olaparib dosage adjustments

[Goodgirl98]

when I first started olaparib 4 months back, my Haemoglobin and platelets dropped significantly. I was asked to take 2 tabs (150mg each) twice a day. When haem dropped to 6.8, my doc reduced the dose to 1tab *2 and put me on iron supplement.

Day before, haem went Upto 11, hence he has upped my dose to 2 tabs in morning and 1 at night. I have 2 questions:

1. I was feeling so good on the lower dose and hoped to continue with it. But does lower dose mean lower efficacy, is that why they bump to the optimal one? When I asked the doc this q earlier when he lowered the dose, he said no, don’t worry, let’s reduce the toxicity in your body first.

2. My side effects are minimal but the drowsy, unwell feel is a major irritant (on the higher dose). How did you react to it? Does the body settle in and accept the drug some time or should I accept this is the way it is will be during its usage?

[Katmal-UK]

Hi. I ill have been on Olaparib 9 years in just over 2 weeks time. My experience is that the side effects do become more tolerable. I continued to work full time up until I was made redundant last Christmas. As to efficacy at a lower dose I know of a lot of ladies who have done well on it . There is a facebook group for Olaparib/Lynparza which you may find useful . Good luck, Kathy x

[Goodgirl98 in reply to Katmal-UK]

thanks so much for the reassurance. I will check out the group.

[Lyndy2]

Hello, it’s true that the body does adapt to it over time. These drugs are still pretty new and I think oncologists are trying to find the sweet spot for patients between efficacy and side effects. I wanted to start low and build up the dose but the instruction (from NHS and drug companies) is to start high and reduce if the patient doesn’t cope. This is not a patient centred approach as many suffer with side effects and even more are frightened by the possible effects. I hope you find a balance with it xx

[Goodgirl98 in reply to Lyndy2]

That’s been my experience as well that docs are allowed to reduce toxicity only if critical parameters go way down. I don’t get it how it is not based on gender/height/weight as generally done. Had a tough day today with nausea and dysentery; hope it settles in within a week.

[Trickysite]

Common story. I am nowon 400 mg. per day and drink Spatone iron and eat liver, red meat etc. I am small and lightweight. It is NHS protocol to start all on 600mg. I hear there is no evidence fir lower efficacy on reduced dose. My iron kept dropping on higher doses and had to have blood transfusions. Now stable. Good luck.

[Goodgirl98 in reply to Trickysite]

Glad to hear you were able to find the dosage that works for you. Thanks for your response.

[meadowgirl]

I started on Olaparib in August 2022 on recommended dose of 300mg twice daily. By the second round I felt so exhausted and sick all the time I felt like life wasn’t worth living. I put a post on Ovacome and got several helpful replies. My Oncologist dropped the dose to 200mg twice daily and I really feel like my old self. Someone sent me a link to research that suggests that if you weigh less than 70kg, you can drop the dose, I guess a lower body weight requires less of the drug. I shall be watching my Ca 125, which is currently 13. If it starts creeping up I may have to consider upping the dose. All the best to you x

[Goodgirl98 in reply to meadowgirl]

I am glad to hear there is some research linked to body weight. I am guessing the studies are not mature yet and hence they are going with a one size fits all approach now! So sorry to hear you felt so sick before dropping the dosage. Glad that you are ok now and wishing you the best.

[Miliwife]

Thanks Ladies, these posts have been really helpful for me. I also started Olaparib in August 22 on 600 mg per day but my RBC and haemoglobin has fallen through the floor (twice now following a little break) so the oncologist said we need to reduce the dose. I have been so fatigued and also had nausea/vomiting etc. It was worse than chemo (and being pregnant!). I too was worried about efficacy but reading this has encouraged me that I will start to feel better after what has been a dreadful year. I weigh about 63 kg and am 5 ft 5, so maybe it is connected with weight/height etc. BTW I didn't know you could stay on Olaparib for 9 years? I thought it was 2 and then they take you off it - I know it is a super expensive drug so didn't think the NHS would give patients any more than they had to? Happy Christmas everyone.

[Kblaisel]

I was on Olaparib for 10 months and have been on Niraparib for 4 months ( both in clinical trials). My understanding is that the dose is based on weight and platelet count. I was put on the lower dose and never had side effects, except perhaps fatigue, but that could just be my age, the darkness now and cold bleak weather😞

[delia2]

Hi. I’ve been on Olaparib for 32 months at a reduced dose-400/day for a year, now 300 for a year and a half. I had some cancer left when I started it and it got me to ned.