Biovorin contains leucovorin, also known as folinic acid, a form of reduced folic acid that is used in supportive cancer care. Unlike folic acid, leucovorin does not need to be activated by the enzyme dihydrofolate reductase, making it particularly useful when this pathway is inhibited. It is commonly used to either enhance the effectiveness of certain chemotherapy drugs or to protect healthy cells from their toxic effects. Leucovorin plays a vital role in modulating the impact of cancer treatment.

Mechanism of Action
Leucovorin works by bypassing the need for folic acid activation, supplying cells with a usable form of folate. In combination therapy with chemotherapy agents like fluorouracil, it enhances their activity by stabilising the bond between the drug and its target enzyme, thus increasing its anticancer effect. When used with methotrexate, which inhibits folic acid metabolism, leucovorin acts as a rescue agent by replenishing folate stores in healthy cells and reducing toxicity.

Uses
Biovorin is used in several important clinical settings. It enhances the effectiveness of fluorouracil in the treatment of colorectal and other gastrointestinal cancers. It is also used to prevent or reduce toxic effects of high-dose methotrexate in cancers such as osteosarcoma or lymphoma. In some cases, it is used to treat accidental overdoses of folic acid antagonists or to manage certain types of anaemia caused by folate deficiency.

Adverse Effects
Leucovorin is generally well tolerated when used as directed. Some patients may experience mild side effects such as nausea, vomiting, or allergic reactions including rash and itching. When used in combination with fluorouracil, gastrointestinal side effects such as mouth sores and diarrhoea may become more pronounced. Rarely, seizures or other neurological symptoms may occur, especially in individuals receiving high doses or with existing central nervous system conditions. Regular monitoring during treatment ensures safe and effective use.