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Care During Chemotherapy and Beyond

Rucaparib

(roo KAP a rib)

Trade Name: Rubraca™

Rucaparib is the generic name for the trade name drug Rubraca™. In some cases, health care professionals my use the trade name Rubraca™ when referring to the generic drug name rucaparib.

Drug Type: Rucaparib is an anti-cancer ("antineoplastic" or "cytotoxic") targeted therapy. This medication is classified as a PARP (poly ADP ribose polymerase) inhibitor. (For more detail, see "How Rucaparib Works" below).

What Rucaparib Is Used For

  • Rucaparib is indicated as monotherapy (by itself) in patients with deleterious germline and/or somatic BCRA mutation associated (as detected by an FDA approved test) advanced ovarian cancer who have been treated with 2 or more prior lines of chemotherapy.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Rucaparib Is Given

  • Rucaparib is a pill, taken by mouth, twice a day (about 12 hours apart).
  • It may be taken with or without food.
  • Swallow rucaparib tablets whole. Do not crush or dissolve the tablets.
  • Do not change your dose or stop rucaparib unless your health care provider tells you to.
  • If you miss a dose, take your next dose at your usually scheduled time. Do not take an extra dose to make up for a missed dose.
  • If you take too much rucaparib, call your health care provider right away and go to the emergency room.
  • Do not repeat a vomited dose.
  • Let your doctor know if you are starting any new medications as some medications interact with rucaparib.

The amount of rucaparib that you will receive depends on many factors, your general health or other health problems, and the type of side effects that you may have. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of rucaparib:

  • Most people will not experience all of the rucaparib side effects listed.
  • Side effects are often predictable in terms of their onset, duration, and severity.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking rucaparib:

These are less common side effects (occurring in 10-29%) for patients receiving rucaparib:

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here.

Always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, and go to the emergency room, if you should experience any of the following symptoms:

  • Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)
  • Signs of an allergic reaction, like rash, hives, itching, red, swollen, blistered or peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing or talking, shortness of breath, a cough that is new or worse, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.

The following symptoms require medical attention, but are not a emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting rucaparib treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking rucaparib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Rucaparib may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.).
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking rucaparib. Barrier methods of contraception, such as condoms, are recommended for up to 6 months after last dose of rucaparib.
  • Do not breast feed while taking rucaparib and for 2 weeks after the final dose.

Self-Care Tips

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Rucaparib

You will be checked regularly by your doctor while you are taking rucaparib to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC).

How Rucaparib Works

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, this leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Rucaparib is a targeted therapy. Rucaparib is a poly ADP-ribose polymerase (PARP) enzyme inhibitor, including PARP1, PARP2, and PARP3. PARP enzymes are involved in DNA transcription, cell cycle regulation, and DNA repair. By inhibiting PARP, rucaparib may cause increased formation of PARP-DNA complexes, resulting in DNA damage, apoptosis, and cell death. Increased cytotoxicity due to rucaparib was observed in tumor cell lines deficient in BRCA 1/2 and other DNA repair genes.

Research continues to identify which cancer may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Reference:

  • Rucaparib. Lexicomp Online® [updated 2017 April 10; cited 2017 April 21]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; April 21, 2017.

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