rucaparib + ethinylestradiol + levonorgestrel

Rucaparib + ethinylestradiol + levonorgestrel is a combination of three drugs: rucaparib, a poly(ADP-ribose) polymerase (PARP) inhibitor primarily used as an antineoplastic agent in certain cancers, and ethinylestradiol plus levonorgestrel, which are commonly used oral contraceptive agents. Rucaparib works by inhibiting PARP enzymes involved in DNA repair, thus leading to tumor cell death in BRCA-mutated cancers. Ethinylestradiol acts as a synthetic estrogen, and levonorgestrel as a synthetic progestogen, interfering with ovulation and altering cervical and endometrial environments to provide contraception. This combination is not marketed as a fixed-dose product; rather, their coadministration is studied to evaluate potential pharmacokinetic and safety interactions. Clinical studies show that rucaparib weakly increases plasma exposure of ethinylestradiol and levonorgestrel, mostly through inhibition of their elimination pathways (mainly CYP3A and CYP2C9 systems); however, no clinically meaningful change in contraceptive efficacy or safety profile was detected, and dose adjustment is generally not recommended when they are coadministered[1][2][3].