Indications for glucarpidase rescue in patients receiving therapy with high-dose methotrexate (MTX)*^[1]

Infusion duration for
high-dose MTX

Indication for
glucarpidase rescue

≤24 hours

Serum creatinine significantly elevated relative to baseline measurement and:

36 to 42 hours

48-hour plasma MTX concentration >5 microM

MicroM: micromolar.
* Glucarpidase administration should optimally occur within 48 to 60 hours from the start of the high-dose MTX infusion.

Reference:

Ramsey LB, Balis FM, O'Brien MM, et al. Consensus Guideline for Use of Glucarpidase in Patients with High-Dose Methotrexate Induced Acute Kidney Injury and Delayed Methotrexate Clearance. Oncologist 2018; 23:52.

Graphic 122543 Version 1.0

Indications for glucarpidase rescue in patients receiving therapy with high-dose methotrexate (MTX)*[1]