Interactions between Niraparib and Rucaparib

Niraparib has a moderate potential interaction with Arrhythmia.

Niraparib has the potential to cause effects on pulse rate and blood pressure. Hypertension and hypertensive crisis have been reported in patients treated with niraparib. It is recommended to monitor blood pressure and heart rate monthly for the first year and periodically thereafter during treatment with niraparib. Closely monitor patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. Medically manage hypertension with antihypertensive medications and adjust the dose of niraparib as necessary.

Rucaparib has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

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.

Niraparib has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Niraparib has the potential to cause effects on pulse rate and blood pressure. Hypertension and hypertensive crisis have been reported in patients treated with niraparib. It is recommended to monitor blood pressure and heart rate monthly for the first year and periodically thereafter during treatment with niraparib. Closely monitor patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. Medically manage hypertension with antihypertensive medications and adjust the dose of niraparib as necessary.

Niraparib has a moderate potential interaction with Leukemia.

Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML), including cases with fatal outcome, have been reported with the use of niraparib. It is recommended to use caution when using this agent in patients with MDS/AML, its use must be weighed against the risk. Discontinue the use of niraparib in patients who develop MDS/AML.

Niraparib has a moderate potential interaction with Liver Disease.

No dose adjustment is needed in patients with mild hepatic impairment according to the National Cancer Institute - Organ Dysfunction Working Group (NCI-ODWG) criteria. Caution is recommended in patients with moderate to severe hepatic impairment as the safety of niraparib has not been established in these patients.

Rucaparib has a moderate potential interaction with Liver Disease.

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.

Niraparib has a moderate potential interaction with Myelodysplastic Diseases.

Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML), including cases with fatal outcome, have been reported with the use of niraparib. It is recommended to use caution when using this agent in patients with MDS/AML, its use must be weighed against the risk. Discontinue the use of niraparib in patients who develop MDS/AML.

Niraparib has a moderate potential interaction with Pancytopenia.

Hematologic adverse reactions (thrombocytopenia, anemia and neutropenia) have been reported in patients treated with niraparib. It is recommended to monitor complete blood counts weekly for the first month, monthly for the next eleven months of treatment, and periodically after this time. Do not start niraparib until patients have recovered from hematological toxicity caused by previous chemotherapy (less than equal to Grade 1). If hematological toxicities do not resolve within 28 days following interruption, discontinue niraparib, and refer the patient to a hematologist for further investigations, including bone marrow analysis and blood sample for cytogenetics.

Niraparib has a moderate potential interaction with Renal Dysfunction.

No dose adjustment is necessary for patients with mild to moderate renal impairment. Caution is recommended in patients with severe renal impairment or end stage renal disease undergoing hemodialysis as the safety of niraparib has not been established in these patients.

Rucaparib has a moderate potential interaction with Renal Dysfunction.

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.