Glucarpidase, also known as carboxypeptidase G2, is a recombinant enzyme produced by genetic engineering that is used to rapidly reduce toxic levels of methotrexate (MTX) in the blood. MTX is an antineoplastic drug used to treat a variety of cancers; however, it can cause life-threatening toxicity and even death if not promptly and effectively removed from the body. Glucarpidase works by hydrolyzing MTX molecules and reducing their concentration to safe levels. This enzyme is approved for use in adults and children over the age of two months who develop serious MTX toxicity due to impaired renal function.
Glucarpidase, sold under the brand name Voraxaze, is a medication used for the treatment of elevated levels of methotrexate (a chemotherapy medication) in cancer patients who have impaired kidney function . Methotrexate is typically eliminated by the kidneys, but in patients with impaired kidney function, methotrexate can stay in the body for too long and cause serious side effects. Glucarpidase is an enzyme that breaks down methotrexate into inactive metabolites, which are then eliminated by the body.
Glucarpidase is given by intravenous (IV) injection over a 5-minute period. The recommended dose is 50 units/kg. Glucarpidase is typically given only once, but it may be given again if methotrexate levels are not reduced enough.
The most common side effects of glucarpidase are nausea, vomiting, headache, flushing, and itching. These side effects are usually mild and go away on their own. Glucarpidase can also cause serious allergic reactions, including trouble breathing, swelling of the face, lips, or tongue, and hives. If you experience any of these symptoms, get medical help right away.
Glucarpidase is not for everyone. It should not be used in people who are allergic to glucarpidase or any of the ingredients in the medication. It should also not be used in people with normal kidney function or in people who do not have high levels of methotrexate in their blood.