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Interactions between Rubraca and Triptorelin

1 drug interaction and 10 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

triptorelin rucaparib

Applies to: triptorelin and Rubraca (rucaparib)
Generally avoid

Long-term androgen deprivation therapy (ADT) can prolong the QT interval. Coadministration of ADT with other agents that may prolong the QT interval could also result in additive effects and an increased risk of ventricular arrhythmias including torsade de pointes and sudden death. The risk may be increased in patients with certain underlying risk factors like congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). Studies in young men have shown that endogenous serum testosterone levels are inversely associated with QTc (QT interval corrected for heart rate) duration. Clinical trials in men with low serum testosterone levels have reported testosterone administration being associated with a shortening of QTc. Likewise, studies using ADT have shown that it may prolong the QT interval; however, this effect may vary by drug, dose, or even each drug class that can be used to reduce testosterone levels. A clinical study comparing abarelix to a luteinizing hormone-releasing hormone agonist plus nonsteroidal antiandrogen therapy found that both therapies prolonged the mean Fridericia-corrected QT interval (QTcF) by more than 10 msec from baseline. Approximately 20% of patients in both groups had either changes from baseline QTc of >30 msec or end-of-treatment QTc values >450 msec. Similarly, a study comparing degarelix to leuprolide found that approximately 20% of patients on each drug had QT/QTc intervals >450 msec after 1 year of treatment. From baseline to end of study, the median change in QTcF was 12.3 msec for degarelix and 16.7 msec for leuprolide. Some drugs used to lower testosterone levels may also have other side effects that can predispose a patient to QT prolongation and torsade de pointes. For example, inhibitors of 17 alpha-hydroxylase/C17,20-lyase (CYP17) like abiraterone may cause hypokalemia as a result of increased mineralocorticoid levels. Clinical data on ADT prolonging the QT interval in women and children are lacking.

Management

The benefits of androgen deprivation therapy (ADT) should be carefully assessed against the potential risk in patients receiving other drugs known to prolong the QT interval. Electrolyte abnormalities should be corrected prior to initiating therapy, and monitoring of electrocardiograms and electrolytes may be advisable. The manufacturer's labeling as well as current clinical guidelines should be consulted for monitoring recommendations.

References (18)
  1. (2002) "Product Information. Lupron (leuprolide)." TAP Pharmaceuticals Inc
  2. (2001) "Product Information. Zoladex (goserelin)." Astra-Zeneca Pharmaceuticals
  3. (2001) "Product Information. Trelstar (triptorelin)." Pharmacia and Upjohn
  4. (2002) "Product Information. Eligard (leuprolide)." Sanofi Winthrop Pharmaceuticals
  5. (2003) "Product Information. Plenaxis (abarelix)." Praecis Pharmaceuticals Inc
  6. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  7. (2010) "Product Information. Vantas (histrelin)." Endo Pharmaceuticals (formally Indevus Pharmaceuticals Inc)
  8. Krishna KB, Fuqua JS, rogol ad, et al. (2019) "Use of gonadotropin-releasing hormone analogs in children: update by an international consortium." Horm Res Paediatr, 91, p. 357-72
  9. Lazzerini PE, Bertolozzi I, Acampa M, et al. (2023) Androgen deprivation therapy for prostatic cancer in patients with torsades de pointes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239032/
  10. Gagliano-Juca T, Travison TG, kantoff pw, et al. (2018) "Androgen deprivation therapy is associated with prolongation of QTc interval in men with prostate cancer." J Endocr Soc, 2, p. 485-96
  11. Gheorghe GS, Hodorogea AS, Ciobanu A, Nanea IT, Gheorghe ACD (2021) "Androgen deprivation therapy, hypogonadism and cardiovascular toxicity in men with advanced prostate cancer." Curr Oncol, 28, p. 3331-46
  12. (2023) "Product Information. Firmagon (degarelix)." Ferring Pharmaceuticals Pty Ltd
  13. (2020) "Product Information. Firmagon (degarelix)." Ferring Pharmaceuticals Inc
  14. (2021) "Product Information. Zytiga (abiraterone)." Janssen-Cilag Pty Ltd
  15. (2023) "Product Information. Abiraterone (abiraterone)." Wockhardt UK Ltd
  16. (2025) "Product Information. Andriga-10 (abiraterone-prednisolone)." Actor Pharmaceuticals Pty Ltd
  17. (2025) "Product Information. Abiraterone Acetate (abiraterone)." BluePoint Laboratories
  18. Pharmaris Canada Inc. (2025) Product monograph: abiraterone acetate tablets (prz-abiraterone). https://pdf.hres.ca/dpd_pm/00072012.PDF

Food/lifestyle interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

10 potential interactions Applies to: 8 conditions, including Heart Failure, Diabetes Mellitus, Liver Disease, Long QT Syndrome, and Cardiovascular Conditions and Disorders.

Bone Marrow Depression/Low Blood Counts

Moderate:

Rubraca

The rucaparib in Rubraca 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.

Cardiovascular Conditions and Disorders

Moderate:

triptorelin

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

Increased risk of developing myocardial infarction, sudden cardiac death and stroke has been reported in association with the use of GnRH agonists such as leuprolide, and triptorelin. Cardiovascular risk factors should be evaluated carefully before treatment initiation. Patients should be monitored for symptoms and signs suggestive of development or cardiovascular disease and should be managed according to current clinical practice.

Diabetes Mellitus

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Diabetes Mellitus.

Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists such as leuprolide and triptorelin. Caution is advised in patients with diabetes as treatment with these agents may risk glycemic control. Monitor blood glucose and/or HbA1c periodically in patients receiving treatment.

Electrolyte Abnormalities

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Electrolyte Abnormalities.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Heart Failure

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Heart Failure.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Liver Disease

Moderate:

Rubraca

The rucaparib in Rubraca 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.

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Liver Disease.

Clinical trials with triptorelin showed that subjects with renal or liver impairment had 2- to 4-fold higher exposure (AUC values) than healthy men. Caution and monitoring of adverse events is recommended.

Long QT Syndrome

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Long QT Syndrome.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Renal Dysfunction

Moderate:

Rubraca

The rucaparib in Rubraca 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.

Moderate:

triptorelin

Triptorelin has a moderate potential interaction with Renal Dysfunction.

Clinical trials with triptorelin showed that subjects with renal or liver impairment had 2- to 4-fold higher exposure (AUC values) than healthy men. Caution and monitoring of adverse events is recommended.

More resources

Rubraca

A total of 762 drugs are known to interact with Rubraca.

triptorelin

A total of 296 drugs are known to interact with triptorelin.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.