GLUCARPIDASE
(Voraxaze, carboxypeptidase)Standard Prescription
Glucarpidase __ units IV {intrathecal} (__ units /kg /dose), one dose.
Glucarpidase __ units intrathecal, one dose.
Dosages
Methotrexate toxicity: 50 units/kg/dose IV once
Intrathecal methotrexate overdose: 2000 units/dose intrathecally once
Intrathecal methotrexate overdose: 2000 units/dose intrathecally once
Mechanism of Action
Indicated for the treatment of toxic plasma methotrexate concentrations
in patients with delayed methotrexate clearance due to impaired renal
function. Glucarpidase rapidly hydrolyzes methotrexate to inactive
metabolites.
Forms Supplied
Injection: 1000 unit vial available only through Special Access Program.
Emergency stock for western Canada is maintained at McKesson Wholesale but will only be released upon approval by Health Canada
Emergency stock for western Canada is maintained at McKesson Wholesale but will only be released upon approval by Health Canada
Comments
Indicated for the treatment of toxic plasma methotrexate concentrations in patients with delayed methotrexate clearance and/or in the presence of deteriorating renal function. Refer to individual chemotherapy protocol for glucarpidase indications.
Glucarpidase should be administered within 48-60 hours of start of methotrexate.
Do not administer leucovorin within 2 hours of glucarpidase.
Measurement of methotrexate serum levels using immunoassays is unreliable for samples collected within 48 hours following glucarpidase administration and levels will appear falsely high due to the interference of the inactive metabolite of methotrexate (this method is used at BCCH).
Anaphylaxis is rare (<1%). Paresthesias, flushing, nausea, vomiting, hypotension, headache may occur.
Glucarpidase should be administered within 48-60 hours of start of methotrexate.
Glucarpidase rapidly hydrolyzes methotrexate to inactive metabolites.
Do not administer leucovorin within 2 hours of glucarpidase.
Measurement of methotrexate serum levels using immunoassays is unreliable for samples collected within 48 hours following glucarpidase administration and levels will appear falsely high due to the interference of the inactive metabolite of methotrexate (this method is used at BCCH).
Anaphylaxis is rare (<1%). Paresthesias, flushing, nausea, vomiting, hypotension, headache may occur.
References
450, 451, 452, 519
Last Edited
2022-01-04 04:16:49