Consensus guidelines for use recommend administration of Voraxaze® (glucarpidase) at 48 hours following initiation of high-dose methotrexate (HDMTX) therapy when MTX concentrations are above 5 μM (2.27 μg/mL) and the serum creatinine is elevated relative to the baseline measurement.1
Beyond 48 to 60 hours, life-threatening toxicities and even death may not be preventable. Early and rapid reduction of methotrexate (MTX) concentrations can lower the risk of irreversible damage.1
*For MTX doses of 1-8 g/m2 over 24 hours, if MTX concentration is >120 μM or CrCl is greater than 1.5x baseline, continue supportive care and check MTX concentration at 36 hours1. CrCl, creatinine clearance.