Rucaparib Dosage
Medically reviewed by Drugs.com. Last updated on Jan 3, 2025.
Applies to the following strengths: 200 mg; 250 mg; 300 mg
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Ovarian Cancer
600 mg orally twice a day
Duration of therapy: Until disease progression or unacceptable toxicity
Uses: For the maintenance treatment of patients with a deleterious BRCA (breast cancer gene) mutation (germline and/or somatic)-associated recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy
Usual Adult Dose for Fallopian Tube Cancer
600 mg orally twice a day
Duration of therapy: Until disease progression or unacceptable toxicity
Uses: For the maintenance treatment of patients with a deleterious BRCA (breast cancer gene) mutation (germline and/or somatic)-associated recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy
Usual Adult Dose for Peritoneal Cancer
600 mg orally twice a day
Duration of therapy: Until disease progression or unacceptable toxicity
Uses: For the maintenance treatment of patients with a deleterious BRCA (breast cancer gene) mutation (germline and/or somatic)-associated recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy
Usual Adult Dose for Prostate Cancer
600 mg orally twice a day
Duration of therapy: Until disease progression or unacceptable toxicity
Comments:
- This indication was approved under accelerated approval based on objective response rate and duration of response; continued approval may depend on verification and description of clinical benefit in confirmatory trials.
- Selection of patients for treatment should be based on a US FDA-approved companion diagnostic for this drug.
- Patients should also receive a gonadotropin-releasing hormone (GnRH) analog concurrently or should have had bilateral orchiectomy.
Use: For the treatment of patients with a deleterious BRCA mutation (germline and/or somatic)-associated metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor-directed therapy and a taxane-based chemotherapy
Renal Dose Adjustments
Mild to moderate renal dysfunction (CrCl between 30 and 89 mL/min): No adjustment recommended
Severe renal dysfunction (CrCl less than 30 mL/min): Data not available
Comments:
- CrCl as estimated by the Cockcroft-Gault method
Liver Dose Adjustments
Mild to moderate liver dysfunction (total bilirubin up to 3 times the upper limit of normal [3 x ULN] or AST greater than ULN): No adjustment recommended
Severe liver dysfunction (total bilirubin greater than 3 x ULN and any AST): Data not available
Dose Adjustments
Interruption of therapy or dose reduction should be considered to manage adverse reactions.
Recommended Dose Reductions:
- Starting dose: 600 mg orally twice a day
- First dose reduction: 500 mg orally twice a day
- Second dose reduction: 400 mg orally twice a day
- Third dose reduction: 300 mg orally twice a day
Hematological Toxicities:
- This drug should not be started until patients have recovered from hematological toxicity caused by previous chemotherapy (grade 1 or less).
- For prolonged hematological toxicities (greater than 4 weeks): This drug should be interrupted or the dose should be reduced as recommended above; blood counts should be monitored weekly until recovery.
- If levels have not recovered to grade 1 or less after 4 weeks of if myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) is suspected: Patients should be referred to a hematologist for further investigations (including bone marrow analysis and blood sample for cytogenetics).
- If MDS/AML is confirmed: This drug should be discontinued.
Precautions
CONTRAINDICATIONS: None
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Select patients for maintenance treatment of recurrent ovarian cancer based on the presence of a deleterious BRCA mutation (germline and/or somatic).
- A US FDA-approved test for the detection of deleterious germline and/or somatic BRCA mutations is not currently available.
- Select patients for the treatment of mCRPC based on the presence of a deleterious BRCA mutation (germline and/or somatic) in plasma specimens.
- A negative result from a plasma specimen does not mean that the patient's tumor is negative for BRCA mutations.
- If the plasma specimen has a negative result, consider performing further genomic testing using tumor specimens as clinically indicated.
- Administer with or without food.
- Administer doses about 12 hours apart.
Storage requirements:
- Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F).
General:
- For information on US FDA-approved tests for detection of a BRCA mutation in patients with ovarian cancer or with prostate cancer: www.fda.gov/CompanionDiagnostics
Monitoring:
- Hematologic: CBC for cytopenia (at baseline) and for clinically significant changes (monthly thereafter during therapy)
Patient advice:
- Read the US FDA-approved patient labeling (Patient Information).
- Contact health care provider if you experience weakness, feeling tired, fever, weight loss, frequent infections, bruising, bleeding easily, breathlessness, blood in urine/stool, laboratory findings of low blood cell counts, or a need for blood transfusions.
- Patients of childbearing potential: Inform health care provider if you are pregnant or become pregnant; use effective contraception during therapy and for 6 months after the last dose.
- Male patients with female partners of childbearing potential or who are pregnant: Use effective contraception during therapy and for 3 months after the last dose.
- Male patients: Do not donate sperm during therapy and for 3 months after the last dose.
- Use appropriate sun protection because the susceptibility to sunburn is increased during therapy.
- Do not breastfeed during therapy and for 2 weeks after the last dose.
- If a dose is missed or vomiting occurs after taking a dose, do not take an extra dose; take the next dose at the regular time.
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