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Medicine at a glance
Rucaparib, also called Rubraca, is a targeted cancer medicine taken as tablets. It belongs to a group called PARP inhibitors. It interferes with the repair of damaged DNA inside cells, which can make certain cancer cells less able to survive. Your team selects treatment using your diagnosis, previous treatment and relevant tumour or genetic test results.
The usual starting dose is 600 mg twice daily, approximately 12 hours apart, with or without food. Regular blood tests are essential, even when you feel well. Important issues include low blood counts, nausea, tiredness, sensitivity to sunlight and changes in liver or kidney blood tests. Your own prescription takes priority over the examples in this page.
What rucaparib is and how it works
DNA carries a cell's instructions. Cells have several systems for repairing DNA damage. PARP proteins help with some of these repairs. Rucaparib blocks PARP activity and can trap PARP on DNA, allowing damage to build up. Cancer cells with problems in other repair systems may be particularly vulnerable. BRCA1 and BRCA2 are genes involved in one of those systems.
A targeted treatment can still affect healthy cells. The word “targeted” does not mean that side effects are always mild. It also does not mean that every cancer with a DNA-repair gene change will respond.
Sometimes rucaparib is used as maintenance treatment: treatment intended to help keep cancer controlled after a response to earlier treatment. Your team will explain your particular aim and how they will assess benefit. Side effects cannot tell you whether the medicine is working.
How the team decides whether it is suitable
Selection rules differ between treatment settings and have changed as longer-term evidence has become available. Older websites may describe uses that no longer match current recommendations. Your oncologist will explain why rucaparib fits your current situation rather than relying on a general list of cancers.
BRCA testing may be important. A change found only in tumour cells is called somatic; a change that can be inherited is called germline. A tumour result does not automatically mean relatives have the same change. Ask whether genetic counselling or a separate inherited-gene test is appropriate. For some treatment decisions, a negative blood-based tumour test may need follow-up testing of tumour tissue.
The team also considers recovery from earlier treatment, blood counts, kidney and liver function, other medicines and your daily wellbeing. Severe kidney or liver impairment needs particular specialist assessment because evidence is limited. Do not work out a dose from one laboratory result yourself.
Before treatment starts
Give the team a complete list of prescribed medicines, medicines bought without a prescription, vitamins, herbal preparations and supplements. Bring photos of packaging if names are unclear. Tell them about previous persistent low blood counts, transfusions, liver or kidney disease, recurrent infections, bowel obstruction and any current vomiting or difficulty passing stools.
Baseline checks include a full blood count and assessment of liver and kidney function. Blood counts affected by previous chemotherapy need to recover sufficiently before rucaparib starts. A pregnancy test is arranged when pregnancy is possible. Other tests, including infection screening, depend on your history and local practice.
Ask for a written tablet schedule, your blood-test dates and the hospital's 24-hour oncology contact number. Check who supplies repeat prescriptions and how early to request them. If treatment follows chemotherapy, the team will set the appropriate start date; do not choose one from an online timetable.
How to take rucaparib
Dose and daily routine
The usual starting prescription is 600 mg in the morning and 600 mg in the evening, approximately 12 hours apart. At that dose, each administration contains two 300 mg tablets. Rubraca also comes in 200 mg and 250 mg strengths. The number and strength of tablets can change if your dose is reduced, so check each new prescription carefully.
Take tablets with or without food. A consistent routine can help you remember doses. Swallow them whole with water; do not chew, crush or break them. If swallowing is difficult, ask the oncology pharmacist for advice before changing the tablets or trying a feeding-tube preparation.
There is usually no scheduled tablet-free week. However, your oncologist may pause treatment or reduce the dose for side effects or abnormal tests. Do not restart after a medically advised pause until the team confirms the dose and date.
If your plan includes ongoing medicine to keep testosterone low, continue it unless your team changes the plan. Rucaparib does not replace this treatment. Surgical removal of both testicles may remove the need for these medicines.
Missed tablets, vomiting and accidental extra doses
If you miss a dose, skip it and take the next dose at the usual time. Do not take an extra dose or double the next one. If you vomit after swallowing the tablets, do not replace that dose, even if you think little medicine stayed down. Resume at the next scheduled time and report repeated vomiting.
If you take too much, contact your oncology team or an emergency department immediately. Keep the packaging and record approximately how many tablets you took and when. Do not wait for symptoms before asking for help.
Storage and practical handling
Keep tablets in their original packaging, away from children, moisture, excessive heat and direct sunlight. Follow your supplied storage label; the US label specifies room temperature of 20–25°C (68–77°F). Ask the pharmacist about storage during hot weather or travel. Return unused tablets through the hospital or pharmacy rather than sharing them or discarding them in household waste.
Monitoring and checking whether treatment is working
A full blood count is checked before treatment and at least monthly during treatment. It measures red cells, infection-fighting white cells and platelets, which help stop bleeding. Additional checks are needed when symptoms occur or counts fall. A previous normal result does not rule out a new problem.
Persistently low counts may require treatment interruption or reduction and weekly blood tests. If counts do not recover adequately after about four weeks, or a serious marrow problem is suspected sooner, the team may refer you to a blood specialist. Further tests can include a bone-marrow sample and tests of the chromosomes in blood-forming cells.
Liver and kidney blood tests are also monitored. A rise in liver enzymes can occur early and may settle, but the team assesses its severity and other results before deciding whether treatment can continue. The kidney marker creatinine can rise partly because rucaparib changes how the kidneys transport it; that does not automatically mean kidney damage. Genuine kidney problems and dehydration still need checking.
Appointments also cover appetite, weight, energy, bowel habits and medicines. Scans and other disease-specific assessments are arranged according to your treatment plan. Ask what improvement, stability or progression would mean for your next decision.
Common side effects and ways to manage them
Tiredness and low red blood cells
Fatigue can feel different from ordinary tiredness and may interfere with concentration or daily tasks. Plan rest breaks and activity around your energy. Gentle movement may help when you feel able, but do not push through dizziness, chest discomfort or marked breathlessness. Anaemia is a possible contributor and may need treatment, including a transfusion in some circumstances.
Nausea, appetite and taste
Take prescribed anti-sickness medicine as instructed. Small meals and frequent snacks may be easier than large portions. Try different temperatures or textures when food tastes unusual. Tell the team if nausea continues, your weight falls or you are struggling to eat: a different anti-sickness plan or dietitian review may help. Persistent vomiting needs prompt advice because it can cause dehydration.
Diarrhoea, constipation and indigestion
Report changes in your usual bowel pattern. Follow your team's plan for diarrhoea medicines or laxatives rather than repeatedly treating yourself. Take regular fluids within any restriction you have been given for another condition. Severe pain, abdominal swelling, vomiting or inability to pass stools or wind needs urgent assessment instead of extra laxatives.
Skin and sunlight
Rucaparib can make skin burn more easily in sunlight. Limit direct sun exposure and use protective clothing, a hat and high-protection sunscreen. European information specifies SPF 50 or higher for sunscreen and lip balm. Reapply protection according to the product instructions. These precautions matter even if you have never burned easily before.
Report a new rash, troublesome itching or painful palms and soles. Gentle skin care and a plain moisturiser may help, but blistering, broken skin or symptoms affecting walking deserve prompt review. Do not assume every rash is simply sunburn.
Other symptoms
Headache, dizziness, muscle or joint discomfort, mouth soreness and swelling can occur. Report symptoms that persist or affect daily activities. Use a soft toothbrush and tell the team if mouth soreness limits drinking. New breathlessness, unusual bleeding or rapidly worsening symptoms require prompt assessment rather than routine self-care.
Important risks that need medical assessment
Infection and bleeding from low blood counts
Low white cells can make infections more serious. Low platelets can cause easy bruising, nosebleeds, bleeding gums or small spots under the skin. Tell the team promptly about these changes. Blood in urine or stools, black stools or bleeding that does not stop needs urgent help.
Persistent bone-marrow problems
Myelodysplastic syndrome, usually shortened to MDS, is a disorder of blood-forming cells. Acute myeloid leukaemia, or AML, is a blood cancer. These serious, sometimes fatal problems have occurred during or after rucaparib treatment. Previous chemotherapy and other DNA-damaging treatments also contribute to risk. The chance varies between patient groups; one percentage does not describe everyone's risk.
Warning symptoms overlap with ordinary low blood counts: continuing exhaustion, breathlessness, repeated infections, fever, unusual bruising, bleeding or unexplained weight loss. Most low counts do not mean MDS or AML, but persistent abnormalities need investigation. Rucaparib is stopped if either condition is confirmed. Follow-up remains important after the tablets finish.
Bowel obstruction
A blocked bowel has been reported in people receiving rucaparib, particularly in the setting of abdominal cancer. The cancer itself can contribute, so it is not always possible to attribute the problem to the medicine. Severe or cramping abdominal pain, swelling, repeated vomiting and inability to pass stools or wind need urgent assessment.
Liver, kidney and allergic problems
Contact the team urgently for yellow skin or eyes, dark urine, markedly reduced urine, or new swelling with feeling unwell. Do not dismiss these because many laboratory changes are mild. Sudden swelling of the lips, tongue or throat, wheezing or difficulty breathing can be an allergic emergency. Do not take further rucaparib after a suspected serious allergic reaction until a clinician has assessed you.
When to seek urgent help
Call your hospital's urgent oncology number immediately if you develop fever, shivering, signs of infection or feel suddenly unwell, even without fever. Follow the temperature threshold your hospital gives you. UK patient sources advise urgent contact at 37.5°C (99.5°F) or above or below 36°C (96.8°F); a different local threshold should not delay calling when you feel ill.
Seek emergency care for severe breathing difficulty, chest pain, collapse, major bleeding, sudden facial or throat swelling, or severe abdominal pain with persistent vomiting. Cancer also increases clot risk: a newly painful, swollen limb needs urgent advice, and sudden breathlessness or chest pain needs emergency assessment.
Urgent same-day advice is also needed for repeated vomiting, worsening diarrhoea, inability to drink, reduced urine, jaundice or new unexplained bleeding. Tell the clinician you take rucaparib and when your last dose was. If you cannot reach your oncology service and symptoms are significant, go to emergency care rather than waiting until the next clinic appointment.
Other medicines, supplements and vaccines
Rucaparib can increase the amount of several other medicines in the body. Important examples include warfarin, phenytoin, theophylline, tizanidine and certain strong pain medicines or transplant medicines. Warfarin may need closer INR blood testing. The pharmacist may adjust a companion medicine or choose an alternative; do not stop essential medicines yourself.
European information also advises caution with medicines that strongly affect drug-processing enzymes or transporters, and with metformin. This is a reason for a full interaction check, not a rule that all such combinations are forbidden. Acid-reducing medicines do not automatically require the spacing rules used with some other cancer tablets. Ask before starting any new prescription, supplement or herbal product.
Discuss vaccinations with the oncology team. Live vaccines may be unsuitable when your immune defences are reduced, and the timing of other vaccines may need planning around your treatment and blood counts. Tell dentists, emergency clinicians and other prescribers that you are taking rucaparib.
Everyday life during treatment
A dose diary or phone reminder can help you maintain the twice-daily routine. Keep an updated medicine list and carry your oncology contact details when away from home. Arrange blood tests and enough medication before travel; do not change the dose schedule across time zones without advice.
You may be able to continue work and usual activities, with adjustments for fatigue or appointments. Do not drive or operate machinery when dizzy, excessively tired or otherwise unable to concentrate safely. Ask about individual exercise and infection precautions if blood counts are low.
There is no special diet that makes rucaparib work. Focus on foods you can manage and discuss persistent weight loss early. Ask about alcohol if you have nausea, dehydration or abnormal liver results. Support with sleep, anxiety, finances and practical care is part of treatment, too; tell the team which difficulties are affecting you most.
Pregnancy, contraception, fertility and breastfeeding
Rucaparib can harm a developing baby. When pregnancy is possible, testing is needed before treatment. Use effective contraception during treatment and for six months after the last dose. Contact the team immediately if pregnancy occurs or is suspected. Your clinician can help choose a suitable method, taking your other medicines and health into account.
The US label also advises male patients with a partner who is pregnant or could become pregnant to use effective contraception during treatment and for three months after the final dose. Do not donate sperm during treatment or for those three months. The European product information addresses a female treatment population and does not provide a separate male interval. Ask for written advice appropriate to your prescription.
Do not breastfeed during treatment or for two weeks after the final dose. Effects on human fertility are not fully known. If having children in future matters to you, ask about fertility advice and preservation before treatment begins when feasible. Do not assume absent periods or reduced fertility removes the need for contraception.
Other medicines can require longer contraception or breastfeeding precautions. Confirm the end dates for your complete treatment plan with the team.
After a pause or when treatment finishes
A temporary pause or dose reduction can help manage side effects safely. It does not by itself mean the medicine has failed. Confirm exactly when to restart and which tablet strength to use. Never make up doses missed during a treatment interruption.
Duration depends on your plan. Some European maintenance schedules specify a maximum of two years, while other schedules continue while benefit remains and side effects are manageable. Your team will explain the relevant stopping point and ongoing monitoring.
Continue follow-up for unresolved symptoms and low blood counts. Report persistent fatigue, infections, bruising or bleeding after treatment because serious marrow problems can appear later. Keep using contraception and follow the breastfeeding restrictions for the full advised period. Ask whom to contact once routine tablet appointments end.
Frequently asked questions
1. Is rucaparib the same as Rubraca?
Yes. Rucaparib is the medicine's generic name and Rubraca is its verified brand name. Check both the tablet strength and your prescribed number of tablets when a new supply arrives. The different strengths are not interchangeable tablet for tablet.
2. Is this chemotherapy or immunotherapy?
It is a targeted treatment called a PARP inhibitor. It is not an immune-checkpoint treatment. It interferes with DNA repair and can still cause important effects on healthy cells, particularly blood-forming cells.
3. Does everyone need a BRCA mutation?
Testing requirements depend on the precise treatment setting and applicable guidance. Current US uses are BRCA-selected, while European maintenance wording differs. Ask your oncologist what your test shows and why it supports your plan; do not apply another patient's eligibility rules to yourself.
4. Does a tumour BRCA result mean my family is at risk?
Not necessarily. A tumour-only change may not be inherited. Your team may recommend separate germline testing or genetic counselling to clarify this. Testing can help distinguish treatment information from information relevant to relatives.
5. Why is an older leaflet different from my oncologist's advice?
Evidence and authorised uses have changed. In particular, current selection should not be inferred from an old broad description of PARP treatment. Ask the team to explain the current evidence behind your recommendation and your available alternatives.
6. Do I take the tablets with a meal?
Either with or without food is acceptable. Aim for two regular times approximately 12 hours apart. If nausea makes the routine difficult, ask for help with anti-sickness treatment instead of frequently missing doses.
7. Can I crush a tablet if it is difficult to swallow?
Do not crush, chew or break it. Tell the oncology pharmacist about swallowing problems before altering the tablets or using a feeding tube. They can assess the safest practical way to manage your treatment.
8. What if I forget my morning dose?
Skip the missed dose and take the next scheduled dose at its normal time. Do not take a catch-up dose or double your evening dose. Tell the team if missed doses are becoming frequent so they can help with the routine.
9. Should I take another dose after vomiting?
No. Do not replace it; take the next dose at the scheduled time. Contact the team if vomiting continues, you cannot keep fluids down or you are passing less urine. These symptoms can lead to dehydration.
10. Why do I need blood tests when I feel well?
Blood counts and liver or kidney markers can change before symptoms appear. Monthly blood-count monitoring is part of the safety plan, with extra checks when necessary. Keep appointments even when treatment seems easy to tolerate.
11. Does a low blood count mean I have leukaemia?
Usually it does not. Low counts are a recognised treatment effect. Persistent or unexplained abnormalities need investigation because MDS or AML is a serious possibility in a minority of patients. Your team may arrange weekly tests and specialist review.
12. Does a higher creatinine result prove kidney damage?
No. Rucaparib can interfere with transport of creatinine, increasing the blood result without necessarily damaging kidney filtration. Dehydration and genuine kidney illness remain possible, so the clinician must assess the whole picture rather than ignoring the result.
13. What sun protection do I need?
Limit direct sunlight, cover exposed skin and use a hat. European instructions recommend sunscreen and lip balm with SPF 50 or higher. Tell the team about significant sunburn, blistering or rash despite protection.
14. Can constipation become an emergency?
Yes, particularly when accompanied by worsening pain, swelling, repeated vomiting or inability to pass wind. These can indicate bowel obstruction and need urgent assessment. Do not keep adding laxatives while waiting for severe symptoms to settle.
15. Can I continue warfarin or diabetes tablets?
Possibly, but the pharmacist must check your exact medicines. Warfarin may require more frequent INR monitoring, and metformin needs consideration because rucaparib can affect medicine transport. Do not independently stop or change either treatment.
16. Should I stop my hormone-suppression treatment?
If your rucaparib plan includes ongoing treatment to lower testosterone, it usually continues. The US label requires continued medical suppression unless surgical removal of both testicles has already provided it. Confirm your whole plan with the team before cancelling injections or tablets.
17. Will a lower dose still be worthwhile?
The team may reduce treatment to improve safety and tolerability while continuing to assess benefit. A reduction is an established management option. Ask what prompted the change and what will be checked before deciding whether to continue.
18. How long must contraception continue?
For patients who could become pregnant, six months after the final dose. US instructions for male patients specify three months when a partner is pregnant or could become pregnant, with no sperm donation during that period. Confirm your individual plan in writing.
19. When can breastfeeding restart?
Both current US and European information advise no breastfeeding during treatment and for two weeks after the last dose. If other medicines are involved, ask whether they require a longer interval before restarting.
20. What should I report after stopping treatment?
Persistent or worsening fatigue, breathlessness, repeated infections, unusual bruising or bleeding still need assessment. Low counts and serious marrow problems can require follow-up after treatment ends. Keep your oncology contact details and attend planned blood tests.
Sources and review information
Sources checked: 1 October 2026. Read with the leaflet for your prescribed formulation and your hospital’s treatment plan.
