Olaparib is an oral anticancer medicine classified as a poly(ADP-ribose) polymerase (PARP) inhibitor. It is designed to interfere with DNA-repair processes and is used in specific cancer-treatment settings where inhibition of PARP can provide a therapeutic advantage.
Olaparib is not appropriate for all cancers or all patients. Its clinical use depends on the patient’s diagnosis, disease stage, previous treatment, molecular or genetic findings where relevant, organ function, concomitant medicines, and the applicable prescribing information.
The 150 mg tablet strength is featured on this website through two branded products:
- Olanib 150 mg — Everest Pharmaceuticals Ltd.
- Olakin 150 mg — Ziska Pharmaceuticals Limited
Both products contain olaparib 150 mg as the active pharmaceutical ingredient.
Pharmacological Class
Olaparib belongs to the class of medicines known as PARP inhibitors.
PARP enzymes participate in cellular responses to DNA damage. By inhibiting PARP activity, olaparib interferes with certain DNA-repair processes. Olaparib can also promote retention of PARP proteins on DNA, commonly referred to as PARP trapping.
The combined effects can increase DNA damage within susceptible cancer cells.
This mechanism is particularly relevant to tumors that already have deficiencies in other DNA-repair pathways.
DNA Repair and Cancer
DNA is continuously exposed to damage from normal cellular processes and environmental factors. Healthy cells have multiple mechanisms for identifying and repairing this damage.
Cancer cells also rely on DNA-repair pathways to survive the genetic instability associated with uncontrolled growth.
Some cancers contain defects in pathways responsible for repairing double-stranded DNA damage. One important pathway is homologous recombination repair.
BRCA1 and BRCA2 are important components of this repair system.
When cancer cells have significant defects in homologous recombination, they may become more dependent on alternative repair mechanisms, including pathways involving PARP.
Olaparib exploits this biological vulnerability in appropriately selected patients.
Synthetic Lethality
The therapeutic principle behind PARP inhibition is often described as synthetic lethality.
In simplified terms, a cancer cell may already have one important DNA-repair pathway that is defective. If treatment blocks another pathway on which the cancer cell depends, the combined loss of repair capacity can become lethal to the cancer cell.
Normal cells may retain functioning alternative repair mechanisms and therefore may be less vulnerable to this particular combination of defects.
However, normal tissues can still be affected by olaparib. This explains why patients can experience adverse effects during treatment.
BRCA1 and BRCA2
BRCA1 and BRCA2 are genes involved in DNA repair.
Harmful changes in these genes can impair homologous recombination repair and may make certain cancers more sensitive to PARP inhibition.
BRCA mutations can be classified according to where they are detected.
Germline BRCA Mutation
A germline mutation is present in cells throughout the body and can be inherited.
A germline BRCA mutation may have implications for:
- Cancer-treatment selection
- Risk of developing certain cancers
- Genetic counseling
- Testing of appropriate family members
Somatic BRCA Mutation
A somatic mutation develops in cells during a person’s lifetime and may be present specifically in tumor tissue.
A somatic BRCA alteration can provide clinically relevant information for certain treatment decisions, but it is different from an inherited germline mutation.
Patients should discuss genetic results with their oncology team and, when appropriate, a genetics professional.
Homologous Recombination Deficiency
Homologous recombination deficiency (HRD) describes impaired function of the homologous recombination DNA-repair system.
HRD can arise from different genetic or molecular abnormalities.
In some olaparib treatment settings, HRD status can help identify patients who may be appropriate for treatment, sometimes together with BRCA mutation status.
The exact definition and testing requirements for HRD vary according to the cancer type and treatment indication.
A positive biomarker result does not by itself replace a complete clinical assessment.
Clinical Uses of Olaparib
Depending on the applicable regulatory approval, olaparib has clinical uses in selected patients with certain forms of:
- Ovarian cancer
- Fallopian tube cancer
- Primary peritoneal cancer
- HER2-negative breast cancer
- Pancreatic adenocarcinoma
- Metastatic castration-resistant prostate cancer
- Certain additional cancers or treatment combinations in specific jurisdictions
The approved indications are not identical in every country.
For example, the U.S. prescribing information and European regulatory information contain overlapping but not completely identical treatment settings.
Healthcare professionals should therefore use the prescribing information applicable to the patient’s country and specific product.
Maintenance Therapy
A major clinical role for olaparib is maintenance treatment.
Maintenance therapy is generally given after another treatment has produced a response or controlled the disease.
In selected cancers, olaparib may be continued to delay disease progression after a favorable response to previous platinum-based chemotherapy or another appropriate treatment.
The objective is to maintain disease control rather than to treat every patient with the same fixed duration or schedule.
Treatment duration can vary according to the indication and the patient’s clinical circumstances.
Clinical Selection in Ovarian Cancer
For certain advanced epithelial ovarian, fallopian tube, and primary peritoneal cancers, olaparib may be used as maintenance therapy after a complete or partial response to platinum-based chemotherapy.
In some indications, a relevant BRCA mutation is required.
In other settings, olaparib may be used with bevacizumab when the tumor meets specified HRD-related criteria.
For recurrent disease, eligibility may depend on the presence of a relevant BRCA mutation and response to platinum-based chemotherapy.
The patient’s previous treatment history is therefore an important part of the clinical decision.
Clinical Selection in Breast Cancer
Olaparib has an established role in selected HER2-negative breast cancers associated with germline BRCA mutations.
In high-risk early breast cancer, it may be used as adjuvant treatment after appropriate neoadjuvant or adjuvant chemotherapy.
In metastatic breast cancer, it may be used as systemic treatment in appropriately selected patients.
Clinical selection requires consideration of factors such as:
- Germline BRCA status
- HER2 status
- Disease stage
- Previous chemotherapy
- Previous systemic treatments
- Overall health
- Other available treatment options
Clinical Selection in Pancreatic Cancer
In certain jurisdictions, olaparib is used as maintenance treatment for selected patients with metastatic pancreatic adenocarcinoma and a germline BRCA1/2 mutation following appropriate platinum-based chemotherapy.
The purpose of treatment is to help maintain disease control in patients who have responded appropriately or whose disease remains controlled after platinum therapy.
Not all pancreatic cancers have BRCA-related DNA-repair abnormalities, so molecular testing can be clinically important when considering this treatment.
Clinical Selection in Prostate Cancer
Olaparib is used in selected patients with metastatic castration-resistant prostate cancer whose tumors have specific alterations involving DNA-repair pathways.
A BRCA mutation is an important example of a clinically relevant alteration.
In certain approved settings, olaparib may be combined with abiraterone and prednisone or prednisolone for appropriate patients with BRCA-mutated disease.
The selection of treatment depends on the patient’s molecular results, prior treatment, disease status, and the approved regimen being considered.
Dose and Clinical Exposure
For applicable adult tablet indications, the standard recommended olaparib dose is commonly 300 mg twice daily.
The 150 mg tablet can therefore be used as two tablets per dose when the full 300 mg dose is prescribed.
However, the dose may need to be reduced because of:
- Moderate renal impairment
- Adverse reactions
- Certain clinically important drug interactions
- Other patient-specific considerations
The dose should always be determined by the treating healthcare professional.
Pharmacokinetic Considerations
Olaparib is absorbed following oral administration and undergoes metabolism involving several pathways, including CYP3A.
This makes interactions with CYP3A inhibitors and inducers clinically important.
Strong or moderate CYP3A inhibitors can increase olaparib exposure.
Strong or moderate CYP3A inducers can decrease olaparib exposure and may reduce its effectiveness.
Because of these interactions, healthcare professionals should review all medicines being taken by a patient before and during olaparib therapy.
Kidney Function
Kidney function is an important clinical consideration.
The U.S. prescribing information recommends a reduced olaparib dose for patients with moderate renal impairment, defined as creatinine clearance of 31–50 mL/min.
Patients with kidney disease should inform their oncology team before starting treatment.
Kidney function may be assessed through blood testing and estimated creatinine clearance or another clinically appropriate method.
Patients should not change their dose independently based on a laboratory result.
Hematologic Monitoring
Olaparib can cause decreases in blood-cell counts.
Healthcare professionals commonly monitor complete blood counts during treatment.
Monitoring can help identify:
- Anemia
- Neutropenia
- Leukopenia
- Thrombocytopenia
Patients receiving long-term treatment may require continued periodic monitoring.
If significant blood-count abnormalities occur, the healthcare team may interrupt treatment, reduce the dose, investigate the cause, or provide appropriate supportive management.
Myelodysplastic Syndrome and Acute Myeloid Leukemia
An important but uncommon safety concern associated with olaparib and other PARP inhibitors is myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
The risk is considered clinically important because these are serious disorders of the blood and bone marrow.
Persistent or unexplained blood-count abnormalities should therefore be investigated appropriately.
A patient should not assume that ongoing anemia or other blood abnormalities are simply an expected side effect of treatment.
Pneumonitis
Olaparib can also cause pneumonitis, an inflammatory condition affecting the lungs.
Patients should report new or worsening respiratory symptoms such as:
- Shortness of breath
- Difficulty breathing
- Persistent cough
- Chest discomfort
- Unexplained respiratory changes
Prompt clinical assessment may be necessary to determine the cause.
Pregnancy Considerations
Olaparib can cause fetal harm.
Pregnancy status and reproductive considerations should be discussed with the healthcare professional before treatment begins.
Patients who can become pregnant should receive appropriate advice regarding contraception during treatment and after treatment according to the applicable prescribing information.
Patients should contact their healthcare professional if pregnancy occurs during treatment.
Breastfeeding
Breastfeeding is not recommended during olaparib treatment and for the specified period after treatment according to the applicable prescribing information.
Patients who are breastfeeding or planning to breastfeed should discuss the situation with their healthcare professional before starting treatment.
Clinical Monitoring of Treatment Response
Monitoring does not only involve checking for side effects.
The oncology team may also evaluate whether the cancer is responding to or remaining controlled by treatment.
Depending on the cancer, monitoring may involve:
- Clinical examination
- Symptoms and functional status
- Blood tests
- Tumor markers were clinically useful
- Imaging studies
- Genetic or molecular information
- Assessment of adverse effects
The exact monitoring schedule depends on the cancer type and treatment plan.
What Clinical Response Means
A clinical response can have different meanings depending on the treatment setting.
A tumor may shrink, remain stable, or show progression.
In maintenance treatment, the objective may be to delay progression rather than produce a large reduction in tumor size.
Therefore, a patient should not judge treatment effectiveness solely by how they feel or by whether the tumor immediately becomes smaller.
The oncology team interprets imaging, laboratory results, symptoms, and other clinical information together.
Treatment Adherence
Consistent use of prescribed olaparib is important.
Patients taking twice-daily therapy should aim to follow the prescribed schedule as closely as possible.
If side effects interfere with treatment adherence, patients should inform their oncology team.
The appropriate response may be supportive treatment, dose adjustment, temporary interruption, or another clinically appropriate strategy.
Patients should not simply stop taking the medicine because of manageable side effects without discussing the problem with their healthcare team.
Clinical Drug Interactions
Before prescribing olaparib, healthcare professionals should consider medicines that may alter olaparib concentrations.
Patients should report all medications, including:
- Prescription medicines
- Over-the-counter medicines
- Vitamins
- Herbal preparations
- Dietary supplements
Particular attention should be paid to CYP3A inhibitors and inducers.
Grapefruit and Seville oranges can also affect CYP3A activity and should be avoided according to the applicable prescribing information.
Important Clinical Perspective
Olaparib is a precision-oriented cancer treatment, but it should not be described as a treatment that works for every patient with a particular cancer.
The presence of a biomarker may support treatment selection, but the complete clinical situation remains important.
A patient’s previous treatment, organ function, performance status, concurrent medicines, adverse-effect profile, and other treatment options all contribute to the final decision.
Clinical Information Summary
| Clinical Feature | Olaparib |
|---|---|
| Drug class | PARP inhibitor |
| Active ingredient | Olaparib |
| Featured strength | 150 mg tablet |
| Main biological target | PARP enzymes |
| Key mechanism | PARP inhibition and PARP trapping |
| Important biomarkers | BRCA1/2 and, in selected settings, HRD-related characteristics |
| Route | Oral |
| Common applicable adult tablet dose | 300 mg twice daily |
| Food requirement | With or without food |
| Important monitoring | Blood counts, kidney function, clinical status |
| Major interaction pathway | CYP3A |
| Important serious risks | MDS/AML, pneumonitis, embryo-fetal toxicity |
| Treatment role | Selected treatment and maintenance settings |
Final Clinical Perspective
Olaparib represents an important approach to cancer treatment based on the concept that some tumors depend heavily on DNA-repair pathways for survival.
By inhibiting PARP, olaparib can interfere with DNA repair and exploit vulnerabilities in selected cancer cells. This is particularly relevant to tumors with BRCA-related or other homologous recombination repair abnormalities.
Clinical use must remain individualized.
The decision to prescribe olaparib should be based on the patient’s specific cancer diagnosis, applicable treatment indication, biomarker information where required, previous treatment, kidney function, potential drug interactions, and overall medical condition.
Olanib 150 mg and Olakin 150 mg are 150 mg olaparib products featured on this website. Their use should follow the prescribing instructions provided by a qualified healthcare professional and the applicable product information.
This clinical information is educational and should not replace professional medical judgment, current prescribing information, or individualized oncology care.