Indications
Juparib Tablet is used for:
Ovarian cancer, Fallopian tube cancer, Primary peritoneal cancer, Breast cancer, Pancreatic Cancer, Prostate Cancer
Adult Dose
Oral
Ovarian Cancer
Recurrent ovarian cancer
Indicated as maintenance treatment for recurrent ovarian cancer (including epithelial ovarian, fallopian tube or primary peritoneal cancer) in adults who are in complete or partial response to platinum-based chemotherapy
300 mg PO BID
Continue until disease progression, unacceptable toxicity
Advanced ovarian cancer (monotherapy)
Indicated as first-line maintenance treatment for deleterious or suspected deleterious somatic or germline BRCA-mutated (gBRCAm) advanced ovarian cancer in patients who are in complete or partial response to first-line platinum-based chemotherapy
300 mg PO BID
Continue until disease progression, unacceptable toxicity, or completion of 2 years of treatment
Completion of 2 years of treatment
Patients with complete response (no radiologic evidence): Stop treatment
Patients with evidence of disease and may benefit from continuous treatment: Treat beyond 2 years
Advanced ovarian cancer (combination therapy)
Indicated as first-line maintenance treatment for advanced ovarian cancer in combination with bevacizumab for adults who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD) positive status defined by either a deleterious or suspected deleterious BRCA mutation, and/or genomic instability
Olaparib 300 mg PO BID, plus
Bevacizumab 15 mg/kg IV q3Weeks for a total of 15 months (including with chemotherapy and as maintenance)
Continue until disease progression, unacceptable toxicity, or completion of 2 years of treatment
Refer to prescribing information for bevacizumab when used in combination with olaparib for more information
Completion of 2 years of treatment
Patients with complete response (no radiologic evidence): Stop treatment
Patients with evidence of disease and may benefit from continuous treatment: Treat beyond 2 years
Advanced ovarian cancer (after ?3 lines of chemotherapy)
Indicated for treatment of adults with deleterious or suspected deleterious gBRCAm advanced ovarian cancer who have been treated with ?3 prior lines of chemotherapy
300 mg PO BID
Continue treatment until disease progression or unacceptable toxicity
Breast Cancer
Indicated for deleterious or suspected deleterious gBRCAm, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer
Patients who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting
Patients with hormone receptor (HR)-positive breast cancer should have been treated with prior endocrine therapy or be considered inappropriate for endocrine therapy
300 mg PO BID
Continue treatment until disease progression or unacceptable toxicity
Pancreatic Cancer
Indicated for first-line maintenance treatment of adults with deleterious or suspected deleterious gBRCAm metastatic pancreatic adenocarcinoma whose disease has not progressed on at least 16 weeks of a first-line platinum-based chemotherapy regimen
300 mg PO BID
Continue treatment until disease progression or unacceptable toxicity
Metastatic Castration-Resistant Prostate Cancer
Indicated for deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) in adults who have progressed following prior treatment with enzalutamide or abiraterone
300 mg PO BID
Continue until disease progression or unacceptable toxicity
Should also receive a gonadotropin-releasing hormone (GnRH) analog concurrently or should have had bilateral orchiectomy
Hepatic impairment
Mild to moderate hepatic impairment (Child-Pugh Class A and B): No dosage adjustment necessary
Severe hepatic impairment (Child-Pugh Class C): Not studied
Child Dose
Renal Dose
Renal impairment
Mild (CrCl 50-80 mL/min): No dosage adjustment necessary
Moderate (CrCl 31-50 mL/min): Reduce dose to 200 mg (two 100-mg tablets) BID
Severe (CrCl <30 mL/min or dialysis): Not evaluated
Administration
May be taken with or without food. Swallow whole, do not chew/crush/dissolve/divide.
Contra Indications
Precautions
Pneumonitis, including fatal cases, occurred in <1%; interrupt treatment if pneumonitis is suspected; discontinue if pneumonitis is confirmed
Can cause fetal harm when administered to a pregnant woman based on its mechanism of action and findings in animals; (see Pregnancy)
Venous thromboembolic events, including pulmonary embolism, occurred in mCRPC patients who were treated with olaparib and androgen deprivation therapy; monitor for signs and symptoms of venous thrombosis and pulmonary embolism and treat as medically appropriate, which may include long-term anticoagulation as clinically indicated
Myelodysplastic syndrome/ acute myeloid leukemia
Myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) occurred in clinical trials
Monitor complete blood cell count for cytopenia at baseline and monthly thereafter for clinically significant changes during treatment
Do not initiate treatment until hematological toxicity caused by previous chemotherapy (Grade ≤1) resolves
Pregnancy-Lactation
Pregnancy
Based on findings in animals and mechanism of action, fetal harm may occur when administered to a pregnant woman; there are no available data on use in pregnant women to inform of drug associated risk
Olaparib was teratogenic and caused embryo-fetal toxicity in rats at exposures below those in patients receiving the recommended human dose of 400 mg BID
Contraception
In women of childbearing potential, avoid pregnancy by using effective contraception during treatment and for at least 6 month after receiving the last dose; pregnancy testing is recommended for females of reproductive potential prior to initiating treatment
Based on findings in genetic toxicity and animal reproduction studies, advise male patients with female partners of reproductive potential or who are pregnant to use effective contraception during treatment and for 3 months following the last dose of olaparib
Advise male patients not to donate sperm during therapy and for 3 months following the last dose of olaparib
Lactation
No data are available regarding presence of olaparib in human milk, or on effects on breastfed infant or on milk production; because of potential for serious adverse reactions in breastfed infants from therapy, advise lactating women not to breastfeed during treatment and for 1 month after receiving last dose
Interactions
May reduce efficacy of hormonal contraceptives. May decrease serum concentration with moderate or severe CYP3A4 inducers. May increase serum concentration with moderate or strong CYP3A4 inhibitors. Increased myelosuppression with other antineoplastic agents.
Side Effects
Side effects of Olaparib :
>10% (Maintenance Treatment for BRCA-mutated Advanced Ovarian)
Decreased hemoglobin (87%)
Increased mean corpuscular volume (87%)
Nausea (77%)
Decrease leukocytes (70%)
Fatigue (67%)
Decreased lymphocytes (67%)
Decreased ANC (51%)
Abdominal pain (45%)
Vomiting (40%)
Anemia (38%)
Diarrhea (37%)
Decreased platelets (35%)
Increased serum creatinine (34%)
Constipation (28%)
Upper respiratory tract infection (eg, influenza, nasopharyngitis, bronchitis) (28%)
Dysgeusia (26%)
Anemia, Grade 3 or 4 (21%)
Dizziness (20%)
Decreased appetite (20%)
Decreased hemoglobin, Grade 3 or 4 (19%)
Neutropenia (17%)
Dyspepsia (17%)
Dyspnea (15%)
Decreased lymphocytes, Grade 3 or 4 (14%)
Urinary tract infection (13%)
Thrombocytopenia (11%)
Stomatitis (11%)
>10% (Maintenance Treatment for Recurrent Advanced Ovarian)
Increased mean corpuscular volume (89%)
Decreased hemoglobin (83%)
Nausea (76%)
Decreased leukocytes (69%)
Decreased lymphocytes (67%)
Fatigue (66%)
Decreased ANC (51%)
Anemia (44%)
Increased serum creatinine (44%)
Decreased platelets (42%)
Vomiting (37%)
Upper respiratory tract infection (36%)
Diarrhea (33%)
Arthralgia/myalgia (30%)
Dysgeusia (27%)
Headache (26%)
Decreased appetite (22%)
Stomatitis (20%)
Neutropenia (19%)
Cough (18%)
Leukopenia (16%)
Hypomagnesemia (14%)
Thrombocytopenia (14%)
Dizziness (13%)
Dyspepsia (11%)
Increased creatinine (11%)
1-10% (BRCA-mutated Advanced Ovarian)
Maintenance treatment
Neutropenia, Grade 3 or 4 (6%)
Fatigue, Grade 3 or 4 (4%)
Leukopenia, Grade 3 or 4 (3%)
Diarrhea, Grade 3 or 4 (3%)
Abdominal pain, Grade 3 or 4 (2%)
Thrombocytopenia, Grade 3 or 4 (1%)
Nausea, Grade 3 or 4 (1%)
1-10% (Maintenance Treatment for Recurrent Advanced Ovarian)
Edema (8%)
Rash (6%)
Fatigue, Grade 3 or 4 (4%)
Nausea, Grade 3 or 4 (3%)
Vomiting, Grade 3 or 4 (3%)
Diarrhea, Grade 3 or 4 (2%)
Lymphopenia (1%)
Headache, Grade 3 or 4 (1%)
Stomatitis, Grade 3 or 4 (1%)
Mode of Action
Inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3
PARP enzymes are involved in normal cellular homeostasis, such as DNA transcription, cell cycle regulation, and DNA repair
Note
Juparib 150 mg Tablet generic name is Olaparib. Juparib 150 mg Tablet is manufactured by Jenphar Bangladesh Ltd.Juparib is availble in all over Bangladesh.
Mes BD drug index information on Juparib Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.