Rucaparib (Rubraca)
Rucaparib is a 
. It is also known as Rubraca.
It is a treatment for a number of different cancer types.
You pronounce rucaparib as roo-ka-pur-ib.
You may have rucaparib after treatment with platinum chemotherapy if it has worked. This is called maintenance treatment. Platinum chemotherapy includes the drugs cisplatin and carboplatin.
How does rucaparib work?
Rucaparib is a targeted drug called a PARP is a protein that helps damaged cells to repair themselves. Rucaparib stops PARP working.
Some cancer cells rely on PARP to keep their healthy. This includes cancer cells with a change in the BRCA genes. So, when rucaparib stops PARP from repairing DNA damage, the cancer cells die.
How do you have rucaparib?
You have rucaparib as tablets.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you miss a dose.
How often do you have rucaparib?
You take rucaparib twice a day.
You start taking rucaparib no later than 8 weeks after the last dose of platinum chemotherapy. You take it for as long as it is working, and the side effects aren't too bad. This is called maintenance treatment.
Tests
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
What are the side effects of rucaparib?
Side effects can vary from person to person. They also depend on what other treatments you're having.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
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you have severe side effects
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your side effects aren’t getting any better
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your side effects are getting worse
Early treatment can help manage side effects better.
Contact your advice line immediately if you have signs of infection, including a temperature above 37.5C or below 36C.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
Common side effects
Each of these effects happens in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising and bleeding
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Loss of appetite
You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
Taste changes
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.
Dizziness
This is usually mild. Don’t drive or operate machinery if you have dizziness.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Diarrhoea
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
Indigestion or heartburn
Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Skin problems
Skin problems include a skin rash, redness and skin sensitivity to sunlight. This usually goes back to normal when your treatment finishes.
Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to stop the rash and soothe your skin. It's important to cover up or use sunblock if you go out in the sun.
Tiredness and weakness
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
High temperature (fever)
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
High levels of creatinine and liver enzymes in your body
You have regular blood tests during treatment to check for this.
Shortness of breath
You might feel short of breath. Talk to your doctor or nurse if you do.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- a blood cancer called myelodysplastic syndrome or acute myeloid leukaemia (AML). Your doctor will check for this
- loss of body fluids (dehydration) which can cause a dry mouth and feeling thirsty or lightheaded
- high levels of cholesterol in the blood
- soreness, redness and peeling on palms or soles of the feet (hand foot syndrome)
- a blockage in the bowel (bowel obstruction)
- allergic reaction which can include swelling of the face and eyes
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do you need to know?
Other medicines, foods and drinks
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
Loss of fertility
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Pregnancy and contraception
This treatment may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Breastfeeding
It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment and for 2 weeks afterwards.
Treatment for other conditions
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Immunisations
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your recovers from treatment.
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
