Leucovorin rescue after high-dose MTX therapy 15 mg every 6 hr for 10 doses 24 hr after start of MTX infusion.
Normal MTX elimination 15 mg orally, IM, or IV every 6 hr for 60 hr (10 doses starting at 24 hr after start of MTX infusion).
Delayed MTX elimination Continue 15 mg orally, IM, or IV every 6 hr, until MTX level is <0.05 micromolar.
Delayed early MTX elimination &/or evidence of acute renal injury 150 mg IV every 3 hr, until MTX level is <1 micromolar, then 15 mg IV every 3 hr until MTX level is <0.05 micromolar.
Impaired MTX elimination or inadvertent overdosage 10 mg/m
2 IM, IV, or orally every 6 hr, may be increased to 100 mg/m
2 IV every 3 hr until serum MTX level is <10
-8 M.
Megaloblastic anemia due to folic acid deficiency Up to 1 mg daily.
Advanced CRC 200 mg/m
2 by slow IV inj over a minimum of 3 min, followed by 5-fluorouracil at 370 mg/m
2 IV inj or 20 mg/m
2 IV inj followed by 5-fluorouracil at 425 mg/m
2 IV inj. Repeat daily for 5 days. May be repeated at 4-wk intervals, for 2 courses & then at 4-5 wk intervals if patient has completely recovered from the toxic effects of prior treatment course.
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