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Prescribing Information
Important Safety Information
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Delayed Methotrexate clearance due to acute kidney injury is an oncologic emergency 

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Delayed Methotrexate clearance due to acute kidney injury is an oncologic emergency 

Only Voraxaze® (glucarpidase) can lower methotrexate (MTX) levels by ≥97% in 15 minutes, reducing the risk for severe toxicities and death. 

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ACT EARLY

Early treatment with Voraxaze resulted in significantly lower rates of toxicity and mortality. 

View Efficacy
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ACT WITH CONFIDENCE

Review hospitalization outcomes based on actual Medicare claims data for patients treated with Voraxaze. 

View Hospital Outcomes With Voraxaze
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MTX MONITORING TOOL

See if your patient is clearing MTX as expected.

Learn How to Use MTXPK.org
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Why Stock Voraxaze

Voraxaze lowers plasma MTX by ≥97% in 15 minutes. 

View Efficacy

High-Dose Methotrexate (HDMTX) Toxicity and Acute Kidney Injury

Keep Voraxaze top-of-mind when treating with HDMTX.

Learn About HDMTX Toxicity

Identify and Treat Delayed MTX Clearance Early

Consensus Guidelines recommend early use of Voraxaze. 

View Guidelines
References
1.

Widemann BC, Balis FM, Kim A, et al. Glucarpidase, leucovorin, and thymidine for high-dose methotrexate-induced renal dysfunction: clinical and pharmacologic factors affecting outcomes. J Clin Oncol. 2010;28(25):3979-3986.

2.

Ramsey LB, Balis FM, O’Brien MM, et al. Consensus Guideline for use of glucarpidase in patients with high-dose methotrexate induced acute kidney injury and delayed methotrexate clearance. Oncologist. 2018;23(1):52-61.

3.

Howard SC, McCormick J, Pui CH, Buddington RK, Harvey RD. Preventing and managing toxicities of high-dose methotrexate. Oncologist. 2016;21(12):1471-1482.

4.

Widemann BC, Adamson PC. Understanding and managing methotrexate nephrotoxicity. Oncologist. 2006;11(6):694-703.

5.

Voraxaze®. Prescribing information. BTG International Inc.; 2019.

6.

Ward S, King T, Chauhan N. Pooled analysis of time to administration of glucarpidase for methotrexate toxicity versus mortality. Clin Toxicol. 2013;51(7):575-724. Abstract 7.

7.

Demiralp B, Koenig L, Kala J, et al. Length of stay, mortality, and readmissions among Medicare cancer patients treated with glucarpidase and conventional care: a retrospective study. Clinicoecon Outcomes Res. 2019;11:129-144.

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Indication and Important Safety Information
Indication and Limitations of Use
  • Voraxaze® is a carboxypeptidase indicated to reduce toxic plasma methotrexate concentration (greater than 1 micromole per liter) in adult and pediatric patients with delayed methotrexate clearance (plasma methotrexate concentrations greater than 2 standard deviations of the mean methotrexate excretion curve specific for the dose of methotrexate administered) due to impaired renal function
  • Limitations of Use: Voraxaze® is not recommended for use in patients who exhibit the expected clearance and expected plasma methotrexate concentration. Reducing plasma methotrexate concentration in these patients may result in subtherapeutic exposure to methotrexate
Important Safety Information
WARNINGS AND PRECAUTIONS

Serious Hypersensitivity Reactions

  • Serious hypersensitivity reactions, including anaphylactic reactions, may occur. Serious hypersensitivity reactions occurred in less than 1% of patients

Monitoring Methotrexate Concentration/Interference with Assay

  • Methotrexate concentrations within 48 hours following Voraxaze® administration can only be reliably measured by a chromatographic method due to interference from metabolites. Measurement of methotrexate concentrations within 48 hours of Voraxaze® administration using immunoassays results in an overestimation of the methotrexate concentration

ADVERSE REACTIONS

  • In clinical trials, the most common related adverse events (occurring in >1% of patients) were paresthesia, flushing, nausea and/or vomiting, hypotension and headache

DRUG INTERACTIONS

  • Voraxaze® can decrease leucovorin concentration, which may decrease the effect of leucovorin rescue unless leucovorin is dosed as recommended, and may also reduce the concentrations other folate analogs or folate analog metabolic inhibitors

Please see full Prescribing Information.