Rubraca is a brand-name prescription drug. It’s FDA-approved to treat certain forms of cancer of the ovaries, fallopian tubes, and peritoneum (thin layer of tissue that lines the inside of your belly).*† Rubraca is also FDA-approved to treat particular types of prostate cancer in adults.†

Rubraca contains the active ingredient rucaparib, which belongs to a group of drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors block the PARP enzyme. The PARP enzyme helps cancer cells repair themselves and grow. By blocking this enzyme, PARP inhibitors can keep cancer cells from growing.

Rubraca comes as a tablet that you swallow. It’s available in three strengths: 200 milligrams (mg), 250 mg, and 300 mg. You’ll likely take Rubraca twice a day.

* Certain cancers that occur in the fallopian tubes and peritoneum can resemble ovarian cancer, so sometimes they’re referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.
† For detailed information on these uses, see the “Rubraca for ovarian cancer” and “Rubraca for prostate cancer” sections.

FDA approval

In 2016, the Food and Drug Administration (FDA) approved Rubraca to treat certain forms of ovarian cancer.

Then in 2020, the FDA gave Rubraca accelerated approval to treat certain forms of prostate cancer.

The FDA usually approves drugs only after thorough clinical trials have been held. However, for certain medications, such as Rubraca, the FDA approved the drug before all the studies were completed. Accelerated approval is when the FDA gives early approval for drugs used for serious conditions, such as prostate cancer, that have few treatment choices.

The accelerated approval for Rubraca was based on the results from early clinical studies. After more studies have been done, the FDA will decide on whether to grant full approval.

Effectiveness

To learn about the effectiveness of Rubraca, see the “Rubraca for ovarian cancer” and “Rubraca for prostate cancer” sections below.

Rubraca is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Rubraca can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rubraca. These lists don’t include all possible side effects.

For more information on the possible side effects of Rubraca, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Rubraca, you can do so through MedWatch.

Mild side effects

Mild side effects of Rubraca can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Rubraca. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Rubraca’s prescribing information.
† For more information on these side effects, see “Side effect details” below.

Serious side effects

Serious side effects from Rubraca aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information on these side effects, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug orwhether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rubraca. In clinical studies, 13% to 43% of adults with ovarian cancer experienced a rash or rash-like allergic skin reaction to Rubraca. This was compared with 23% of adults who took a placebo (treatment with no active drug).

In adults with prostate cancer, 27% of adults who took Rubraca developed a rash. Rubraca wasn’t compared with a different drug or a placebo.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)
  • photosensitivity (See the “Sensitivity to light” section below for details.)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Rubraca. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Nausea

One side effect of Rubraca is nausea. In clinical studies, nausea occurred in:

  • 52% to 77% of people who took Rubraca, depending on the condition being treated
  • 36% of people who were taking a placebo (a treatment without any active drug)

The length of time that people experienced nausea while taking Rubraca in these clinical studies isn’t known. However, of people who took Rubraca in the same clinical studies:

  • 6% to 15% experienced nausea so bothersome that they had to be given a lower dose, depending on the condition being treated
  • 3% experienced nausea so bothersome that they had to stop treatment

Talk with your doctor if you experience nausea while taking this medication. They can suggest ways to help ease your discomfort.

Fatigue

One of the most common side effects of Rubraca is a lack of energy called fatigue. In clinical studies:

  • 62% to 77% of people who took Rubraca experienced fatigue, depending on the condition being treated
  • 46% of people who were taking a placebo experienced fatigue

It isn’t known how long people experienced fatigue while taking Rubraca in these clinical studies. However, 10% to 13% of people who took Rubraca in the same clinical studies experienced fatigue so bothersome that they had to be given a lower dose. (The percentage varied depending on the condition being treated.)

Symptoms of fatigue can include:

  • trouble concentrating
  • muscle aches
  • feeling drowsy during the day

Talk with your doctor if you have fatigue while taking Rubraca. They can recommend ways to help you boost your energy.

Depression

In some cases, Rubraca use may cause depression. In a clinical study, depression occurred in 11% of people who were given Rubraca to treat their ovarian cancer.* It isn’t known how often depression occurred in people in this study who took a placebo.

The percentage of people who experienced depression in clinical studies of Rubraca for prostate cancer isn’t known.

Symptoms of depression can include:

  • lack of interest in activities you used to like
  • appetite changes
  • sleeping more or less than usual
  • feeling depressed

If you have any symptoms of depression while taking Rubraca, talk with your doctor right away. They can recommend treatments that may help or a different medication.

* Certain cancers that occur in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

Sensitivity to light

Rubraca use may cause photosensitivity, which is a sensitivity to sunlight. This side effect occurred in 10% of people who took Rubraca for the treatment of ovarian cancer* in a clinical study. The percentage of people who experienced photosensitivity while taking other drugs in this study isn’t known.

The percentage of people who experienced photosensitivity in clinical studies of Rubraca for prostate cancer isn’t known.

Symptoms of photosensitivity can include:

You should avoid spending time in the sun while taking Rubraca. If you have to be in sunlight, wear sunscreen and clothing that protects your skin. Talk with your doctor about your risk for photosensitivity while taking Rubraca.

* Certain cancers that occur in the fallopian tubes and peritoneum can resemble ovarian cancer, so sometimes they’re referred to as ovarian cancer. Throughout this this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

Anemia

Rubraca may cause anemia, which is a low number of red blood cells. In clinical studies, anemia occurred in:

  • 39% to 44% of people who took Rubraca, depending on the condition being treated
  • 5% of people who took a placebo

The length of time that people experienced anemia while taking Rubraca in these clinical studies isn’t known. However, of people who took Rubraca in the same clinical studies:

  • 14% to 17% experienced anemia so bothersome that they had to be given a lower dose, depending on the condition being treated
  • 3% experienced anemia so bothersome that they had to stop treatment

You may not have any symptoms of anemia unless it’s severe. Symptoms of anemia can include:

Talk with your doctor if you experience any of these symptoms while taking Rubraca. They can recommend treatments that may help or a different medication.

Myelodysplastic syndrome and acute myeloid leukemia

Rarely, Rubraca use can cause serious problems in bone marrow. This can lead to myelodysplastic syndrome (MDS), a group of bone marrow and blood cancers in which your bone marrow stops making healthy blood cells. In some people, MDS can lead to a white blood cell cancer called acute myeloid leukemia (AML).

In clinical trials, this MDS or AML was seen in certain people who received Rubraca. They were people who had previously been treated with platinum-containing chemotherapy or certain other medications for their cancer.

During clinical trials, from a pool of 1,146 people who took Rubraca, 20 people (1.7%) developed MDS or AML. These conditions occurred in people who had been taking Rubraca for as little as 4 weeks to almost 4.5 years.

Interestingly, in an ongoing clinical trial of 209 people with metastatic castration-resistant prostate cancer (mCRPC), neither MDS nor AML has been reported. Everyone in the study received Rubraca. Since the trial is still continuing, more will be learned about the side effects of Rubraca in this group of people once the study is completed.

MDS and AML are very serious conditions, and in some cases people who took Rubraca and developed MDS or AML in clinical trials died. However, it’s not known how often death occurred.

Symptoms of MDS and AML

Symptoms of MDS and AML can include:

While taking Rubraca, tell your doctor right away if you experience any of these symptoms. Many of them overlap with those of other blood disorders. Your doctor may run blood tests to check if you have a blood disorder. If your blood counts are lower than normal, your doctor may pause or lower your dose of Rubraca until your blood cell counts improve. If the lab tests confirm that you have MDS or AML, your doctor will likely stop your treatment.

Hair loss (not a side effect)

Hair loss wasn’t observed in clinical studies of Rubraca. However, hair loss is a common side effect of chemotherapy and some other cancer medications.

Talk with your doctor if you’re concerned about hair loss while taking Rubraca. They can suggest treatments that may help.

The Food and Drug Administration (FDA) approves prescription drugs such as Rubraca to treat certain conditions. Rubraca may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Rubraca for ovarian cancer (including fallopian tube and peritoneal cancer)

Rubraca is FDA-approved for use in adults with certain forms of ovarian cancer. Certain cancers that occur in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

The specific type of ovarian cancer that Rubraca treats is epithelial ovarian cancer. “Epithelial” means that the cancer is in the epithelium (outer lining) of the ovary. And the type of peritoneal cancer Rubraca is used to treat is called primary peritoneal cancer. To be “primary,” the cancer must begin and grow in the peritoneum.

For this purpose of treating ovarian cancer, Rubraca can be used for:

  • ovarian cancer that is recurrent (has come back) and is responding to a platinum-based chemotherapy
    • “Responding” means that you’re having a partial or complete response to the treatment. With a partial response, the treatment lowered the level of cancer cells to some extent. With a complete response, the treatment lowered cancer cells to a level that couldn’t be detected with blood tests.
    • Rubraca is called a maintenance treatment because you may take it long term to lower the risk of your cancer worsening or coming back.
  • ovarian cancer in adults with a certain BRCA genetic mutation (damage to a gene that protects against breast cancer)
    • The BRCA mutation must be deleterious. “Deleterious” means the mutation increases your risk for developing certain cancers.
    • The mutation must also be germline, somatic, or both. “Germline” refers to a mutation that you inherit from one of your parents. “Somatic” refers to a mutation that isn’t inherited from a parent.
    • Rubraca is used for this ovarian cancer in adults who have been previously treated with at least two chemotherapies.

Symptoms of ovarian cancer can include feeling bloated and having pain in the pelvic area, belly, or back. There may be vaginal bleeding that’s not expected if the ovaries or fallopian tubes are involved. You may also feel full before you’re done eating with primary peritoneal cancer.

Effectiveness for ovarian cancer

Clinical studies have shown that Rubraca is an effective treatment for ovarian cancer.

A look at progression-free survival

One clinical study looked at adults whose ovarian cancer had returned and was responding to platinum-based chemotherapy. Rubraca was compared with a placebo (treatment with no active drug).

Researchers wanted to know if people who were given Rubraca for ovarian cancer would have better progression-free survival than people given a placebo. “Progression-free survival” is the amount of time someone lives without their cancer getting worse. People were given Rubraca or a placebo until their cancer worsened or until they could no longer tolerate the treatment’s side effects.

It took about 10.8 months for cancer to grow or spread in half of the people who took Rubraca. It took about 5.4 months for cancer to grow or spread in half of the people who took a placebo.

In half of the adults who had a BRCA mutation and took Rubraca, it took about 13.6 to 16.6 months for their cancer to grow or spread. In half of the adults with a BRCA mutation who took a placebo, it took about 5.4 months for their cancer to spread.

Rubraca and cancer growth

Another clinical study evaluated adults with ovarian cancer and a BRCA genetic mutation who hadn’t responded to at least two previous chemotherapy drugs. Researchers wanted to know if Rubraca would stop the cancer from growing. People were given Rubraca until their cancer worsened or until they could no longer tolerate its side effects.

Rubraca prevented ovarian cancer from growing in 54% of people who took the drug. In half of the people, Rubraca prevented the cancer from growing for about 9.2 months.

The Food and Drug Administration (FDA) has approved Rubraca for use in adults with certain forms of prostate cancer. For this purpose:

  • The cancer must be metastatic (spread to other areas of the body) and castration-resistant. “Castration” refers to the decrease of testosterone levels. Abnormal testosterone levels often play a role in causing prostate cancer to grow. Prostate cancer is called castration-resistant if the cancer keeps spreading or growing despite the use of surgery or treatment to decrease the level of testosterone.
  • You must have a certain BRCA genetic mutation (damage to a gene that protects against breast cancer).
    • The BRCA mutation must be deleterious. “Deleterious” means the mutation increases your risk for developing certain cancers.
    • The mutation must also be germline, somatic, or both. “Germline” refers to a mutation that you inherit from one of your parents. “Somatic” refers to a mutation that isn’t inherited from a parent.
    • In addition, you must have been previously treated with anti-androgen therapy and chemotherapy with a type of drug called a taxane. Anti-androgen therapy is a term used to describe drugs that block the effects of your androgen hormones. (Testosterone is a type of androgen). Androgen hormones stimulate the growth of cancer cells on your prostate. So anti-androgen therapy helps prevent cancer cells from growing.

The FDA gave Rubraca accelerated approval for the prostate cancer use based on early clinical studies of the drug. After more studies have been done, the FDA will decide on whether to grant full approval. To learn more, see the “FDA approval” section above.

Prostate cancer occurs in males and starts in the prostate gland. This gland is located between the bladder and penis.

Symptoms of prostate cancer can include pain while urinating and blood in semen or urine. Symptoms can also include having trouble with starting to urinate and maintaining urine flow.

Effectiveness for prostate cancer

Clinical studies have shown that Rubraca is an effective treatment for prostate cancer.

One clinical study looked at adults whose prostate cancer had a BRCA genetic mutation. They had also been treated with anti-androgen therapy and taxane chemotherapy. Researchers wanted to know if Rubraca would stop the cancer from growing. People were given Rubraca until their cancer worsened or until they could no longer tolerate the treatment’s side effects.

Rubraca helped tumors shrink in 44% of people who took the drug. In this clinical trial, tumors had to have shrunk in size by at least 30% to be counted in the study results. Rubraca wasn’t compared with a different drug or a placebo (treatment with no active drug).

The amount of time that Rubraca prevented the cancer from growing ranged from 1.7 months to 2 years. The long-term follow-up for this trial is still ongoing.

In addition to the uses listed above, Rubraca may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Rubraca is used for certain other conditions. Below is information on other possible uses for Rubraca.

Rubraca for breast cancer (off-label use)

The Food and Drug Administration (FDA) hasn’t approved Rubraca to treat breast cancer. However, the drug is sometimes used off-label for this purpose. More research is needed to determine Rubraca’s role in treating this condition. Clinical studies such as this one are currently evaluating the effectiveness of Rubraca for breast cancer.

Talk with your doctor if you have questions about using Rubraca to treat breast cancer.

Rubraca for pancreatic cancer (off-label use)

Rubraca isn’t FDA-approved to treat pancreatic cancer. However, the drug is sometimes used off-label for this purpose. A clinical study has shown Rubraca to be effective for treating pancreatic cancer in adults with BRCA genetic mutations who had previously received at least two chemotherapy drugs.

If you’d like to learn more about using Rubraca to treat pancreatic cancer, talk with your doctor.

Rubraca and children

Rubraca isn’t approved for use in children. It’s not known if the drug is safe or effective for children.

Here are answers to some frequently asked questions about Rubraca.

Is Rubraca chemotherapy?

No, Rubraca isn’t a chemotherapy drug. Chemotherapy drugs kill cells that are rapidly growing. Chemotherapy drugs can’t tell the difference between cancer cells and cells that are healthy. Healthy cells can be harmed by chemotherapy, leading to many side effects.

Rubraca is a targeted therapy for cancer. Because targeted therapies focus specifically on cancer cells, the therapies have less of an effect on healthy cells than chemotherapy.

Rubraca belongs to a group of drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors specifically block the PARP enzyme to keep cancer cells from growing. An enzyme is a protein that aids chemical changes in your body.

When will I need blood tests during Rubraca treatment?

Your doctor will check your blood before you start treatment with Rubraca and every month while you take the drug. If you have low blood cell counts, they may check your blood every week. Your doctor may also pause your Rubraca use until your blood cell counts improve.

The reason you’ll need blood tests is because taking Rubraca may cause you to have thrombocytopenia (low count of blood cells called platelets). The drug can also cause leukopenia, lymphocytopenia, and neutropenia, which are low counts of certain white blood cells.

Rarely, taking Rubraca can also cause two serious conditions called myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). These are disorders of the bone marrow. Both conditions can have similar symptoms to the blood disorders mentioned above. For more information on blood disorders, MDS, and AML, see the “Side effect details” section above.

If you have questions about having blood tests during Rubraca treatment, talk with your doctor.

Why do I need to stay out of the sun while taking Rubraca?

Taking Rubraca may cause you to develop photosensitivity (sensitivity to sunlight). Photosensitivity may cause skin blistering, rash, or sunburn. This side effect occurred in 10% of people who took Rubraca for the treatment of ovarian cancer* in a clinical study. The percentage of people who experienced photosensitivity in clinical studies of Rubraca for prostate cancer isn’t known.

For more information, including tips on how to protect yourself, see the “Sensitivity to light” section under “Side effect details.”

* Certain cancers that occur in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

Do I need to monitor any side effects of Rubraca?

Throughout your Rubraca treatment, your doctor will perform lab tests (such as blood tests) to monitor you for some of the drug’s side effects. But it may also be helpful for you to keep a record of how you feel while taking Rubraca. The drug’s manufacturer provides a 60-page journal to aid you in keeping track of your treatment. It contains spots for you to rate how you feel and list any side effects you have.

If you have concerns about experiencing side effects while taking Rubraca, talk with your doctor.

If I vomit after taking Rubraca, should I have another dose?

No, you shouldn’t take another dose of Rubraca after vomiting. Take your next dose at the usual time. Talk with your doctor if you vomit while taking Rubraca. They can help determine the cause and suggest treatments that may help.

The Rubraca dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Rubraca to treat
  • your age
  • side effects you may experience
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Rubraca comes as a tablet that you swallow. It’s available in three strengths: 200 milligrams (mg), 250 mg, and 300 mg.

Dosage for ovarian cancer

Rubraca can be used to treat epithelial ovarian cancer* that has come back and is responding to a platinum-based chemotherapy. The drug can also be used to treat ovarian cancer if you have a certain BRCA genetic mutation (damage to a gene that protects against breast cancer). You must have been previously treated with at least two chemotherapies. For details on this use of Rubraca, see the “Rubraca for ovarian cancer” section above.

The recommended dosage of Rubraca for ovarian cancer is 600 mg (two 300-mg tablets) twice a day. You can take the medication with or without food.

If you develop serious side effects from Rubraca, your doctor may lower or pause your dose. To learn more about the drug’s possible side effects, see the “Rubraca side effects” section above.

Talk with your doctor about any side effects you may experience while taking Rubraca.

* Certain cancers that occur in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

Dosage for prostate cancer

Rubraca can be used to treat prostate cancer that is metastatic and castration-resistant. Also, you must have a certain BRCA genetic mutation (damage to a gene that protects against breast cancer). In addition, you must have been previously treated with anti-androgen therapy and chemotherapy with a type of drug called a taxane. For more about this use of Rubraca, see the “Rubraca for prostate cancer” section above.

The recommended dosage of Rubraca for prostate cancer is 600 mg (two 300-mg tablets) twice a day. You can take the medication with or without food.

What if I miss a dose?

If you miss a dose of Rubraca, take your next dose at the usual time. Don’t take an extra dose to make up for the missed dose.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Rubraca is meant to be used as a long-term treatment as long as the drug is effective and you don’t have bothersome side effects. If you and your doctor determine that Rubraca is safe and effective for you, you’ll likely take it long term.

You may wonder how Rubraca compares with other medications that are prescribed for similar uses. Here we look at how Rubraca and Lynparza are alike and different.

Ingredients

Rubraca contains the drug rucaparib. Lynparza contains the drug olaparib.

Both Rubraca and Lynparza belong to a class of drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. A class of drugs is a group of drugs that work in a similar way.

PARP inhibitors block the PARP enzyme. The PARP enzyme helps cancer cells repair themselves and grow. By blocking this enzyme, PARP inhibitors can keep cancer cells from growing.

Uses

The Food and Drug Administration (FDA) has approved Rubraca and Lynparza to treat certain forms of ovarian cancer* and prostate cancer† in adults. Lynparza is also approved to treat other cancers.

* Certain cancers in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.
† The FDA gave Rubraca accelerated approval for this use based on early clinical studies of the drug. After more studies have been done, the FDA will decide on whether to grant full approval. To learn more, see the “FDA approval” section above.

For ovarian cancer

For ovarian cancer, both drugs are approved to treat certain forms of epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. For this purpose, the cancer must be recurrent and be responding to a platinum-based chemotherapy. Rubraca and Lynparza are used as maintenance treatments.

The drugs are also approved to treat other forms of ovarian cancer. For details on Rubraca’s uses, see the “Rubraca for ovarian cancer” section above. For information on Lynparza’s uses, talk with your doctor.

For prostate cancer

Rubraca and Lynparza are approved to treat different forms of prostate cancer. For more information on Rubraca’s use, refer to the “Rubraca for prostate cancer” section above. And your doctor can tell you more about Lynparza’s use.

Other uses

Lynparza is also approved for use in adults with certain forms of breast cancer and pancreatic cancer.

Drug forms and administration

Rubraca and Lynparza both come as tablets that you swallow. Each drug is typically taken twice a day.

Side effects and risks

Rubraca and Lynparza can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Rubraca and Lynparza (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Rubraca, with Lynparza, or with both drugs (when taken individually).

Effectiveness

Rubraca and Lynparza have different FDA-approved uses, but they’re both used to treat certain forms of ovarian and prostate cancer.

These drugs haven’t been directly compared in clinical studies, but studies have found both Rubraca and Lynparza to be effective for treating the conditions mentioned above.

Costs

According to estimates on WellRx.com, costs of Rubraca tablets and Lynparza tablets will vary depending on your treatment plan. The actual price you’ll pay for either drug also depends on your insurance plan, your location, and the pharmacy you use.

Rubraca and Lynparza are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Like Lynparza (above), the drug Zejula has uses similar to those of Rubraca. Here’s a comparison of how Rubraca and Zejula are alike and different.

Ingredients

Rubraca contains the drug rucaparib. Zejula contains the drug niraparib.

Both Rubraca and Zejula belong to a class of drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. A class of drugs is a group of drugs that work in a similar way.

PARP inhibitors block the PARP enzyme. The PARP enzyme helps cancer cells repair themselves and grow. By blocking this enzyme, PARP inhibitors can keep cancer cells from growing.

Uses

The Food and Drug Administration (FDA) has approved Rubraca and Zejula to treat certain forms of ovarian cancer* in adults. Rubraca is also FDA-approved to treat certain forms of prostate cancer in adults.

* Certain cancers in the fallopian tubes and peritoneum (thin layer of tissue that lines the inside of your belly) can resemble ovarian cancer. As a result, they’re sometimes referred to as ovarian cancer. Throughout this article, cancer of the ovaries, fallopian tubes, and peritoneum are all called ovarian cancer.

For ovarian cancer

For ovarian cancer, Rubraca and Zejula are both approved to treat certain forms of epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. For this purpose, the cancer must be recurrent and be responding to a platinum-based chemotherapy. Rubraca and Zejula are used as maintenance treatments.

The drugs are also approved to treat other forms of ovarian cancer. For details on Rubraca’s uses, see the “Rubraca for ovarian cancer” section above. For information on Zejula’s uses, talk with your doctor.

Other use

Rubraca is also approved for use in adults to treat certain forms of prostate cancer. To learn more, refer to the “Rubraca for prostate cancer” section above.

Drug forms and administration

Rubraca comes as a tablet that you swallow. You’ll likely take it twice a day.

Zejula comes as a capsule that you swallow. You’ll likely take it once a day.

Side effects and risks

Rubraca and Zejula can cause similar and different side effects. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Rubraca, with Zejula, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Rubraca, with Zejula, or with both drugs (when taken individually).

Effectiveness

Rubraca and Zejula have different FDA-approved uses, but they’re both used to treat certain forms of ovarian cancer.

These drugs haven’t been directly compared in clinical studies, but studies have found both Rubraca and Zejula to be effective for treating certain forms of ovarian cancer.

Costs

According to estimates on WellRx.com, the costs of Rubraca tablets and Zejula capsules will vary depending on your treatment plan. The actual price you’ll pay for either drug also depends on your insurance plan, your location, and the pharmacy you use.

Rubraca and Zejula are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

There are no known interactions between Rubraca and alcohol. Talk with your doctor about how much alcohol is safe for you to drink during your treatment with Rubraca.

You should take Rubraca according to your doctor’s or healthcare provider’s instructions.

Rubraca comes as a tablet that you swallow. For more information on how to take Rubraca, visit the manufacturer’s website.

When to take

You’ll likely take Rubraca twice a day. Each dose should be about 12 hours apart. Try to take your doses at the same time each day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Rubraca with food

You can take Rubraca with or without food. However, taking the medication with a meal can help you remember when to take Rubraca.

Can Rubraca be crushed, split, or chewed?

No, you shouldn’t crush, split, or chew Rubraca. You should swallow the tablets whole.

The Food and Drug Administration (FDA) has approved Rubraca for use in adults with certain forms of ovarian cancer and prostate cancer. For details on these uses, see the “Rubraca for ovarian cancer” and “Rubraca for prostate cancer” sections above.

About the cancers

With cancer, cells start to multiply and grow out of control. Here’s some information on the different cancers that Rubraca treats.

Ovarian cancer

Ovarian cancer refers to cancer that grows in the ovaries, the organs in females that produce eggs. Rubraca is approved to treat epithelial ovarian cancer. “Epithelial” means that the cancer is in the epithelium (outer lining) of the ovary.

Ovarian cancer includes:

  • Fallopian tube cancer. This type of cancer occurs in thefallopian tubes, which connect the ovaries in females to the womb.
  • Primary peritoneal cancer. Primary peritoneal cancer grows in the peritoneum, the inside lining of the abdomen (belly).

Prostate cancer

Prostate cancer occurs in males and starts in the prostate gland. This gland is located between the bladder and penis.

What Rubraca does

Rubraca contains the drug rucaparib, which belongs to a class of drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. A class of drugs is a group of medications that work in a similar way.

PARP inhibitors block the PARP enzyme. (An enzyme is a protein that aids chemical changes in your body.) The PARP enzyme helps cancer cells repair themselves and grow. By blocking this enzyme, PARP inhibitors can keep cancer cells from growing.

How long does it take to work?

Rubraca starts working right away to slow the growth of cancer.

You won’t notice Rubraca working in your body. But your doctor will perform tests to check if Rubraca is working for you. You may be given a blood test to check the levels of specific proteins that can predict if your cancer is improving. Or your doctor will order imaging tests like a CT scan to see if the tumors in your body have shrunk or disappeared.

Your doctor may also regularly ask you questions on how you’re feeling and if any of your symptoms of cancer have improved.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rubraca, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for ovarian cancer

Examples of other drugs that may be used to treat ovarian cancer include:

  • bevacizumab (Avastin, Mvasi, Zirabev)
  • carboplatin (Paraplatin)
  • cisplatin
  • cyclophosphamide
  • doxorubicin (Doxil)
  • etoposide
  • gemcitabine (Gemzar, Infugem)
  • niraparib (Zejula)
  • olaparib (Lynparza)
  • paclitaxel
  • topotecan (Hycamtin)

Alternatives for prostate cancer

Examples of other drugs that may be used to treat prostate cancer include:

  • abiraterone acetate (Yonsa, Zytiga)
  • biclutamide (Casodex)
  • buserelin
  • flutamide
  • goserelin (Zoladex)
  • ketoconazole (Nizoral, Extina, Xolegel)
  • leuprolide (Eligard, Lupron Depot)
  • megestrol
  • olaparib (Lynparza)

Rubraca can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Rubraca and other medications

Below is a list of medications that can interact with Rubraca. This list doesn’t contain all drugs that may interact with Rubraca.

Before taking Rubraca, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rubraca and the metabolism of certain medications

Rubraca can affect how your body metabolizes (breaks down) other medications.

Medications broken down by CYP1A2

Your body uses an enzyme called CYP1A2 to break down certain medications. (An enzyme is a type of protein.) Rubraca can block the action of CYP1A2, raising the levels of medications that depend on CYP1A2 in your blood. This can increase your risk for side effects from these medications.

The following examples are drugs that are broken down in your body by the CYP1A2 enzyme:

  • alosetron (Lotronex)
  • clozapine (Clozaril)
  • duloxetine (Cymbalta)
  • pirfenidone (Esbriet)
  • ramelteon (Rozerem)
  • tasimelteon (Hetlioz)
  • theophylline (Elixophyllin, Theo-24, Theochron)
  • tizanidine (Zanaflex)

If you use any of these medications, tell your doctor before you start taking Rubraca. They may need to change the dose of these drugs.

Medications broken down by CYP3A

Your body uses an enzyme called CYP3A to break down certain drugs. Rubraca can block the action of CYP3A, raising the levels of the drugs that depend on CYP3A in your blood. This can increase your risk for side effects from these medications.

The following examples are drugs that are broken down in your body by the CYP3A enzyme:

  • alfentanil
  • alprazolam (Xanax)
  • buspirone
  • felodipine
  • indinavir (Crixivan)
  • midazolam
  • pimozide
  • quetiapine (Seroquel)
  • simvastatin (Zocor)
  • sirolimus (Rapamune)
  • tacrolimus (Astagraf XL, Prograf)

If you take any of these drugs, talk with your doctor before starting treatment with Rubraca. They may need to change the dose of these medications.

Medications broken down by CYP2C9

Your body uses an enzyme called CYP2C9 to break down certain medications. Rubraca can block the action of CYP2C9, raising the levels of the medications that depend on CYP2C9 in your blood. This can increase your risk for side effects from these drugs.

The following examples are drugs that are broken down in your body by the CYP2C9 enzyme:

  • celecoxib (Celebrex)
  • glimepiride (Amaryl)
  • phenytoin (Dilantin, Phenytek)
  • tolbutamide
  • warfarin (Coumadin, Jantoven)

If you use any of these medications, tell your doctor before you start taking Rubraca. They may need to change the dose of these drugs.

Medications broken down by CYP2C19

Your body uses an enzyme called CYP2C19 to break down certain medications. Rubraca can block the action of CYP2C19, raising the levels of the medications that depend on CYP2C19 in your blood. This can increase your risk for side effects from these medications.

The following examples are drugs that are broken down in your body by the CYP2C19 enzyme:

  • diazepam (Valium)
  • lansoprazole (Prevacid)
  • omeprazole (Prilosec)
  • rabeprazole (Aciphex)
  • voriconazole (Vfend)

If you take any of these drugs, talk with your doctor before starting treatment with Rubraca. They may need to change the dose of these medications.

Rubraca and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Rubraca. However, you should still check with your doctor or pharmacist before using any of these products while taking Rubraca.

Rubraca and foods

There aren’t any foods that have been specifically reported to interact with Rubraca. If you have any questions about eating certain foods with Rubraca, talk with your doctor.

As with all medications, the cost of Rubraca can vary. To find current prices for Rubraca in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Rubraca at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Rubraca, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Rubraca, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Rubraca, or if you need help understanding your insurance coverage, help is available.

Clovis Oncology, Inc., the manufacturer of Rubraca, offers a program called Rubraca Connections. For more information and to find out if you’re eligible for support, call 844-779-7707 or visit the program website.

Generic version

Rubraca isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Rubraca isn’t safe to take while pregnant. Based on animal studies, Rubraca may cause harm to the fetus and miscarriage when used during pregnancy.

To make sure that you’re not pregnant when you start taking Rubraca, your doctor may give you a pregnancy test before you begin treatment.

Talk with your doctor right away if you become pregnant while taking Rubraca.

Rubraca isn’t safe to take while pregnant. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Rubraca.

For more information about taking Rubraca during pregnancy, see the “Rubraca and pregnancy” section above.

For women using Rubraca

If you can become pregnant, be sure to use birth control while you take Rubraca and for 6 months after you have your last Rubraca dose. If you become pregnant during your Rubraca treatment, tell your doctor right away.

For men using Rubraca

If your sexual partner is pregnant or can become pregnant, be sure to use birth control while you take Rubraca and for 3 months after your last Rubraca dose.

Also, you shouldn’t donate sperm while you use Rubraca and for 3 months after you have your last Rubraca dose.

It’s not known if Rubraca can pass into breast milk. Because of the potential of side effects in children, you shouldn’t breastfeed during treatment with Rubraca. You should wait to breastfeed until at least 2 weeks following your last dose.

If you’re breastfeeding or are planning to breastfeed, talk with your doctor. They can advise you on the best way to feed your child as well as treatment options other than Rubraca.

This drug comes with several precautions. Before taking Rubraca, talk with your doctor about your health history. Rubraca may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Rubraca or any of its ingredients, you shouldn’t take Rubraca. Ask your doctor what other medications are better options for you.
  • Pregnancy. It’s not safe to use Rubraca while pregnant. For more information, please see the “Rubraca and pregnancy” section above.
  • Breastfeeding. It’s recommended that you don’t breastfeed while using Rubraca. For more information, please see the “Rubraca and breastfeeding” section above.

Note: For more information about the potential negative effects of Rubraca, see the “Rubraca side effects” section above.

Do not use more Rubraca than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

Keep in mind that you shouldn’t take another dose of Rubraca after vomiting. Take your next dose at the usual time.

What to do in case you take too much Rubraca

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Rubraca from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Rubraca tablets at room temperature between 68°F and 77°F (20°C to 25°C). Be sure to keep the medication in a tightly sealed container away from light. Avoid storing Rubraca in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Rubraca and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Rubraca is indicated to treat certain forms of:

  • Ovarian cancer:
    • As a maintenance treatment of recurrent epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer in adults who are completely or partially responding to a platinum-based chemotherapy.
    • Recurrent epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer in adults who are positive for a deleterious BRCA mutation that is germline, somatic, or both. The adults must have been previously treated with at least two chemotherapies. Patients should be selected for therapy on the basis of a companion diagnostic that is approved by the Food and Drug Administration (FDA) for Rubraca.
  • Prostate cancer:
    • Metastatic, castration-resistant prostate cancer in adults. They must be positive for a deleterious BRCA mutation that is germline, somatic, or both. The adults must have been previously treated with androgen receptor-directed therapy and chemotherapy with a taxane.

Administration

The recommended dosage of Rubraca tablets is 600 mg by mouth twice daily. They can be taken with or without food.

Mechanism of action

Rubraca is a poly (ADP-ribose) polymerase (PARP) enzyme inhibitor that increases the formation of PARP-DNA complexes, resulting in cellular apoptosis. PARP inhibition has been observed in BRCA-positive and BRCA-negative tumor cell lines.

Pharmacokinetics and metabolism

Rubraca is primarily metabolized by CYP2D6 with minor metabolism via CYP1A2 and CYP3A4.

The time to peak concentrations is 1.9 hours. Administration with a high-fat meal increases drug exposure by 38% and maximum concentrations by 20% in comparison to fasted conditions.

Contraindications

There are no known contraindications.

Storage

Rubraca should be stored at room temperature between 68°F and 77°F (20°C to 25°C). However, temperature excursions between 59°F and 86°F (15°C and 30°C) are allowed.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.