Abstract
The scientific basis for using folinic acid in combination with the antiparasitic drugs prescribed to AIDS patients has been reviewed. In vitro and experimental data are unclear. On the basis of folinic acid metabolism and pharmacology and of clinical experience, we suggest that folinic acid should not be systematically added to the curative treatment of pneumocystosis with cotrimoxazole. Folinic acid may be added to prophylactic regimens using high-dose cotrimoxazole (i.e. 800 mg sulfamethoxazole twice a day) and in malnourished patients. It should be administered as soon as cytopenia occurs in the course of treatment. Concerning toxoplasmosis, the addition of folinic acid is recommended in doses of 10 to 20 mg/day in acute therapy and 5 to 10 mg/day in maintenance therapy. Dosage must be adjusted to the results of blood counts.
MeSH terms
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Acquired Immunodeficiency Syndrome / complications*
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Drug Therapy, Combination
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Folic Acid / metabolism
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Hematologic Diseases / chemically induced
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Hematologic Diseases / complications
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Hematologic Diseases / prevention & control*
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Humans
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Leucovorin / pharmacokinetics
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Leucovorin / therapeutic use*
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Opportunistic Infections / complications
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Opportunistic Infections / drug therapy
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Opportunistic Infections / metabolism
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Pneumonia, Pneumocystis / complications
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Pneumonia, Pneumocystis / drug therapy*
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Pneumonia, Pneumocystis / metabolism
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Pyrimethamine / adverse effects
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Pyrimethamine / therapeutic use
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Sulfadiazine / therapeutic use
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Toxoplasmosis, Cerebral / complications
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Toxoplasmosis, Cerebral / drug therapy
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Toxoplasmosis, Cerebral / metabolism
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Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects*
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
Substances
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Sulfadiazine
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Trimethoprim, Sulfamethoxazole Drug Combination
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Folic Acid
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Leucovorin
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Pyrimethamine