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Why is this medication prescribed?

Patients with renal illness who are taking methotrexate to treat specific forms of cancer can use glucarpidase to stop any negative effects of the drug (Rheumatrex, Trexall). Glucarpidase belongs to the group of drugs known as enzymes. It functions by assisting in the breakdown and elimination of methotrexate from the body.

How should this medicine be used?

A liquid must be added to the powder form of glucarpidase before injecting it intravenously (into a vein). As a single dose, it is typically administered over five minutes. Glucarpidase is administered along with leucovorin (an additional drug intended to stop the negative effects of methotrexate) up until laboratory testing indicate that further treatment is not required.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking glucarpidase,

  • If you have any allergies, including to glucarpidase, other medicines, or any of the substances in glucarpidase injection, notify your doctor and pharmacist very away. Request a list of the components from your pharmacist.
  • Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now taking or intend to use. Be sure to bring up levoleucovorin (Fusilev), folic acid (Folicet, in multivitamins), or pemetrexed (Alimta). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
  • Leucovorin should be administered at least two hours before or two hours after glucarpidase if you are receiving it.
  • Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while taking glucarpidase.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What side effects can this medication cause?

Side effects from glucarpidase are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Vomiting

Some adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

  • Fever
  • Chills
  • Feeling heated or flushed
  • Rash
  • Hives
  • Itching
  • Throat constriction or breathing issues
  • Skin sensations such as tingling, burning, prickling, or creeping
  • Headache

Other negative consequences of glucarpidase are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at or by phone at 1-800-332-1088 if you have a serious side event.

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how your body is responding to glucarpidase, your doctor will request a few lab tests.

Anything you want to know about glucarpidase, ask your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Voraxaze®
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