talazoparib tosylate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
talazoparib tosylate: clinical details
Prescribing considerations
- Initiate and supervise treatment through a clinician experienced in anticancer therapy.
- For breast cancer, confirm a deleterious or suspected deleterious germline BRCA mutation using a validated test and arrange genetic counselling where appropriate.
- Review renal function, interacting medicines and recovery from previous treatment-related haematological toxicity before initiation.
Contraindications and cautions
- Hypersensitivity to talazoparib or any excipient.
- Breastfeeding.
- The combination with enzalutamide is not recommended in severe hepatic impairment because pharmacokinetics and safety are unestablished.
Monitoring
- Full blood count before treatment, monthly during treatment and when clinically indicated.
- Assess promptly for cytopenias and investigate suspected myelodysplastic syndrome or acute myeloid leukaemia.
- Renal function at baseline and during treatment as clinically appropriate.
- Pregnancy testing before treatment in patients who could become pregnant.
Clinical pharmacology
Talazoparib inhibits PARP1 and PARP2 through catalytic inhibition and PARP trapping. It is a P-glycoprotein and BCRP substrate and is eliminated mainly by renal clearance as unchanged compound.
Formulation and product differences
- The selected product is a hard capsule containing talazoparib tosylate equivalent to talazoparib.
- Capsules must be swallowed whole and must not be opened or dissolved.
talazoparib tosylate preparations and strengths
Capsule
Route: Oral
Strengths: 0.1 mg, 0.25 mg, 1 mg
talazoparib tosylate interactions
The cancer team should review prescribed, non-prescription and herbal products before treatment and whenever medicines change.
Strong P-glycoprotein inhibitors, including clarithromycin, itraconazole, ritonavir and verapamil
These can increase talazoparib exposure and adverse effects, so concurrent use should generally be avoided or specialist-managed.
Strong BCRP inhibitors, including ciclosporin and curcumin supplements
These may increase talazoparib exposure; avoid concurrent use where possible and monitor closely if unavoidable.
Carbamazepine, phenytoin and St John’s wort
These may reduce talazoparib exposure and potentially reduce its effect.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.