Drug Interaction Report

Using olaparib together with niraparib may increase the risk of bone marrow impairment, which may lead to serious conditions known as Myelodysplastic Syndrome or Acute Myeloid Leukemia. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know if you experience weakness, fatigue, fever, weight loss, infections, shortness of breath, unusual bleeding or bruising, or blood in urine or stool. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Do not consume grapefruit, grapefruit juice, or Seville oranges during treatment with olaparib. Doing so can significantly increase the blood levels of olaparib and increase the risk and/or severity of side effects such as nausea, vomiting, diarrhea, indigestion, loss of appetite, abdominal pain or discomfort, lung problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The recommended maximum number of medicines in the 'PARP inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'PARP inhibitors' category:

• olaparib
• Zejula (niraparib)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.