Drug General Information (ID: DDIVGAQKZF)
Drug Name			Leucovorin		Drug Info		Glucarpidase		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Folate Supplements				Antidotes
Structure

Mechanism of Leucovorin-Glucarpidase Interaction (Severity Level: Moderate)
Increased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Leucovorin				Glucarpidase
Mechanism		Glucarpidase substrate				Glucarpidase recombinant enzyme
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Increased metabolism of Leucovorin caused by Glucarpidase

Recommended Action
Management		Leucovorin should be continued following treatment with glucarpidase however, it should not be administered within two hours before or two hours after a dose of glucarpidase. For the first 48 hours after glucarpidase administration, the same leucovorin dose as given prior to glucarpidase treatment is appropriate. Beyond 48 hours, the leucovorin dose should be based on the measured methotrexate concentration. Do not discontinue leucovorin based on the determination of a single methotrexate concentration below the leucovorin treatment threshold. Therapy with leucovorin should be continued until the methotrexate concentration has been maintained below the leucovorin treatment threshold for a minimum of 3 days. Hydration and alkalinization of the urine should be continued as indicated.

References
1	Product Information. Voraxaze (glucarpidase). BTG International Inc, West Conshohocken, PA.