LYNPARZA is the only PARP inhibitor approved for the 4 types of advanced 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.”https://www.lynparza.com/what-is-lynparza.html

Lynparza/Olaparib-Induced Nausea Ovarian Cancer:

Now that’s just one of the most common side effects that women experience with Olaparib (Lynparza), and it’s particularly bothersome because it’s present on a daily basis, as opposed to the nausea of chemotherapy, which lasts for about three or four days and then subsides.

The nausea is usually mild to moderate or less than a grade two. The nausea is usually present in the first month of therapy. Most women report it within the first two weeks, but it can be as early as day three. Vomiting is far less common and is preventable if the nausea is well controlled.

Anti-emetics

Anti-emetics, diet, good hydration, dose interruption and dose reduction are all ways to manage the nausea. When we start a patient on Olaparib, Lynparza, I counsel them proactively about the possible side effects and provide a prescription for antiemetic upfront.

I start with prochlorperazine or Metoclopramide 10 milligrams every six hours on an as-needed basis for patients who are intolerant or allergic to this class of medication, then a prescription for a serotonin agonist such as ondansetron 8 milligrams every eight hours is provided along with a bowel management plan.

Olanzapine

Olanazapine

If the nausea is not well controlled, then holding the drug for one to two days after the nausea subsides has usually has a resetting effect, and the drug can be restarted. If the nausea persists, then I recommend olanzapine 2.5 to five milligrams, once daily.

Olanzapine has the added benefit of helping with sleep when taken in the evening. Dietary measures include small frequent meals, avoiding rich or fatty foods, and hydration with at least 60 ounces of fluid per day. Olaparib (Lynparza) can be taken with or without food, but for women who experience nausea after dosing than a snack or a small meal before taking the medication is useful.

Ginger+H2 blocker

Ginger tea, ginger candy, flat ginger ale or cola helps some women, I add an H2 blocker like Famotidine, if there’s a component of indigestion along with the nausea. 

Stop and re-evaluate

If the nausea is not well controlled after escalation of antiemetic or holding the drug, then a dose reduction is appropriate and usually solves the problem. The key is to have a plan in place before the medication is started and to adjust it for each individual.

NCCN guidelinesPARP inhibitorsBRCAOvarian cancerOlaparib_Patient_Education