Glucarpidase
Glucarpidase is a recombinant bacterial enzyme used as a rescue therapy to treat toxic methotrexate levels in patients with impaired kidney function. It works by rapidly breaking down methotrexate into inactive metabolites, helping to prevent severe side effects when the drug cannot be properly cleared from the body.
A recombinant enzyme that rapidly inactivates toxic methotrexate levels in patients with renal impairment.
Key facts at a glance
- ATC
- V03AF09
- RxNorm
- 1242127
- Generic
- Glucarpidase
- Class
- atc-v03
- Brands
- Voraxaze
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Treatment of toxic methotrexate levels (methotrexate toxicity) in patients with delayed methotrexate clearance due to impaired renal function, particularly in cases of high-dose methotrexate therapy for cancer.
Glucarpidase is a recombinant bacterial carboxypeptidase enzyme that hydrolyzes the carboxyl-terminal glutamate residue from methotrexate, converting it to its inactive metabolite DAMPA (4-deoxy-4-amino-N10-methylpteroic acid) and glutamate, thereby rapidly reducing circulating methotrexate levels.
Must be administered alongside (not as a replacement for) leucovorin rescue. Leucovorin should not be given within 2 hours before or after glucarpidase due to potential interference. Methotrexate levels should not be measured for several days after administration as standard assays may be affected. Prompt administration within the first 24-48 hours provides optimal benefit.
Official drug label
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This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy