | round | — |
| b;485 | 25 mg | green | round | — |
| ING;181 | 5 mg | white | round | — |
| ING;182 | 10 mg | white | round | — |
| ING;183 | 15 mg | yellow | round | — |
| ING;184 | 25 mg | yellow | round | — |
| ING;184 | 25 mg | yellow | round | — |
| 54;293 | 5 mg | white | round | — |
| 54;942 | 10 mg | white | round | — |
| 54;650 | 15 mg | yellow | round | — |
| 54;013 | 25 mg | yellow | round | — |
| 54;293 | 5 mg | white | round | — |
How long leucovorin keeps
The date on a sealed pack is not the only one: some leucovorin labels start a second clock once the product is opened or mixed, as short as 7 days.
Does leucovorin expire? The in-use limits and storage rules from its labelsWhat people report to the FDA about leucovorin
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 20,372 reports naming leucovorin, and the FDA flagged 90% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- diarrhoea1,882 reports
- nausea1,483 reports
- vomiting1,206 reports
- neutropenia1,170 reports
- pyrexia1,041 reports
- fatigue975 reports
- dyspnoea750 reports
- asthenia703 reports
Read these as a signal, not a rate. A report does not mean leucovorin caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 25, 2026.
Related calculators
Frequently asked questions
What is Vykoura?
Leucovorin is a folate analog, also known as folinic acid, Citrovorum factor, or 5-formyl-5,6,7,8-tetrahydrofolic acid calcium salt. This compound has the chemical designation of Calcium N-(p-((((6RS)-2-amino-5-formyl 5,6,7,8-tetrahydro-4-hydroxy-6-pteridinyl)methyl)amino)benzoyl)-L-glutamate (1:1).
What kind of drug is leucovorin?
The FDA classifies leucovorin as a folate analog. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take leucovorin with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run leucovorin against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is leucovorin sold under?
We track 3 leucovorin-containing products in the U.S.: Wellcovorin, Leucovorin Calcium and Vykoura. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does leucovorin come in?
Across the brands we track, leucovorin is currently marketed as injectable, solution and tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic leucovorin?
Yes. Our catalog lists 1 generic leucovorin product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Leucovorin: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/leucovorin
- MLA
- “Leucovorin: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/leucovorin.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for leucovorin on DailyMed (NIH) ↗.