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How can I tell if they're administering the leucovorin properly?

by Donna Myers
for About.com

Updated: June 25, 2008

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Question: How can I tell if they're administering the leucovorin properly?
Answer: One of the best ways to protect yourself is to view your healthcare provider as your equal rather than as some superior being who cannot be questioned. If a question pops into your mind, ask it. If you wonder why they're doing what they're doing, ask. If something seems wrong, bring it up. If they're doing something differently than usual, ask why. If things just don't seem right, speak up. Health professionals are people; sometimes people, no matter how well trained or how well intentioned, make mistakes. That said, here are some things to look for and ask about regarding treatment with leucovorin:

Leucovorin injection into a vein

Leucovorin should always be injected into the vein slowly. Do not let anyone inject you with more than 160 milligrams per minute. The calcium content of leucovorin makes it dangerous to do so.

Look closely at the leucovorin bottle when they withdraw the medicine for your shot. Is it Leucovorin? Can you see the expiration date? If the bottle is clear glass, look at the medicine. Leucovorin should be a clear, colorless liquid. Check for discoloration, cloudiness, or partiulate matter (bits and pieces of whatever). Also, the bottle shouldn't be leaking. If you find any problems, address them with your healthcare provider.

Leucovorin via an I.V. bag

To administer leucovorin via an I.V. drip, it has to be diluted. If you have doubts about your healthcare provider's competency, why not give them a pop quiz? Ask how the leucovorin solution was made. The answer should be:

(a) We diluted the leucovorin with 5% Dextrose Injection, 0.9% Sodium Chloride Injection, and Lactated Ringer's Injection (or Ringer's Injection) to give a final concentration of 0.05 mg/mL leucovorin, or

(b) We created a hypertonic infusion solution by diluting the leucovorin with 10% Dextrose Injection and 5% Dextrose in 0.9% Sodium Chloride Injection to give a final concentration of 0.05 mg/mL of leucovorin.

Once you know the answer, ask how long ago they made it. Solution (a) can be stored at room temperature for 24 hours. Solution (b) can only be stored at room temperature for 8 hours.

Related Questions: Related Articles: Sources:
1. Bedford Laboratories. Leucovorin product insert.
2. Center for Drug Evaluation and Research. Oncology Tools - Leucovorin Product Label.
3. Cleveland Clinic. What You Need to Know About Leucovorin.
4. Drug Digest. Leucovorin Insert.
5. Hamilton Regional Cancer Centre. Medication Information Sheet: Leucovorin Injection.
6. HealthTouch Online. Leucovorin Injection.
7. Medline Plus. Leucovorin (Systemic).
8. Rx Med. Leucovorin Calcium Injection.
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