Olaparib should be taken with meals to improve tolerance; The dosage adjustment is mainly based on toxicity grading, with the first reduction to 250mg and the second reduction to 200mg; the decision to discontinue should be based on disease progression, severe toxicity, or ILD. All adjustments must be made under the guidance of a physician and cannot be changed by oneself.

1、 Fasting or with meals?

It is recommended to take it with meals as a priority to reduce digestive reactions such as nausea and stomach discomfort.

If there is no obvious discomfort when taking on an empty stomach, it can also be taken on an empty stomach, but it needs to be taken at a fixed time every day to maintain consistency.

Swallow whole pill, do not crush, chew or dissolve.

2、 Principle of dose adjustment

2.1 Standard starting dose

300mg， Twice daily (capsule dosage form) or 300mg, twice daily (tablet), follow the doctor's advice.

2.2 Reduction related to adverse reactions

Grade ≥ 3 hematological toxicity (such as neutropenia and thrombocytopenia):

First reduction: Reduce to 250mg twice a day.

Secondary reduction: Reduce to 200mg, twice a day.

Non hematological toxicity (such as nausea and fatigue) ≥ grade 3 and lasting>48 hours can also be considered for gradual reduction.

2.3 Abnormal liver or kidney function

Moderate to severe liver dysfunction (Child Pugh B/C): Not recommended for use.

Severe renal insufficiency (CrCl<30mL/min): Not recommended for use; CrCl 30-50mL/min can be reduced to 200mg twice a day.

3、 Suggestion for discontinuation of medication

3.1 Disease progression

If there is clear progress in imaging or clinical studies and no sustained benefit, the medication will be permanently discontinued.

3.2 Intolerable toxicity

After two reductions, there were still ≥ grade 3 adverse reactions and the medication was permanently discontinued.

3.3 Interstitial lung disease (ILD)

Diagnosed or highly suspected of ILD, immediately and permanently discontinue medication, do not restart.

3.4 Planned Surgery

Stop taking medication at least 3-5 days before scheduled surgery, and wait for the wound to heal well (usually ≥ 1 week) before recovery after surgery.