TheraRadar
Data updated: Mar 29, 2026

VORAXAZE

GLUCARPIDASE
Approved 2012-01-17

Voraxaze (glucarpidase) is a carboxypeptidase indicated to reduce toxic plasma methotrexate concentrations in adult and pediatric patients. It is specifically used for patients experiencing delayed methotrexate clearance due to impaired renal function. The treatment is intended for individuals with plasma methotrexate concentrations greater than 1 micromole per liter that exceed two standard deviations of the mean excretion curve for the administered dose. It is not recommended for patients with expected clearance levels, as reducing concentrations in these individuals may lead to subtherapeutic methotrexate exposure.

Source: FDA Label • BTG INTERNATIONAL INC • Carboxypeptidase

How VORAXAZE Works

Voraxaze is a recombinant bacterial enzyme that functions by hydrolyzing the carboxyl-terminal glutamate residue from folic acid and classical antifolates. Specifically, the drug converts methotrexate into its inactive metabolites, 4-deoxy-4-amino-N10-methylpteroic acid (DAMPA) and glutamate. By facilitating this conversion, the enzyme provides an alternate non-renal pathway for methotrexate elimination. This mechanism is utilized in patients undergoing high-dose methotrexate treatment who have developed renal dysfunction.

1
Indication
--
Phase 3 Trials
1
Priority Reviews
14
Years on Market

Details

Status
Prescription
First Approved
2012-01-17
Routes
INJECTION
Dosage Forms
INJECTABLE

Companies

Active Ingredient: GLUCARPIDASE

VORAXAZE Approval History

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What VORAXAZE Treats

1 indications

VORAXAZE is approved for 1 conditions since its original approval in 2012. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Toxic plasma methotrexate concentration in adult and pediatric patients with delayed methotrexate clearance due to impaired renal function
Source: FDA Label
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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

VORAXAZE FDA Label Details

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Indications & Usage

FDA Label (PDF)

VORAXAZE is indicated to reduce toxic plasma methotrexate concentration (greater than 1 micromole per liter) in adult and pediatric patients with delayed methotrexate clearance (plasma methotrexate concentrations greater than 2 standard deviations of the mean methotrexate excretion curve specific for the dose of methotrexate administered) due to impaired renal function. Limitations of Use: VORAXAZE is not recommended for use in patients who exhibit the expected clearance and expected plasma methotrexate concentration. Reducing plasma methotrexate concentration in these patients may result in s...

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.