Folate repletion
Reduced folate repletion
- Restores thymidylate and purine synthesis
- Rescues marrow from antifolates
- “Rescue” bypasses the block rather than reversing the drug
- Supplies reduced folate directly, bypassing dihydrofolate reductase
- ➔ so it works even when DHFR is inhibited
- Rescues normal cells after high-dose methotrexate
Drugs with this mechanism (1)
- Leucovorin — Reduced folate that rescues methotrexate toxicity but potentiates fluorouracil.
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