Glucarpidase (Intravenous)

Overview

It is possible that whilst receiving chemotherapy treatment, a patient may develop kidney failure. Under such circumstances, the concentration of methotrexate in the blood could get too high, leading to a lot of dangerous health implications. Glucarpidase is the drug then prescribed to such patients as a means to help reduce the levels of Glucarpidase in the blood.

Glucarpidase, as an enzyme, works by breaking down the methotrexate, so that it can be more easily eliminated by the patient's body. Effectively, it performs the necessary function that the kidneys no longer can, and helps treat unanticipated overdoses of methotrexate. Be aware that this drug is only available via a doctor's prescription. It has a very specific set of uses and should only be taken by certain patients under strict medical supervision.

Condition(s) treated

  • Methotrexate overdose

Type of medicine

  • Powder for injectable solution

Side effects

As well as helping to treat a possible overdose, it is possible that Glucarpidase could cause a number of unwanted side effects. In some cases, these side effects are less severe, but in other cases require immediate medical assistance. Directly below is a list of these more serious side effects which require you to contact your doctor immediately. You may not necessarily encounter any of these, or it is possible that you will encounter more than one. You should, therefore, familiarise yourself with the possible effects to look out for.

Less common

  • Unusual weakness or tiredness

Rare

  • Hoarseness

As mentioned, the side effects you experience will not necessarily warrant immediate attention. Instead, you may find that these symptoms pass over time as your body adjusts to the medicine. However, it is understandable that such effects may still be worrying, especially if they are apparent for a continued period of time. If this is the case and you would like to find out if there are ways to reduce the effects, then you should contact your doctor. They may be able to advise certain ways to reduce the symptoms you are experiencing and can answer any other questions you have surrounding the medicine.

Less common

  • Nausea

Rare

  • Shaking or trembling of the feet or hands

It is possible that you experience other side effects not listed here. If this is the case, then you can still contact your doctor. They can seek to understand why they are occurring and offer any possible guidance as to how to help reduce the effects.

Dosage

Below you can find the average dosages given to patients suffering from a toxic plasma methotrexate overdose. This is where the concentration of methotrexate is greater than one micromole per litre and where there is impaired renal function. However, you should be aware that you will not be required to calculate or self-administer any dosages of Glucarpidase. Instead, your doctor will assess your condition and make a necessary injection.

  • Adults. Have a single IV injection of 50 units per kg of body weight

As mentioned, you will not need to self-administer this drug. Instead, it will be given by a trained nurse or doctor in a hospital setting. The solution is injected through a needle that is placed into one of your veins.

If you are also using the drug leucovorin, you should take Glucarpidase at least two hours before or after.

Alongside using Glucarpidase, you should also drink plenty of extra fluids. This will allow your kidneys to work as best as possible and to help prevent further kidney problems.

Interactions

It is possible that Glucarpidase will interact with other drugs you are currently taking. These interactions can range in their severity but are oftentimes avoided wherever possible. To help anticipate any possible interactions, you should make your doctor fully aware of any and all drugs you are currently taking. This includes any prescription or non-prescription drugs, as well as any herbal or vitamin supplements. Directly below is a list of all drugs which are known to interact with Glucarpidase.

If the anticipated interaction is severe than your doctor may need to alter one or both of the drugs. In other cases, your doctor may simply be able to alter the dosages of one or both of the medicines in order to limit any such interactions. This will be done if taking both drugs at the same time is still the best course of treatment for your medical condition.

  • Leucovorin

As well as interacting with drugs, it is possible that Glucarpidase will interact with certain aspects of your dietary intake. This includes things that you eat, drink and smoke. Your doctor may require you to update them on your typical dietary intake so they can make any necessary adjustments. They may need to make further adjustments to your diet in order to limit any interactions occurring after you have received this injection.

Warnings

Before giving you this drug, your doctor will want to ensure that it is indeed the best course of treatment for you and will not cause unwanted effects on your medical condition. As a part of this examination, they will need to be aware of any and all allergies you currently suffer from. This includes any allergies you have to dyes, preservatives, animals and foods.

The studies that have been performed on pediatric patients receiving this medicine have not indicated any problems that would make the drug any less useful. However, it must be noted that efficacy and safety have not yet been established in patients who are younger than one month old. Your doctor can advise on any more recent studies or of any potentially increased risks your child may face.

The studies that have been performed on older patients have not highlighted any geriatric-specific problems that would make this drug any less useful. If you do face any increased risks, then your doctor can weigh these against the benefits of receiving this medicine.

As of writing, it is unclear as to whether suitable studies have been carried out on pregnant women receiving this medicine. Instead, your doctor is best placed to advise on any increased risks and then weigh these against the benefits of using this medicine.

There are no studies that have yet been carried out on breastfeeding women receiving this medicine. Again, you will need to discuss this with your doctor if you are currently breastfeeding and they are looking to administer Glucarpidase.

After you have received this medicine, your doctor will want to closely monitor your condition to check the effect that it is having and make adjustments for any unwanted effects that may occur. During this period, your doctor may require you to take urine or blood tests to check for such effects. If they set any appointments after your receiving of this injection, you should attend them all.

It is possible that you will experience a severe allergic reaction after having received Glucarpidase. If you spot any of the following symptoms, then inform your doctor immediately.

  • Rash

Storage

You will not be required to store this medicine at all. Instead, it will be given by a trained nurse or doctor in a hospital setting. They will be responsible for its safe storage and transportation.

Summary

If you have suffered kidney failure and have therefore overdosed on methotrexate, then Glucarpidase is a very useful drug. It can help to break down the amount of methotrexate in your body and flush it away now that your kidneys are unable to. However, you should be aware that this drug is not suitable for all patients and is only given to certain patients. You should, therefore, be open and honest with your doctor about your complete medical history in order to decide whether or not this is suitable.

Above you can find a list of many of the side effects you may experience as a result of taking this drug. If you suffer from any of those mentioned and would like relief from your symptoms, you should contact your doctor. They can advise on the best course of action. Similarly, they are best placed to answer any other questions you may have. Finally, if your doctor offers any more guidance or necessary dietary changes after having received Glucarpidase, you should follow these closely. This will enable the best course of treatment for you and maximise the benefits of using Glucarpidase.