Paper II — 2021 February (Supplementary) (2010 Scheme) — Q15

Paper II

2021 February (Supplementary) (2010 Scheme)

Question

Folic acid/Folinic acid with methotrexate Name the following (Two examples for each) (5x1=5)

Q150.3 marksShort Answers★✓

Answer

Chosen drug: Folinic acid

Justification: Methotrexate acts by inhibiting dihydrofolate reductase, blocking the conversion of both dietary folic acid AND dihydrofolate to the active tetrahydrofolate. Folic acid requires this same blocked enzymatic step for activation, so it cannot bypass methotrexate’s action. Folinic acid (leucovorin), a reduced folate, directly provides the active tetrahydrofolate derivative, bypassing the blocked enzyme entirely — making it the correct “rescue” agent used with high-dose methotrexate therapy, unlike folic acid.

Related Concepts

1. 1Cancer Chemotherapy

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