An enzyme called glucarpidase is used to alleviate methotrexate toxicity, particularly in those with reduced kidney function. It functions by dissolving methotrexate into inert metabolites that the body can quickly get rid of. When glucarpidase is injected intravenously, methotrexate levels are quickly lowered, lessening the medication's harmful effects. Hypotension, nausea, and allergic reactions are typical side effects. Patients taking leucovorin, a medication that is frequently taken with methotrexate, need to be closely watched for potential interactions since glucarpidase can reduce the drug's efficacy. When taking both medications, timing and administration must be done correctly.