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Rucaparib

  • PARP inhibitorsPARP inhibitors
  • High alertAn error with this medicine can cause serious harm: double checks and protocols are used.
  • Pregnancy: avoidAvoid in pregnancy. Can harm the fetus: a pregnancy test is done before starting, effective contraception is used during treatment and for a time afterwards (by women and by men…

A PARP inhibitor for BRCA-mutated ovarian and prostate cancer. It causes photosensitivity and can raise the effect of warfarin.

Updated

Also called: rucaparib camsylate

Quick facts

Group
PARP inhibitors
Target
Poly(ADP-ribose) polymerases PARP1 and PARP2
Key effects
Nausea · Fatigue and anaemia · Diarrhoea
Monitor
BRCA test before starting
ATC
L01XK03

No doses: the clinician sets them by the current guideline.

Mechanism of action

The figure shows rucaparib in the NAD+ site of the human PARP1 catalytic domain.

Target in 3D: Poly(ADP-ribose) polymerases PARP1 and PARP2. PDB structure 6VKK (RCSB PDB, public domain). View the structure at RCSB PDB

Rucaparib inhibits PARP1, PARP2 and PARP3 at the NAD+ site and traps them on DNA, which is lethal to tumour cells lacking BRCA-dependent homologous recombination. It also inhibits several CYP enzymes, the source of its drug interactions.

  1. Blocks PARP1-3 at the NAD+ site and traps them on DNA
  2. BRCA-deficient tumour cells cannot repair the damage
  3. Also inhibits CYP1A2, CYP3A, CYP2C9 and CYP2C19

Indications

  • Maintenance in recurrent BRCA-mutated ovarian, fallopian tube or primary peritoneal cancer after a response to platinum. Ovarian cancer →
  • BRCA-mutated metastatic castration-resistant prostate cancer after androgen receptor-directed therapy. Prostate cancer →

Adverse effects

Common

  • Nausea, vomiting, decreased appetite, bad taste
  • Fatigue and anaemia
  • Diarrhoea, constipation, abdominal pain
  • Mouth sores
  • Sensitivity to sunlight and rash

Contraindications

  • No absolute contraindications in the label apart from hypersensitivity; see the warnings

Key interactions

Warfarin (a CYP2C9 substrate)
Its effect can rise; the INR is checked more often.
Narrow-margin substrates of CYP1A2, CYP3A, CYP2C9 or CYP2C19
Rucaparib can raise their levels; doses or monitoring may need changes.

What is monitored

  • BRCA test before starting
  • Complete blood count during treatment
  • INR in patients on warfarin

Administration and safety

  • Oral tablets twice daily at evenly spaced times, with or without food.
  • Sun protection: protective clothing, hat, sunglasses and sunscreen.

Pregnancy and breastfeeding

Avoid in pregnancy. Can harm the fetus: a pregnancy test is done before starting, effective contraception is used during treatment and for a time afterwards (by women and by men with partners who could conceive), and breastfeeding is avoided.

Nursing care

  • Review blood counts before and during treatment; teach to report pallor, fatigue, bruising, bleeding or fever.
  • Check whether the patient takes warfarin and make sure INR checks are planned.
  • Teach sun protection.
  • Confirm a negative pregnancy test before the first dose and teach contraception during treatment and afterwards.

Pharmacokinetics

Absorption
Oral tablets, twice daily, with or without food.
Metabolism
Mainly CYP2D6, less CYP1A2 and CYP3A4.
Half-life
About 26 hours.

Test yourself

Think of the answer, then tap the question to see it.

Which anticoagulant needs closer INR monitoring with rucaparib, and why?

Warfarin, because rucaparib inhibits CYP2C9.

Which skin precaution applies to rucaparib?

Sun protection, because it causes photosensitivity.

In which two cancers is rucaparib used?

BRCA-mutated ovarian (with fallopian tube and peritoneal) and prostate cancer.

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More Pharmacology questions →

Connections

← Back to the class: PARP inhibitors

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Rucaparib: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Rucaparib Camsylate - NCI (National Cancer Institute, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.