3 Ways to Manage Lynparza/Olaparib-Induced Fatigue Ovarian Cancer
"The goal of cancer treatment is to shrink the tumor and control its growth for as long as possible. This can be accomplished in a variety of ways, such as chemotherapy and targeted therapy, which is a prescription medication that works by targeting the cancer cell’s pathways."
Lynparza/Olaparib-Induced Fatigue Ovarian Cancer:
Prior to initiating Olaparib (Lynparza), all patients should be screened for fatigue in order to establish a baseline patient should be well educated that fatigue is one of the most common side effects of a Lynparza.
Fatigue tends to decrease over time. In our experience, fatigue tends to decrease over the first four to six weeks after initiation. Patients should be instructed that dose modifications or dose interruptions may be required in order to keep patients on Olaparib (Lynparza) as long term therapy as clinically indicated.
When a patient on Olaparib (Lynparza) experiences increased fatigue, she should be evaluated for underlying causes of fatigue. Underlying causes of fatigue include anemia, hypothyroidism, depression, anxiety, insomnia and electrolyte imbalances. Underlying causes of fatigue should be treated appropriately and treated with medication and or supportive care as indicated.
If the workup reveals no underlying cause of fatigue, you should start with non-pharmacological approaches to help manage patient's symptoms. Underlying causes of fatigue should be treated appropriately, as indicated with medication or other supportive treatments as indicated.
Stop and go
If the workup reveals no underlying causes of fatigue, start with non-pharmacological approaches for managing patient symptoms. Non pharmacological interventions the provider can try are encouraging patients to have periods of rest and activity.
Encourage exercise such as walking aerobics, as tolerated, encouraged mindfulness based approaches such as yoga, acupuncture, massage, reiki, and encouraging the patient to stay well hydrated and well nourished.
Sleep is good as well ...
You can also encourage the patients to take small 1.5 hour nap per day.
If your patients fatigue persists despite supportive measures. In treating all potential underlying cause of fatigue, Olaparib (Lynparza) should be held and then restarted at the same dose or reduced dose once the toxicity resolves to grade one or less. For patients with mild fatigue at baseline, the recommended starting dose of Olaparib (Lynparza) of is 300 milligrams BID.
If your patient's fatigue increases while on Olaparib (Lynparza) 300 milligrams BID and all other underlying causes have been ruled out and supportive measures have been implemented. You may want to consider holding Olaparib (Lynparza) for a week or longer to let the fatigue return to baseline.
At that point, you may start the drug at the same dose or a reduced dose. The first dose reduction we typically use is 250 milligrams BID. The second dose reduction that we use is 200 milligrams BID.
For patients who have moderate fatigue at baseline. We often start Olaparib (Lynparza) at a lower dose such as 200 milligrams BID. After a period of two to four weeks once the patient acclimates to the drug. You may be able to dose escalate the drug as tolerated.