The Medical Letter on Drugs and Therapeutics
Glucarpidase (Voraxaze) for Methotrexate Toxicity
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The FDA has approved glucarpidase (Voraxaze – BTG International) for treatment of toxic plasma methotrexate concentrations (>1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function. Glucarpidase has been available in the US since 2007 under a compassionate use open-label treatment protocol (Clinical Trials and Consulting Services, 1-877-398-9829), which will remain in effect until the drug becomes commercially available later this year. There is currently a shortage of IV methotrexate in the US.

HIGH-DOSE METHOTREXATE — Methotrexate is excreted primarily by the kidneys, and in high doses can cause nephrotoxicity. Patients receiving cancer chemotherapy with high-dose methotrexate may develop acute nephrotoxicity leading to delayed elimination of the drug, higher serum concentrations and increased systemic toxicity. Prolonged exposure to high concentrations ... more      

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Title: Glucarpidase (Voraxaze) for Methotrexate Toxicity
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