Rucaparib

Rucaparib (Rubraca®) is a targeted therapy drug. It is used to treat some types of ovarian, fallopian tube and primary peritoneal cancers.

What is rucaparib (Rubraca®)?

Rucaparib (Rubraca®) is used to treat some types of epithelial ovarian cancer, fallopian tube cancer and primary peritoneal cancer.

It is best to read this information with our general information about the type of cancer you have. 

Rucaparib belongs to a group of targeted therapy drugs called PARP inhibitors. PARPs are proteins that help damaged cells repair themselves. Rucaparib blocks (inhibits) the action of PARP in cancer cells. The cancer cells cannot repair themselves and die.

You may have rucaparib after treatment with platinum chemotherapy (either carboplatin or cisplatin) if that has been effective. This is called maintenance treatment. You start taking rucaparib no later than 8 weeks after your last chemotherapy treatment. 

You may also have rucaparib if the cancer comes back after treatment. But you only have rucaparib if you are known to have a BRCA gene mutation. You may have rucaparib after you have already had 2 or more courses of treatment with platinum chemotherapy. 

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How rucaparib is given

Rucaparib comes in tablets, so you can take it at home. You may be given tablets of different strengths.

During treatment, you usually see a cancer doctor, a cancer nurse or specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information.

You have your blood checked regularly during treatment. A nurse or a person trained to take blood (phlebotomist) takes a blood sample from you. This is to check:

  • that your blood cells are at a safe level for you to have treatment
  • how well your kidneys and liver are working.

You usually take rucaparib for as long as it works for you and the side effects are not causing difficulties.

Taking rucaparib tablets

You take rucaparib tablets twice a day, approximately 12 hours apart.

Take the tablets at the same times each day with or without food. Swallow the tablets whole with a large glass of water. Do not crush or dissolve the tablets. If you find it difficult to swallow your tablets,

speak to your doctor or pharmacist.

Never take a double dose of rucaparib. If you are sick after taking the tablets, do not take another dose. Take the next dose at the usual time.

If you forget to take a dose, skip that dose. Take the next dose at the usual time.

Other things to remember about your tablets:

  • Keep them in the original package.
  • Keep them safe and out of sight and reach of children.
  • If your treatment is stopped, return any unused tablets to the pharmacist.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Common side effects

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is sometimes called neutropenia.

An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. Contact the hospital straight away on the 24-hour contact number you have been given if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection
  • your temperature goes below 36°C (96.8°F).

Symptoms of an infection include:

  • feeling shivery and shaking
  • a sore throat
  • a cough
  • breathlessness
  • diarrhoea
  • needing to pass urine (pee) a lot, or discomfort when you pass urine.

It is important to follow any specific advice your cancer treatment team gives you.

You will have regular blood tests during treatment. If needed, your doctor may reduce or delay your treatment for a short time, until your cell count increases.

Bruising and bleeding

This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.

If the number of platelets is low, you may bruise or bleed easily. You may have:

  • nosebleeds
  • bleeding gums
  • heavy periods
  • blood in your urine (pee) or stools (poo)
  • tiny red or purple spots on the skin that may look like a rash.

Tell your doctor if you have any unexplained bruising or bleeding. You may need a drip to give you extra platelets. This is called a platelet transfusion.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:

  • pale skin
  • lack of energy
  • feeling breathless
  • feeling dizzy and light-headed.

Tell your doctor or nurse if you have these symptoms.

If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Feeling sick

You may feel sick when you start taking rucaparib. But this can be controlled with anti-sickness drugs. Take the drugs exactly as your doctor nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluids and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.

If you have diarrhoea:

  • try to drink at least 2 litres (3½ pints) of fluids each day
  • avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
  • contact the hospital for advice.

Loss of appetite

This treatment can affect your appetite. Do not worry if you do not eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.

Changes to your taste

You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste different or have no taste. Try different foods to find out what tastes best to you. Taste changes usually get better after treatment finishes. Your nurse can give you more advice.

Tiredness

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Feeling dizzy

This treatment may cause dizziness. Tell your doctor or nurse if this is a problem. It is important you do not drive or operate machinery if you feel dizzy.

Headaches

This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.

Tummy pain and heartburn

This treatment can cause pain in the tummy (abdomen) and heartburn (indigestion). Tell your nurse or doctor if you have pain. Ask them for advice about how and when to take any drugs for heartburn.

Skin changes

This treatment may affect your skin. It may cause a rash, which might be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.

Rucaparib makes you more sensitive to the sun. If you are out in the sun:

  • use a suncream and lip balm with a sun protection factor (SPF) of at least 50
  • wear clothing that covers your arms, legs and head.

Always tell your doctor or nurse about any changes to your skin. They can give you advice and may prescribe creams or medicines to help. Skin changes usually improve after treatment finishes.

Effects on the liver

This treatment may affect how your liver works. This is usually mild. You will have blood tests to check how well your liver is working.

Effects on the kidneys

This treatment can affect how your kidneys work. This is usually mild and goes back to normal after treatment finishes. You will have blood tests to check how well your kidneys are working. Tell your doctor or nurse if you have blood in your urine (pee) or you are passing urine less than usual.

It is important to drink at least 2 litres (3½ pints) of non-alcoholic fluid each day to help protect your kidneys.

Raised cholesterol level

This treatment can raise the level of cholesterol (a fatty substance) in the blood. You may have a blood test to check the level of cholesterol. Your doctor may give you medicines to control your cholesterol levels.

Less common side effects

Difficulty breathing

Rucaparib can cause difficulty breathing. Contact your doctor straight away if you have difficulty breathing.

Feeling dry (dehydration)

This treatment may make you feel dry (dehydrated). Tell your doctor or nurse if you have signs of dehydration such as:

  • feeling thirsty
  • feeling dizzy or tired
  • passing small amounts of urine
  • dry mouth and eyes.

Dehydration can affect the levels of minerals and salts in your body. Your doctor will take regular blood tests to check these. It is important to drink plenty of fluids while having rucaparib – around 2 litres (3½ pints) a day.

Increased risk of leukaemia

Rarely, rucaparib may increase the risk of developing a blood cancer called myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML). During treatment, doctors monitor your blood cells carefully to check there are no problems.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:

  • throbbing pain, redness or swelling in a leg or arm
  • suddenly feeling breathless or coughing
  • sharp chest pain, which may be worse when you cough or take a deep breath.

If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.

You can help reduce the risk of developing a blood clot by:

  • staying active during treatment
  • drinking plenty of fluids, especially water.

You may be given anticoagulants to help prevent a clot.

Other medicines

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Vaccinations

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.

Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations.

If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines, such as shingles, contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.

Contraception

Your doctor will advise you not to get pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for 6 months after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.

Breastfeeding

You are advised not to breastfeed while having this treatment and for 2 weeks after treatment ends. This is because the drugs could be passed to the baby through breast milk.

Fertility

Some cancer drugs can affect whether you can get pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

About our information


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    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

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