{"entity":{"id":"glucarpidase","kind":"drug","name":"Glucarpidase","aka":["Carboxypeptidase G2"],"tldr":"Glucarpidase (Voraxaze) is a single emergency injection that chops up methotrexate in the blood when a patient's kidneys have failed to clear a high dose, preventing potentially fatal toxicity.","summary":"Glucarpidase was approved by the FDA in January 2012 to reduce toxic plasma methotrexate concentrations (above 1 micromole per litre) in adults and children with delayed methotrexate clearance due to impaired renal function, on pooled single-arm studies in which a single 50 units/kg dose lowered methotrexate by more than 95% within 15 minutes in almost all patients. It does not replace leucovorin, which must continue (given at least two hours apart because glucarpidase also cleaves leucovorin), and it is not for patients with expected clearance. In the EU it is available through named-patient supply rather than a central authorisation. Marketed by BTG, now SERB.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Glucarpidase","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=glucarpidase"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/glucarpidase"}],"tags":["nci-list","supportive"],"related":["methotrexate"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":["serb-pharmaceuticals"],"institutions":[],"pathways":[],"terms":[],"trials":["nct01305655","nct00634322","nct02022358"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Voraxaze","modality":"Recombinant bacterial enzyme (rescue agent)","supportive":true,"mechanism":"Carboxypeptidase G2 from Pseudomonas that cleaves the terminal glutamate from methotrexate, converting it within minutes to inactive DAMPA and glutamate, independent of renal function.","approvals":[{"region":"US","year":2012,"indication":"Toxic plasma methotrexate concentrations with delayed clearance due to impaired renal function"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/glucarpidase/","neighbours":{"drug":[{"id":"methotrexate","kind":"drug","name":"Methotrexate","route":"/drugs/methotrexate/"}],"company":[{"id":"serb-pharmaceuticals","kind":"company","name":"SERB Pharmaceuticals","route":"/companies/serb-pharmaceuticals/"}],"trial":[{"id":"nct01305655","kind":"trial","name":"Glucarpidase Effect on Severe Delayed HDM-clearance in Children Treated With High-dose Mtx in ALL","route":"/trials/nct01305655/"},{"id":"nct00634322","kind":"trial","name":"High Dose Methotrexate With Leucovorin Rescue With or Without Glucarpidase in Osteosarcoma","route":"/trials/nct00634322/"},{"id":"nct02022358","kind":"trial","name":"Will Glucarpidase After Methotrexate Treatment for Bone Sarcoma Lead to Fewer Side Effects and Reduce Chemotherapy Delays?","route":"/trials/nct02022358/"}]}}