Giuseppe Miceli and colleagues describe in a letter recently published in the European Journal of Internal Medicine [1] the case of a patient with methotrexate intoxication who received treatment with glucarpidase alongside standard supportive measures. The authors describe how glucarpidase was administered 8 days after a supposedly incongruous ingestion of oral methotrexate, therefore well outside the recommended therapeutic window for glucarpidase of 48–60 h from the start of high-dose methotrexate infusion [2,3].
