Capecitabine and folic acid: A lethal combination?

BJMO - volume 16, issue 2, march 2022

D. Naudts MD, L-A. Teuwen MD, PhD, J. Van Boven , H. Prenen MD, PhD, T. Vandamme MD, PhD, B. Van Overberghe MD, K. Forceville MD, M. Peeters MD, PhD


5-Fluorouracil (5-FU) and its prodrug capecitabine are widely used and generally well-tolerated chemotherapeutic agents. Although leucovorin, a derivative of folic acid, is routinely used to potentiate the effect of 5-FU, there seems to be little to no awareness about a similar interplay between capecitabine and folic acid, a commonly used supplement. This study presents a case in which a high concentration of folic acid led to fatal capecitabine-related toxicity, with the aim to raise awareness on the interaction between folic acid supplementation and 5-FU/capecitabine treatment toxicity.

(BELG J MED ONCOL 2022;16(2):74–8)

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