Drug interactions
Glucarpidase + Leucovorin
Severity: Major
Glucarpidase and Leucovorin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Glucarpidase can hydrolyze leucovorin and its active metabolite, reducing rescue effect if given close together. Reduced rescue may worsen methotrexate toxicity.
What this interaction means in plain words
Glucarpidase and Leucovorin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Glucarpidase belongs to Miscellaneous; Leucovorin belongs to Miscellaneous.
Why it happens
Glucarpidase is a carboxypeptidase that cleaves folate analogs, including leucovorin.
What to do
Do not give leucovorin within 2 hours before or after glucarpidase. Dose leucovorin on the basis of the methotrexate concentration measured by a chromatographic method.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Glucarpidase
- Folic acid + Glucarpidase Moderate
- Glucarpidase + Methotrexate Moderate
- Glucarpidase + Pemetrexed Minor
- Glucarpidase + Pralatrexate Minor
Other interactions of Leucovorin
- Capecitabine + Leucovorin Major
- Fluorouracil + Leucovorin Major
- Leucovorin + Phenobarbitone Moderate
- Leucovorin + Phenytoin Moderate
Frequently asked questions
Can I take Glucarpidase with Leucovorin?
MediHelp rates the interaction as major. Glucarpidase and Leucovorin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Glucarpidase can hydrolyze leucovorin and its active metabolite, reducing rescue effect if given close together. Reduced rescue may worsen methotrexate toxicity.
How serious is the interaction between Glucarpidase and Leucovorin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give leucovorin within 2 hours before or after glucarpidase. Dose leucovorin on the basis of the methotrexate concentration measured by a chromatographic method.
What other medicines interact with Glucarpidase?
MediHelp also lists interactions of Glucarpidase with, for example, Folic acid, Methotrexate, Pemetrexed. The full list is on the Glucarpidase page.
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