Methotrexate Reversal - Leucovorin Protocol

Methotrexate Reversal\n\nHowever, for women who have taken methotrexate, prescribed progesterone may also be beneficial to support the pregnancy even though it is not an antidote to methotrexate. In addition to our standard progesterone protocol, co-treatment with leucovorin (also called citrovorum factor and 5-formyltetrahydrofolate) is used in some treatment regimens to reduce the toxity of methotrexate.\n\nMethotrexate is an anti-folate medication that is potentially associated with increased risk of multiple birth defects. Based on a limited number of cases in humans, there appears to be increased rate for congential heart defect (CHD), cleft palate, hypospadias, congential diaphragmatic hernia, craniosynostosis, central nervous system abnormalities, limb defects, developmental delay, and cognitive impairment.\n\nLeucovorin supplement to Progesterone for Methotrexate:\n• Dose #1: 30mg PO immediately\n• Dose #2-9: 15mg q6h PO x2 days\n• Folic Acid 4mg qd throughout first trimester