OLATAB

Indications

Olaparib is a targeted cancer medicine taken by mouth. A cancer specialist may use it for certain ovarian, fallopian tube and primary peritoneal cancers, breast cancer, pancreatic cancer and prostate cancer, mainly in people whose cancer has changes in the BRCA genes or other DNA repair genes. It is often used as maintenance treatment after a good response to platinum chemotherapy. Testing is usually done first to decide whether it is suitable.

How It Works

Olaparib blocks PARP, an enzyme that cells use to repair damage to their DNA (genetic material). Cancer cells with faulty BRCA genes already have trouble repairing DNA, so when PARP is also blocked they cannot fix the damage and they die. Healthy cells, which have working repair systems, are affected much less.

Dosage and Administration

The dose is set by the cancer specialist and taken as prescribed, usually twice a day, about 12 hours apart, with or without food. Swallow tablets whole; do not chew, crush or split them. Tablets and capsules of olaparib are not the same strength, so never swap one for the other. The doctor may lower the dose for kidney problems or side effects. If you miss a dose, skip it and take the next dose at the usual time. Avoid grapefruit and grapefruit juice.

Interactions

Tell your cancer team about every medicine and herbal product. Strong or moderate CYP3A blockers such as Clarithromycin, Itraconazole, Ketoconazole, Ritonavir and Verapamil can raise olaparib levels; the dose may need to be lowered. Rifampicin, Carbamazepine, Phenytoin and St John's wort can lower its levels and make it less effective. Other medicines that lower blood counts add to that effect. Avoid live vaccines during treatment.

Contraindications

• Allergy to olaparib or any ingredient of the product.
• Breastfeeding during treatment and for 1 month after the last dose.

Side Effects

Common: nausea, vomiting, tiredness, anaemia (low red blood cells), low white blood cells and platelets, loss of appetite, diarrhoea, indigestion, taste changes, headache, dizziness and cough. Uncommon but serious: blood cancers (myelodysplastic syndrome or acute myeloid leukaemia), inflammation of the lungs (pneumonitis) and blood clots.

Contact your cancer team urgently or get emergency help if you have a fever or other signs of infection, unusual bruising or bleeding, blood in urine or stools, new or worsening breathlessness, cough or chest pain, pain or swelling in one leg, or extreme tiredness with pale skin.

Pregnancy and Lactation

Olaparib can harm an unborn baby. A pregnancy test is done before starting. Women who could become pregnant should use effective contraception during treatment and for 6 months after the last dose, and men with a partner who could become pregnant should use condoms during treatment and for 3 months after, or as the specialist advises. Do not breastfeed during treatment and for 1 month after the last dose.

Precautions and Warnings

Blood counts are checked before starting and regularly during treatment. Treatment may be paused if counts fall. Tell the team about kidney problems or any new breathing symptoms. Do not drive if you feel tired or dizzy. Do not start any new medicine, including herbal products, without asking your cancer team.

Overdose

Taking too much may increase side effects, especially on the blood. There is no specific antidote. Contact your doctor or go to the hospital straight away.

Therapeutic Class

Antineoplastic (anticancer medicine), PARP inhibitor (targeted therapy).

Storage

Store below 30°C in the original pack to protect from moisture, and out of the reach of children. Return unused tablets to the pharmacy; do not throw them in household waste.