Rubraca Disease Interactions

No dose adjustment is recommended for patients with mild to moderate liver dysfunction (total bilirubin up to 3 times the upper limit of normal [3 x ULN] or AST greater than ULN). Caution should be exercised when using this agent in patients with severe liver dysfunction (total bilirubin greater than 3 x ULN and any AST) as rucaparib has not been studied in these patients.

Cases of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) have been reported with the use of rucaparib. Rucaparib should not be started until patients have recovered from hematological toxicity caused by previous chemotherapy (grade 1 or less). It is recommended to monitor complete blood counts for cytopenia at baseline and monthly thereafter for clinically significant changes during therapy. For hematologic toxicities exceeding 4 weeks, rucaparib should be interrupted or the dosage reduced according to the manufacturer product information; blood counts should be monitored weekly until recovery. If levels have not recovered to grade 1 or less after 4 weeks or if MDS/AML is suspected, the patient should be referred to a hematologist for further investigations (including bone marrow analysis and blood sample for cytogenetics). If MDS/AML is confirmed, rucaparib should be discontinued.

No dose adjustment is recommended for patients with mild to moderate renal dysfunction (CrCl between 30 and 89 mL/min [as estimated by Cockcroft-Gault method]). Caution should be exercised when using this agent in patients with severe renal dysfunction (CrCl less than 30 mL/min) or patients on dialysis as rucaparib has not been studied in these patients.