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Fusilev (Intravenous)

Generic name: levoleucovorinlee-voe-loo-koe-VOE-rin ]
Brand names: Fusilev, Khapzory
Drug class: Antidotes

Medically reviewed by Last updated on Oct 24, 2023.

Uses for Fusilev

Levoleucovorin injection is used as a rescue treatment after high-dose methotrexate treatment in patients with osteosarcoma (bone cancer). It is also used to lessen the toxic effects of folic acid blocker overdose or methotrexate in patients who cannot eliminate this drug properly from their bodies. Levoleucovorin injection is also used together with fluorouracil to treat metastatic (cancer that has spread) colon or rectal cancer.

This medicine is to be given by or under the direct supervision of your doctor.

Before using Fusilev

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of levoleucovorin injection in children as rescue treatment after high-dose methotrexate treatment in osteosarcoma.

Appropriate studies have not been performed on the relationship of age to the effects of levoleucovorin injection in children to treat metastatic colorectal cancer. Safety and efficacy have not been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of levoleucovorin injection in the elderly.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Proper use of Fusilev

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

Do not use this medicine together with trimethoprim-sulfamethoxazole for the acute treatment of Pneumocystis jiroveci pneumonia in patients with HIV infection.

Precautions while using Fusilev

It is very important that your doctor check your progress closely while you are receiving this medicine to make sure it is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may cause stomach or bowel problems when used with fluorouracil. Check with your doctor right away if you have swelling of the mouth, diarrhea, confusion, decreased urination, dizziness, dry mouth, fainting, increased heart rate, lightheadedness, rapid breathing, sunken eyes, thirst, unusual tiredness or weakness, or wrinkled skin, which may be severe or longer than usual.

Side Effects of Fusilev

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Incidence not known

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

Commonly used brand name(s)

In the U.S.

Available Dosage Forms:

Therapeutic Class: Methotrexate Rescue

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.