General
Leucovorin
Virtual visit

Leucovorin

With our quick and easy online prescription process, you can manage your health effortlessly — whether you need a first-time prescription for Leucovorin or a refill of an existing one.

Licensed providers in all 50 states

Expert-guided, evidence-based treatments

Skip the trip to the doctor's office

Visit options

Costs shown are for the visit only. You'll pay for medication at your preferred pharmacy.

Video Visit

$25

Est. or $100 w/o insurance

Chat Visit

$30

w/o insurance

Most insurance accepted

Board-certified

No hidden fees

Available nationwide

What is Leucovorin?

Leucovorin is a form of folinic acid—an active form of the B vitamin folate—used in medicine primarily to protect normal cells from the toxic effects of methotrexate chemotherapy (a process called leucovorin rescue), and to enhance the anti-cancer effectiveness of 5-fluorouracil in colorectal cancer treatment. It's also co-administered with pyrimethamine (Daraprim) to prevent the folate deficiency and bone marrow suppression that drug can cause. Unlike folic acid supplements, Leucovorin bypasses the enzyme that methotrexate blocks, allowing normal cells to maintain folate metabolism even during high-dose methotrexate therapy.

Methotrexate rescue

Leucovorin bypasses the dihydrofolate reductase enzyme that methotrexate inhibits, restoring folate-dependent metabolic pathways in normal tissues—protecting bone marrow, GI mucosa, and other rapidly dividing healthy cells from methotrexate toxicity after high-dose chemotherapy.

5-FU chemotherapy enhancement

Stabilizes the bond between 5-fluorouracil and thymidylate synthase, the enzyme 5-FU targets in cancer cells—increasing the duration and potency of 5-FU's DNA-blocking activity and improving its effectiveness in colorectal cancer treatment.

Folate pathway bypass

As a pre-reduced form of folate, Leucovorin can be directly used by cells without enzymatic activation—allowing normal folate metabolism to continue in situations where key folate enzymes are blocked by antifolate drugs or genetic defects.

Virtual visit with clinician

Ongoing support, always available.

You’ll be supported by experienced clinicians who care for a wide range of health needs, from everyday concerns to more complex conditions.

Our clinicians track your progress over time and adjust your care as needed. If medication is prescribed, we’ll manage dosing and monitor for side effects. If lab testing is recommended, we review results and refine your plan accordingly. You’re never left to navigate care on your own.

All your care in one place. That’s the General Medicine difference.

We help you understand your options, connect you to the right clinicians, manage prescriptions, coordinate any needed evaluations, and keep an eye on your overall health along the way. It’s comprehensive care that looks at the full picture — your goals, your history, your lifestyle — and makes it simple to move forward with confidence.

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Frequently Asked Questions

What is leucovorin used for?

Leucovorin has two main uses: protecting normal cells from methotrexate toxicity (leucovorin rescue), and enhancing the effectiveness of 5-fluorouracil chemotherapy in colorectal cancer treatment.

Why is leucovorin given after high-dose methotrexate?

High-dose methotrexate blocks folate metabolism — which is what makes it effective against cancer and autoimmune disease, but also harms normal rapidly dividing cells. Leucovorin bypasses the blockade in normal cells, protecting bone marrow and GI mucosa.

What is the timing between methotrexate and leucovorin rescue?

Timing is critically precise — leucovorin is started at a specific interval after methotrexate (often 24 hours) and continued on a schedule based on methotrexate blood levels. Your clinician will specify the exact protocol.

What side effects might leucovorin itself cause?

Leucovorin is generally very well tolerated. Allergic reactions are rare. When used to enhance 5-FU, GI effects from the chemotherapy — diarrhea and mucositis — may be more pronounced than with 5-FU alone.

Is leucovorin the same as folic acid?

No. Leucovorin (folinic acid) is a pre-reduced, active form of folate that bypasses the enzyme methotrexate blocks. Folic acid requires enzymatic activation — which methotrexate prevents — making it unable to rescue cells blocked by methotrexate.
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