Talazoparib capsules are prescribed to treat either locally advanced breast cancer or breast cancer that has spread to other body parts in adult patients with known or suspected specific gene (gBRCA) mutations.
Patients who are selected for talazoparib treatment should not be treated with more than 3 chemotherapy regimen previously.
Talazoparib works by blocking the action of a particular enzyme (PARP) that is involved in numerous cellular responses.
Talazoparib should not be used in patients-
If there is an allergy to talazoparib
Pregnant or breastfeeding women
Males who undergo treatment to correct infertility
Talazoparib should not be used in children below 18 years of age as the safety and the effectiveness of talazoparib were not tested in these age groups.
Extreme caution is required while giving talazoparib to patients with moderate to severe liver damage or kidney disease.
The recommended dose of talazoparib is 1mg taken once a day.
For patients with kidney disease, the recommended dose is 0.75 mg once a day.
Talazoparib is also available in 0.25 mg capsule form for the convenience of dose reduction treatment.
The dose of talazoparib can be adjusted based on the severity of the side effects experienced by the patient.
Initially, the dose can be reduced to 0.75 mg (three 0.25 mg capsules) once daily if any intolerable side effects occur followed by 0.5 mg (two 0.25 mg capsules) once daily if further dose reductions are necessary.
Talazoparib dose can be again reduced to 0.25 mg once a day if the side effects are severe. The treatment can be discontinued permanently if further dose reductions are required.
Treatment with talazoparib must be continued in patients who never show any disease progression or when the treatment with the drug does not result in intolerable toxicity.
If the patient either vomits or misses a dose of talazoparib, do not take one more capsule or additional dose.
The next capsule should be taken at its usual prescribed time probably the next day as per the schedule.
Talazoparib comes as a capsule to be taken by mouth either with or without food.
Never open or chew the talazoparib capsule but swallow as a whole with a sufficient quantity of water.
Caution should be given for patients with a history of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) and stop the treatment with talazoparib permanently if MDS/AML is confirmed.
Patients given talazoparib should be monitored for the complete blood counts (red blood cell, white blood cell, and platelets) before starting the treatment followed by every month thereafter.
If the patients blood count reduces or if the patient does not recovers with dose reduction after 4 weeks, it is necessary to refer the patient to a hematologist who may order for a bone marrow analysis and gene study.
Do not start the treatment with Talazoparib until the patients have completely recovered from blood and related disorders caused by previous cancer treatment.
Women in reproductive age are advised to use proper contraception during treatment with talazoparib and should continue the contraception for at least 7 months following the last dose.
Breastfeeding is not advised during talazoparib treatment and should not start for at least 1 month after taking the last dose.
The most common side effect of talazoparib is fatigue or tiredness.
Few other side effects reported were:
Blood: Low blood counts (anemia, neutropenia, low platelets or thrombocytopenia)
Gastrointestinal: Nausea, vomiting, diarrhea, abdominal pain
Nervous system: Headache
Others: Alopecia or hair loss, decreased appetite
Male patients with active female partners must follow effective contraception during the treatment and for at least 4 months after stop taking talazoparib to avoid unwanted pregnancy.
Male patients wishing to have a child in future can use sperm bank services before starting the treatment as talazoparib can affect their fertility status.
Women taking talazoparib should be advised to consult their doctor immediately if they become pregnant during the talazoparib therapy.
Co-administration of talazoparib with drugs like amiodarone, carvedilol, clarithromycin , itraconazole, and verapamil can increase the level of Talazoparib in the blood resulting in overdose or toxicity.
If the co-administration with these drugs cannot be avoided, monitor the patients for their potential side effects and treat accordingly.
Store talazoparib capsules at room temperature between 20°C to 25°C (68°F to 77°F).
Keep talazoparib capsules away from the reach of children.
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