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warnings and cautions
5 WARNINGS AND PRECAUTIONS Hypersensitivity Reactions : Withhold or permanently discontinue WELLCOVORIN based on severity and indication. ( 4 , 5.1 ) 5.1 Hypersensitivity Reactions Hypersensitivity reactions, including anaphylactic reactions and urticaria, have been reported following the administration of leucovorin. WELLCOVORIN is contraindicated for the treatment of folic acid antagonist or DHFR inhibitor toxicity in patients with a history of a severe hypersensitivity reaction and for the treatment of FOLR1-CFTD in patients with a history of any hypersensitivity reaction to leucovorin, levoleucovorin, folic acid, or any component of WELLCOVORIN [see Contraindications ( 4 )] . Withhold or permanently discontinue WELLCOVORIN based on the severity of hypersensitivity.
6 ADVERSE REACTIONS The following clinically significant adverse reactions are described elsewhere in the labeling: • Hypersensitivity Reactions [see Warnings and Precautions ( 5.1 )]. The following adverse reactions have been identified during postapproval use of leucovorin (d,l‑leucovorin) or levoleucovorin (l‑leucovorin). Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. • Dermatologic: Pruritus, rash. • Respiratory: Dyspnea. • Other Clinical Events: Rigors, temperature change. Safety information for the treatment of FOLR1-CFTD with oral leucovorin is limited. The available evidence is based on published case reports [see Clinical Studies ( 14.1 )] . Adverse reactions included pruritus, rash, urticaria, dyspnea, hypersensitivity reactions, rigors, and temperature change. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact GlaxoSmithKline at 1‑888‑825‑5249 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.