Difference between revisions of "Glucarpidase (Voraxaze)"

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==General information==
 
==General information==
Class/mechanism: Recombinant bacterial enzyme that degrades folic acid and antifolates such as [[Methotrexate (MTX)|methotrexate]] by hydrolyzing their carboxyl-terminal glutamate residues. Glucarpidase catalyzes the degradation of methotrexate to the inactive metabolites 4-deoxy-4-amino-N10-methylpteroic acid (DAMPA) and glutamate.<ref name="insert">[https://www.btgplc.com/media/1213/voraxaze-prescribing-information-march-13-1.pdf Glucarpidase (Voraxaze) package insert]</ref><ref>[[File:Glucarpidase.pdf|Glucarpidase (Voraxaze) package insert (locally hosted backup)]]</ref><ref>[http://www.btgplc.com/products/specialty-pharmaceuticals/voraxaze Glucarpidase (Voraxaze) manufacturer's website]</ref>
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Class/mechanism: Recombinant bacterial enzyme that degrades folic acid and antifolates such as [[Methotrexate (MTX)|methotrexate]] by hydrolyzing their carboxyl-terminal glutamate residues. Glucarpidase catalyzes the degradation of methotrexate to the inactive metabolites 4-deoxy-4-amino-N10-methylpteroic acid (DAMPA) and glutamate.<ref name="insert">[https://www.btgplc.com/media/1213/voraxaze-prescribing-information-march-13-1.pdf Glucarpidase (Voraxaze) package insert]</ref><ref>[[:File:Glucarpidase.pdf|Glucarpidase (Voraxaze) package insert (locally hosted backup)]]</ref><ref>[http://www.btgplc.com/products/specialty-pharmaceuticals/voraxaze Glucarpidase (Voraxaze) manufacturer's website]</ref>
 
<br>Route: IV
 
<br>Route: IV
 
<br>Extravasation: no information
 
<br>Extravasation: no information
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
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For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.<ref name="insert"></ref>  
  
 
==Patient drug information==
 
==Patient drug information==
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==History of changes in FDA indication==
 
==History of changes in FDA indication==
* 1/17/2012: Initial FDA approval "for the treatment of toxic plasma [[Methotrexate (MTX)|methotrexate]] concentrations (greater than 1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function."
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* 2012-01-17: Initial FDA approval for the treatment of toxic plasma [[Methotrexate (MTX)|methotrexate]] concentrations (greater than 1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function.
 
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==History of changes in PMDA indication==
 +
*2021-09-27: Newly indicated to reduce toxic plasma methotrexate concentration in patients with delayed clearance of methotrexate due to methotrexate/leucovorin salvage therapy.
 
==Also known as==
 
==Also known as==
 
*'''Generic name:''' carboxypeptidase G2
 
*'''Generic name:''' carboxypeptidase G2
*'''Brand name:''' Voraxaze
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*'''Brand names:''' Megludase, Voraxaze
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==References==
 
==References==
 
<references/>
 
<references/>
# Buchen S, Ngampolo D, Melton RG, Hasan C, Zoubek A, Henze G, Bode U, Fleischhack G. Carboxypeptidase G2 rescue in patients with methotrexate intoxication and renal failure. Br J Cancer. 2005 Feb 14;92(3):480-7. [https://www.nature.com/articles/6602337 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2362096/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/15668713 PubMed]
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# Buchen S, Ngampolo D, Melton RG, Hasan C, Zoubek A, Henze G, Bode U, Fleischhack G. Carboxypeptidase G2 rescue in patients with methotrexate intoxication and renal failure. Br J Cancer. 2005 Feb 14;92(3):480-7. [https://doi.org/10.1038/sj.bjc.6602337 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2362096/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/15668713/ PubMed]
  
 
[[Category:Drugs]]
 
[[Category:Drugs]]
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[[Category:FDA approved in 2012]]
 
[[Category:FDA approved in 2012]]
 +
[[Category:PMDA approved in 2021]]

Latest revision as of 00:59, 29 June 2024

General information

Class/mechanism: Recombinant bacterial enzyme that degrades folic acid and antifolates such as methotrexate by hydrolyzing their carboxyl-terminal glutamate residues. Glucarpidase catalyzes the degradation of methotrexate to the inactive metabolites 4-deoxy-4-amino-N10-methylpteroic acid (DAMPA) and glutamate.[1][2][3]
Route: IV
Extravasation: no information

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.[1]

Patient drug information

History of changes in FDA indication

  • 2012-01-17: Initial FDA approval for the treatment of toxic plasma methotrexate concentrations (greater than 1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function.

History of changes in PMDA indication

  • 2021-09-27: Newly indicated to reduce toxic plasma methotrexate concentration in patients with delayed clearance of methotrexate due to methotrexate/leucovorin salvage therapy.

Also known as

  • Generic name: carboxypeptidase G2
  • Brand names: Megludase, Voraxaze

References

  1. Buchen S, Ngampolo D, Melton RG, Hasan C, Zoubek A, Henze G, Bode U, Fleischhack G. Carboxypeptidase G2 rescue in patients with methotrexate intoxication and renal failure. Br J Cancer. 2005 Feb 14;92(3):480-7. link to original article link to PMC article PubMed