Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
rucaparib
Poly(ADP-ribose) polymerase (PARP) inhibitor · null
START
600 mg PO twice daily
TYPICAL MAX
1200 mg/day
STOP IF
MDS/AML signs, persistent grade 3–4 cytopenia, or hepatotoxicity
WATCH
CBC weekly initially then monthly; LFTs; persistent cytopenia → haematology review
CDSCO approvedATC L01XK03
KDIGO 2024 + manufacturer label
- ONSET
- 1h · absorption
- PEAK
- 2h · Tmax
- t½
- 18h · t½
- DURATION
- 12h · twice-daily
EXCRETION
Mainly faecal (~71%); ~17% renal
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Can cause fetal harm — avoid; effective contraception during and 6 months after.
FDA category + note
Top interactionssee all 12 →
- AdalimumabSevereDatabaseDDInter
- AmiodaroneSevereDatabaseDDInter
- AmisulprideSevereDatabaseDDInter
- AnagrelideSevereDatabaseDDInter
Mechanism
Inhibits PARP-1/2/3 enzymes that participate in single-strand DNA break repair; in BRCA1/2-mutant or homologous-recombination-deficient tumour cells this creates synthetic lethality through unrepaired DNA damage at replication forks.
Indications
Recurrent BRCA-mutant ovarian cancer (maintenance after platinum response)Deleterious BRCA-mutant prostate cancer (mCRPC after androgen-axis therapy)
Dosing
- Adult
- 600 mg PO twice daily; reduce for toxicity (500, 400, 300 mg twice daily).
- Pediatric
- Not established.
- Renal adjustment
- No adjustment for CrCl >30; not studied below.
- Hepatic adjustment
- Mild: no adjustment; moderate–severe: not studied — caution.
- Geriatric
- No specific adjustment; monitor cytopenias.
- Max dose
- 1200 mg/day (600 mg twice daily)
Pharmacokinetics
Onset
Tumour effect over weeks
Peak effect
~1.9 h (Tmax)
Duration
~12 h (twice-daily)
Half-life
~17–19 h
Bioavailability
~36%
Protein binding
~70%
Metabolism
Hepatic CYP2D6 + CYP1A2/3A (multiple)
Excretion
Mainly faecal (~71%); ~17% renal
Contraindications
- Severe hypersensitivity
- Caution: significant haematologic disease, severe hepatic impairment
Side effects
Common
Nausea/vomitingFatigueAnaemiaIncreased creatinineDysgeusiaThrombocytopenia
Serious
- Myelodysplastic syndrome / acute myeloid leukaemia (boxed-style class concern)
- Severe myelosuppression
- Hepatotoxicity
- Embryo-fetal toxicity
Pregnancy & lactation
Pregnancy
Can cause fetal harm — avoid; effective contraception during and 6 months after.
Lactation
Avoid breastfeeding during and 2 weeks after therapy.
Drug interactions
Amiodarone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arsenic Trioxide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Baricitinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bedaquiline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bepridil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Berotralstat
Severe
Database
Drug interaction classified as: absorption
Source: DDInter
Brexpiprazole
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Cabozantinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about rucaparib
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20