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Prescribing Information
Important Safety Information
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SAFETY

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Most Common Adverse Reactions With Voraxaze®(glucarpidase) Treatment 

Adverse reactions >1% possibly, probably, or definitely related to Voraxaze ,*

Adverse reaction

N=290, n (%)

Paresthesia

7 (2%)

Flushing✝︎

5 (2%)

Nausea/Vomiting

5 (2%)

Headache

2 (1%)

Hypotension

2 (1%)

*Excluding hematologic, hepatic, or renal adverse reactions. ✝︎This adverse reaction includes the following terms: flushing, feeling hot, burning sensation.

  • Adverse reaction severity was rated as Grade 1 or Grade 2 for all events, except for 1 patient who reported Grade 3 flushing. 
  • Adverse reactions related to toxic methotrexate (MTX) levels due to prolonged MTX clearance included myelosuppression, mucositis, acute hepatitis, and renal dysfunction and failure. 

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References
1.

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

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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.