Levoleucovorin (By injection)

Levoleucovorin (lee-voe-loo-koe-VOE-rin)

Given to prevent the harmful effects of methotrexate (a cancer medicine) in patients with bone cancer (osteosarcoma). Also given to patients who receive too much methotrexate for other conditions. Also used in combination with 5-fluorouracil (Adrucil®) to relieve and prevent symptoms of advanced metastatic (cancer that has already spread) cancer of the colon and rectum. This medicine acts in the body like folic acid (vitamin B9).

Brand Name(s):

Fusilev, Khapzory

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not receive this medicine if you have had an allergic reaction to levoleucovorin or similar medicines such as folic acid (Folvite®) and folinic acid. You should not receive this medicine if you have certain blood problems such as anemia caused by a lack of vitamin B12.

How to Use This Medicine:


  • Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
  • A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using 5-fluorouracil (Adrucil®) or a combination of trimethoprim and sulfamethoxazole (Bactrim® or Septra®). Tell your doctor if you are also using medicine to treat seizures (such as phenobarbital, phenytoin, primidone, Luminal®, Dilantin®, or Mysoline®).

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, dehydration, fluid around the lungs (pleural effusion), or fluid in the stomach (ascites).
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Change in how much or how often you urinate.
  • Fever or chills.
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
  • Seizures or fainting.
  • Shakiness or shivering.
  • Shortness of breath or troubled breathing.
  • Stomach pain, bloody or watery diarrhea.
  • Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

  • Change in taste.
  • Confusion.
  • Dry, cracked, or scaly skin.
  • Hair loss.
  • Loss of appetite.
  • Mild diarrhea, nausea, vomiting, or upset stomach.
  • Skin rash or itching.
  • Sores or white patches on your lips, mouth, or throat.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 11/6/2020

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