Simple Ways to Manage Lynparza/Olaparib-Induced Nausea Ovarian Cancer






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

3 Ways to Manage Lynparza/Olaparib-Induced Fatigue Ovarian Cancer

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

Simple Ways to Manage Lynparza/Olaparib-Induced Nausea Ovarian Cancer

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

Olanzapine

Olanazapine - commons.wikimedia.org

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. 

Simple Ways to Manage Lynparza/Olaparib-Induced Nausea Ovarian Cancer

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.

Obaid

Pharmacist, CPHQ, CHQO, Quality Coordinator, Chemotherapy Preparation incharge. Graduated pharmacy school in 2009 I stood with my classmates as we recited the “Oath of a Pharmacist” in. There is one particular vow that stood out to me as we recited the Oath and I embrace this vow, “I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.” I love being a pharmacist because it allows me to use my knowledge, abilities, and talents to improve patient outcomes in the community hospital in which I am employed as the pharmacy clinical coordinator.

  • Avatar of Aurora Jennina Aurora Jennina says:

    I have been reading through your posts.. Really loved your content.
    Do you think Olanazapine alone can cover the symptoms. Is it FDA approved for this specific use?

    Another question .. about Lynparza use in breast cancer.. what is the recommended dose.? and will insurance cover it?

  • Avatar of Alvin Matienzo Alvin Matienzo says:

    will ginger caps works as well? I mean to decrease the nausea?

  • Avatar of Obaid Obaid says:

    Hello Alvin, Thanks for your question.

    A daily total of 1000 mg of ginger in a capsule preparation can be suggested by care providers as a means of decreasing pregnancy nausea and vomiting in women who tend to herbal medicines.

    this is from pubmed.

    hope that helps.

  • Avatar of Sarkis Misak Sarkis Misak says:

    I was using lynparza for my PC, but i wasnet able to get rid of the nausea after. I think i should tell me doctor about this olanzapine.
    i wonder why he didn’t start me on this?

  • Avatar of Obaid Obaid says:

    Some MDs choose not to go to olanzapine due to some fear of side effects. I’d suggest you speak with your doctor and explain the situation to them.

  • Avatar of Obaid Obaid says:

    Hello Aurora, Thanks for your questions.
    Actually Olanazapine is FDA approved for Agitation/Aggression, Bipolar disorder, Major depressive disorder and Schizophrenia.

    Yet on of the off-label uses is Chemotherapy-induced acute and delayed nausea or vomiting.
    Dose for that use is 5 or 10 mg on first day of chemo , then 5 or 10 mg once daily on days 2, 3 and 4 of post or during chemo.

    as for the other question. It varies.. however, Lynparza general dose for BC patients is 300mg twice daily untill progression or toxicity, whatever comes first. and for the insurance part; in my own community it’s covered if the case is eligible, your oncologist must provide the correct documentation to the insurance officer.

    Hope this helps.
    Sorry for the delayed response.

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