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Rubraca
rucaparib
Adult Dosing .
Dosage forms: TAB: 200 mg, 250 mg, 300 mg
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing including toxicity-related dose adjustments
BRCA-mutated ovarian CA, maintenance tx
- [600 mg PO bid]
- Info: for patients with platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal CA
BRCA-mutated prostate CA, metastatic castration-resistant
- [600 mg PO bid]
- Info: for patients who have received prior tx with androgen deprivation therapy; use with GnRH analog in patients without bilateral orchiectomy
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- incomplete hematologic toxicity recovery after prior chemo use
- avoid: breastfeeding during tx and x2wk after D/C
- avoid: semen donation during tx and x3mo after D/C
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: patients of childbearing potential
- caution: male patients of reproductive potential
- caution: electrolyte abnormalities
- caution: long QT syndrome, congenital
- caution: QT prolongation
- caution: QT prolongation family history
- caution: torsades de pointes history
- caution: ventricular arrhythmia
- caution: bradycardia
- caution: MI, recent
- caution: CHF
Drug Interactions .
Overview
rucaparib
PARP inhibitor
- CYP1A2 inhibitor, moderate
- CYP2C9 inhibitor, weak
- CYP2C19 inhibitor, weak
- CYP3A4 inhibitor, weak
- BCRP inhibitor
- P-gp inhibitor, weak
- immunomodulatory effects
- myelosuppressive oncologic agent
- photosensitivity
- prolongs QT interval (known)
Contraindicated
- adenovirus vaccine, live
- chikungunya vaccine, live
- cholera vaccine, live
- colchicine
- dengue vaccine, live
- domperidone
- dronedarone
- eliglustat
- fezolinetant
- influenza nasal vaccine, live
- levoketoconazole
- measles/mumps/rubella vaccine, live
- pimozide
- rotavirus vaccine, live
- smallpox vaccine, live
- thioridazine
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- adagrasib
- alosetron
- alpelisib
- alprazolam
- aminolevulinic acid topical
- amiodarone
- anagrelide
- apalutamide
- apixaban
- apomorphine
- arsenic trioxide
- artemether/lumefantrine
- asenapine
- azithromycin
- bedaquiline
- bendamustine
- bosentan
- cabozantinib
- ceritinib
- chloramphenicol
- chloroquine
- citalopram
- cladribine oral
- clarithromycin
- clofazimine
- codeine
- crizotinib
- dabigatran
- deferiprone
- degarelix
- desflurane
- desipramine
- dexmedetomidine
- dexmedetomidine injection
- dexrazoxane
- disopyramide
- dofetilide
- donepezil
- dordaviprone
- droperidol
- efavirenz
- encorafenib
- ensartinib
- entrectinib
- ephedra
- epirubicin
- eribulin
- erythromycin
- etrasimod
- fexinidazole
- flecainide
- fluorouracil
- fluoxetine
- foscarnet
- fosfomycin injection
- ganciclovir
- gepotidacin
- gilteritinib
- givinostat
- glasdegib
- goserelin
- grapefruit
- haloperidol
- histrelin
- hydrocodone
- hydroxychloroquine
- hydroxyzine
- ibutilide
- iloperidone
- inotuzumab ozogamicin
- isoflurane
- ivabradine
- ivosidenib
- lefamulin
- leuprolide
- levofloxacin
- lofexidine
- lonafarnib
- loperamide
- lopinavir/ritonavir
- macimorelin
- meperidine
- methadone
- mifepristone
- milsaperidone
- mobocertinib
- moxifloxacin
- neratinib
- nilotinib
- oliceridine
- ondansetron
- osimertinib
- oxaliplatin
- oxycodone
- ozanimod
- pacritinib
- palifermin
- paliperidone
- palonosetron
- pasireotide
- pazopanib
- penicillamine
- pentamidine
- phenobarbital
- pimavanserin
- pirfenidone
- pitolisant
- ponesimod
- porfimer
- pralsetinib
- primaquine
- procainamide
- propafenone
- quetiapine
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- quizartinib
- rabies vaccine
- radium Ra 223 dichloride
- relugolix
- repotrectinib
- revumenib
- ribociclib
- rilpivirine
- rivaroxaban
- romidepsin
- ropeginterferon alfa-2b
- selpercatinib
- sertraline
- sevoflurane
- simvastatin
- siponimod
- sirolimus albumin-bound
- solifenacin
- sorafenib
- sotalol
- taletrectinib
- telavancin
- tetrabenazine
- tizanidine
- topotecan
- toremifene
- tramadol
- trazodone
- triclabendazole
- trifluridine
- triptorelin
- valganciclovir
- vandetanib
- vemurafenib
- venetoclax
- vepdegestrant
- vorasidenib
- ziftomenib
- ziprasidone
Monitor/Modify Tx
- abemaciclib
- acalabrutinib
- afatinib
- aficamten
- albendazole
- albuterol
- albuterol inhaled
- alemtuzumab
- alfentanil
- alfuzosin
- allopurinol
- aminophylline
- amisulpride
- amitriptyline
- anthrax vaccine
- anti-thymocyte globulin
- arformoterol inhaled
- asciminib
- atidarsagene autotemcel
- atorvastatin
- auranofin
- avanafil
- avapritinib
- avian influenza vaccine
- azathioprine
- balsalazide
- baricitinib
- benznidazole
- berotralstat
- betibeglogene autotemcel
- brigatinib
- buprenorphine
- caffeine citrate
- capivasertib
- carbamazepine
- celecoxib
- chikungunya vaccine
- chlorpromazine
- cidofovir
- ciprofloxacin
- clobazam
- clomipramine
- clozapine
- copper histidinate
- COVID-19 vaccine
- cyclophosphamide
- cyclosporine
- dapsone
- dasatinib
- deferasirox
- deuruxolitinib
- deutetrabenazine
- diazepam
- diclofenac
- digoxin
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- docetaxel
- ebola vaccine, live
- edoxaban
- efbemalenograstim alfa
- eflapegrastim (G-CSF)
- elivaldogene autotemcel
- enfortumab vedotin
- eplerenone
- escitalopram
- etuvetidigene autotemcel
- everolimus
- exagamglogene autotemcel
- fedratinib
- felodipine
- fentanyl
- filgrastim (G-CSF)
- finerenone
- fingolimod
- flibanserin
- fluconazole
- flucytosine
- fluphenazine
- fluvastatin
- formoterol inhaled
- fosphenytoin
- fostamatinib
- fostemsavir
- gemtuzumab ozogamicin
- gepirone
- glimepiride
- granisetron
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydroxyurea
- ibrutinib
- influenza vaccine
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- irinotecan
- ixabepilone
- Japanese encephalitis vaccine
- lapatinib
- leflunomide
- lemborexant
- lenvatinib
- levalbuterol inhaled
- lidocaine
- linezolid
- lomitapide
- lovastatin
- lovotibeglogene autotemcel
- lumateperone
- lurasidone
- lurbinectedin
- lymphocyte immune globulin, anti-thymocyte globulin
- marnetegragene autotemcel
- mavacamten
- mavorixafor
- mefloquine
- meningococcal vaccine
- mercaptopurine
- mesalamine
- mesalamine rectal
- methotrexate
- metronidazole
- midazolam
- midostaurin
- mirtazapine
- mitoxantrone
- morphine
- mycophenolate mofetil
- mycophenolic acid
- nifedipine
- nimodipine
- nisoldipine
- ofloxacin
- olodaterol inhaled
- olsalazine
- osilodrostat
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- pemigatinib
- phenytoin
- pitavastatin
- pneumococcal vaccine
- poliovirus vaccine
- pomalidomide
- posaconazole
- pravastatin
- proguanil
- promethazine
- propranolol
- pyrimethamine
- ranolazine
- rasagiline
- red yeast rice
- respiratory syncytial virus vaccine
- ribavirin
- rifabutin
- riociguat
- rituximab
- ropinirole
- rosuvastatin
- ruxolitinib topical
- sacituzumab govitecan
- salmeterol inhaled
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- sebetralstat
- sirolimus
- smallpox/mpox vaccine, live
- stiripentol
- succimer
- sufentanil
- sulfasalazine
- sunitinib
- tacrolimus
- tadalafil
- talazoparib
- tazemetostat
- temsirolimus
- tenofovir alafenamide
- tenofovir disoproxil
- teplizumab
- terbutaline
- teriflunomide
- thalidomide
- theophylline
- tick-borne encephalitis vaccine
- tocilizumab
- tofacitinib
- tolterodine
- tolvaptan
- torsemide
- triazolam
- trimethoprim
- typhoid vaccine
- ubrogepant
- upadacitinib
- valbenazine
- valproic acid
- vancomycin
- vardenafil
- venlafaxine
- vilanterol inhaled
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- voriconazole
- warfarin
- zanubrutinib
- zidovudine
Caution Advised
- abrocitinib
- acitretin
- caffeine
- cariprazine
- carisoprodol
- clopidogrel
- cobimetinib
- conivaptan
- daridorexant
- darolutamide
- dihydroergotamine
- duloxetine
- elinzanetant
- ergotamine
- glecaprevir
- melatonin
- methoxsalen
- methylergonovine
- naldemedine
- palovarotene
- pexidartinib
- pibrentasvir
- ramelteon
- riluzole
- rilzabrutinib
- roflumilast
- roflumilast topical
- seladelpar
- sirolimus topical
- verapamil
- verteporfin
- zolmitriptan
Adverse Reactions .
Serious Reactions
- AML
- myelodysplastic syndrome
- thrombocytopenia
- anemia
- neutropenia
- febrile neutropenia
- infection, serious
- hemorrhage
- QT prolongation
- arrhythmia
- cardiac ischemia
- venous thromboembolism
- renal failure
- hand-foot syndrome
- hypersensitivity reaction
Common Reactions
- asthenia
- nausea
- constipation
- appetite decr.
- diarrhea
- vomiting
- rash
- musculoskeletal pain
- abdominal pain
- dysgeusia
- dyspnea
- anemia
- headache
- peripheral edema
- dizziness
- thrombocytopenia
- ALT or AST elevated
- infection
- stomatitis
- weight decr.
- neutropenia
- insomnia
- photosensitivity
- peripheral neuropathy
- fever
- dyspepsia
- depression
- cough
- acute kidney injury
- Cr incr.
- phosphate decr.
- lymphocytes decr.
- sodium decr.
- alk phos incr.
- glucose incr.
- calcium incr.
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; CBC with diff at baseline, then qmo
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of embryo-fetal death based on animal data at 0.04x recommended human dose and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x6mo after D/C in patients of childbearing potential; use effective contraception, including with pregnant partners, during tx and x3mo after D/C in male patients; avoid semen donation during tx and x3mo after D/C
Lactation
Clinical Summary
avoid breastfeeding during tx and x2wk after D/C; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for rucaparib: liver; CYP450: 1A2, 2D6 (primary), 3A4 substrate
Excretion: for rucaparib: urine, feces; Half-life: 26h
Subclass: PARP Inhibitors
Mechanism of Action
for rucaparib: inhibits poly (ADP-ribose) polymerase (PARP) enzymes and increases PARP-DNA complex formation, resulting in DNA damage and cell death
Formulary .
No Formulary Selected
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