Adult Dosing
Toxic plasma methotrexate concentrations
- Recommended dose: Single IV bolus injection of 50 U/kg over 5 minutes
Note:
- Flush intravenous line before and after administration of glucarpidase
Pediatric Dosing
Toxic plasma methotrexate concentrations
- Recommended dose: Single IV bolus injection of 50 U/kg over 5 minutes
Note:
- Flush intravenous line before and after administration of glucarpidase
[Outline]
See Supplemental Patient Information
- Methotrexate concentrations within 48 hours following glucarpidase administration can only be measured by a chromatographic method. DAMPA is an inactive metabolite of methotrexate, which interferes with methotrexate measurement using immunoassays resulting in an overestimation of methotrexate concentration
- Do not administer leucovorin within 2 hours before or after a dose of glucarpidase as leucovorin is a substrate for glucarpidase. Administer the same leucovorin dose as given prior to glucarpidase administration for the first 48 hours after glucarpidase and later on the basis of measured methotrexate concentration. Continue therapy with leucovorin until the methotrexate concentration has been maintained below the leucovorin treatment threshold for a minimum of 3 days. Continue urine hydration and alkalinization as advised
Caution: Use cautiously in
- Serious allergic reactions
Supplemental Patient Information
- Inform patients that allergic reactions including potentially serious reactions may occur during therapy
- Advise patients to promptly report any signs and symptoms of infusion reactions including fever, chills, feeling hot, flushing, itching, rash, hives, throat tightness or breathing problems, headache, tingling, or numbness
- Educate patients of the importance of continued monitoring of methotrexate blood concentrations and renal status at appropriate intervals even after hospital discharge
Pregnancy Category:C
Breastfeeding: It is unknown whether glucarpidase is excreted in human milk. Manufacturer advises caution.
