Considerations in the management of select ARs

Nervous system disorders

This information is not meant to replace the clinical judgment of the attending physician.

LYNPARZA dose management1

As part of your assessment and management of a potential adverse reaction, evaluate whether LYNPARZA dosing should be interrupted, reduced, or discontinued.

Headache

Patient counseling1,2

Advise patients that:

  • Headache is a common side effect when receiving LYNPARZA
  • Management strategies exist to aid in alleviation of the symptoms of headache
  • Communication with their care team may inform their experience on therapy
  • They should report to their healthcare provider any new or worsening symptoms they experience while taking medication

Clinical evaluation2,3

As part of your clinical evaluation, consider potential causes, including if the patient’s cancer has progressed or recurred, and evaluate appropriately.

Causes of headache may include:

  • Brain or spine tumor
  • Cancer treatments
  • Acute sinusitis
  • Meningitis
  • Medications to treat other disorders
  • Dehydration
  • Changes in sleep or lack of sleep, skipped meals, and stress

Management considerations2,4

Patients should talk with their healthcare team about management strategies, including:

  • Seeking rest in a quiet, dark room
  • Reducing stress through therapy (eg, CBT, biofeedback, massage, acupuncture)
  • Identifying causes or triggers for headaches
  • Keeping a daily log of headaches

Consider medication that may prevent and treat headaches or reduce the pain.

Dysgeusia

Patient counseling1,5

Advise patients that:

  • Dysgeusia is a potential side effect when receiving LYNPARZA
  • Management strategies exist to aid in alleviation of the symptoms of dysgeusia
  • Communication with their care team may inform their experience on therapy
  • They should report to their healthcare provider any new or worsening symptoms they experience while taking medication

Clinical evaluation5,6

As part of your clinical evaluation, consider potential causes, including if the patient’s cancer has progressed or recurred, and evaluate appropriately.

Perform a detailed history and physical exam to determine the causality of dysgeusia.

Causes of dysgeusia may include:

  • Some cancer treatments and some kinds of chemotherapy and targeted drug therapy
  • Surgery to the sinuses or nearby structures in the head
  • Side effects of cancer treatment, such as mouth sores or dryness
  • Dental or gum problems
  • COVID-19

Management considerations5

Considerations include:

  • Keep a food diary to keep track of what food works or doesn't work for you
  • Decide what tastes and smells good to you
  • Serve foods cold or at room temperature to make food tastes and smells easier to tolerate
  • Try using plastic forks, spoons, and knives and glass cups and plates to reduce metallic taste
  • If red meats taste strange, try other protein-rich foods like chicken, fish, peanut butter, beans or peas, tofu, nuts, seeds, eggs, or cheese
  • Try marinating meats in fruit juices, sweet wines, salad dressings, or other sauces
  • Flavor foods with herbs, spices, sugar, or tart flavors like lemon wedges, lemonade, citrus fruits, vinegar, and pickled food
  • Keep your mouth clean and brush your teeth to help ease bad tastes
  • Rinse your mouth with a baking soda, salt, and water mouthwash before eating to help foods taste better. (Mix 1 teaspoon salt and 1 teaspoon baking soda in 4 cups of water. Shake well before swishing and spitting.)

Dizziness

Patient counseling1,7,8

Advise patients that:

  • Dizziness is a common side effect when receiving LYNPARZA
  • Management strategies exist to aid in alleviation of the symptoms of dizziness
  • Communication with their care team may inform their experience on therapy
  • They should report to their healthcare provider any new or worsening symptoms they experience while taking medication

Clinical evaluation7,8

As part of your clinical evaluation, consider potential causes, including if the patient’s cancer has progressed or recurred, and evaluate appropriately.

Communicate with patients to assess:

  • When dizziness occurs and/or gets worse (eg, when sitting or standing up suddenly, walking, moving head, etc)
  • How long dizziness has been occurring
  • Whether there are sight or hearing issues accompanying the dizziness
  • Medications, vitamins, or supplements

Causes of dizziness may include:

  • Medications (eg, antiseizure drugs, antidepressants, sedatives, tranquilizers, and antihypertensive medications)
  • Anemia
  • Drop in blood pressure
  • Poor blood circulation
  • Low blood sugar
  • Overheating and dehydration
  • Inner ear infection or disease
  • Anxiety disorders

Management considerations7

Patients should talk with their healthcare team about management strategies, including:

  • Staying hydrated, eating healthy, getting enough sleep, and avoiding stress
  • Using a cane for stability and avoiding sudden movement
  • Avoiding driving a car or operating heavy machinery if dizziness occurs without warning
  • Avoiding caffeine, alcohol, salt, and tobacco

If no cause is found or if dizziness persists, consider recommending prescription drugs and other treatments to make symptoms more manageable.