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Rubraca 300mg Tablet
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Indications & Clinical Uses
- Rubraca 300 mg (rucaparib, as rucaparib camsylate) is a PARP inhibitor used in adults with a deleterious BRCA mutation.
- It is approved as maintenance treatment for adults with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy, and, following full FDA approval granted in December 2025 (converting the original 2020 accelerated approval), for the treatment of adults with BRCA-mutated metastatic castration-resistant prostate cancer who have already received androgen receptor-directed therapy.
- Because it is used in both women's and men's cancers, Rubraca is not exclusively a women's cancer medicine.
- A BRCA mutation must be confirmed with an approved companion diagnostic test before starting.
- Rubraca is one of several PARP inhibitors, alongside olaparib (Lynparza), niraparib (Zejula) and talazoparib (Talzenna), each with its own approved indications; they are not interchangeable.
Side Effects
- Common side effects may include nausea, fatigue, anaemia, raised liver enzymes, vomiting, diarrhoea, reduced appetite, low platelet counts (thrombocytopenia), altered taste and, in prostate cancer, musculoskeletal pain, each affecting a substantial proportion of patients.
- Rubraca has NO boxed warning, but it carries an important warning for myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML), serious and potentially fatal blood cancers that occurred in about 1.6 percent of patients across studies; report prolonged or unusual bruising, bleeding, fatigue or infections, since these can be early signs.
- Complete blood counts are checked monthly during treatment for this reason.
- Rash and photosensitivity (sun sensitivity) can also occur, so sun protection is advised.
- Seek prompt medical review for symptoms that suggest low blood counts or a new, unexplained bleeding tendency.
Precautions & Warnings
- Rubraca can cause fetal harm, so effective contraception is required for women of reproductive potential during treatment and for 6 months afterward, and for male patients with partners who could become pregnant during treatment and for 3 months afterward; it must not be used in pregnancy, and breastfeeding is not recommended during treatment and for 2 weeks after the last dose.
- Complete blood counts should be checked at baseline and monthly thereafter to monitor for MDS/AML, and treatment should be interrupted or discontinued if this is confirmed.
- Rubraca inhibits several liver enzymes (CYP1A2, CYP3A, CYP2C9 and CYP2C19), so doses of many other medicines may need adjustment.
- No dose adjustment is needed for mild to moderate kidney or liver impairment, but Rubraca has not been studied in severe impairment.
- Rubraca is taken orally and swallowed whole; it should be stored at 20°C to 25°C.
Avoid Interactions
- Rubraca inhibits CYP1A2, CYP3A, CYP2C9 and CYP2C19 in the liver, so it raises blood levels of many other drugs metabolised by these pathways; examples confirmed on the label include caffeine, the sedative midazolam, and the blood thinner warfarin, whose effects and levels can increase notably, so warfarin doses may need closer monitoring and adjustment.
- Combining Rubraca with other medicines cleared by these same liver enzymes, including some statins, antiarrhythmics and antidepressants, may need dose changes under specialist guidance.
- There is no established interaction with grapefruit specifically, but because Rubraca affects multiple CYP enzymes broadly, the oncology team should review every new prescription, over-the-counter medicine, herbal product and supplement before it is started, and any other anticoagulant or antiplatelet medicine should be flagged because of the added risk of bruising or bleeding.
References
Frequently Asked Questions
Rubraca (rucaparib) is a PARP-inhibitor cancer medicine for adults with a BRCA gene mutation. It maintains remission in ovarian, fallopian tube or peritoneal cancer after chemotherapy, and treats metastatic castration-resistant prostate cancer after prior hormone therapy - so it treats both women's and men's cancers, not only ovarian cancer.
Rubraca 300 mg tablets are taken by mouth twice daily, roughly 12 hours apart, with or without food, and swallowed whole. Keep taking it as prescribed unless your oncology team tells you to pause or lower the dose because of side effects.
Common side effects of Rubraca include nausea, fatigue, anaemia, raised liver enzymes and low platelets. A rare but serious risk is MDS or AML, blood cancers linked to PARP inhibitors - report unusual bruising, bleeding, prolonged tiredness or infections to your care team promptly.
Rubraca requires a complete blood count at baseline and then every month, to catch early signs of myelodysplastic syndrome or acute myeloid leukaemia, a rare but serious risk of this medicine class. Liver function is also checked periodically, since Rubraca commonly raises liver enzymes.
Avoid becoming pregnant, since Rubraca can harm a developing baby - use effective contraception during treatment and for months afterward. Tell your oncology team about warfarin, caffeine-heavy habits and other medicines, since Rubraca raises blood levels of many drugs cleared by the liver.
Yes. In December 2025 the FDA converted Rubraca's earlier accelerated approval into full approval for BRCA-mutated metastatic castration-resistant prostate cancer, based on confirmatory trial data. It's used after androgen receptor-directed therapy, alongside its long-standing ovarian cancer indication.
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