Having successfully defended his Indian Wells title in March and reached the Miami Open quarter-finals, Alcaraz injured his right forearm during a practice session in Monaco and he continues to struggle with the problem that has derailed the start of his claycourt season.

The Spaniard's bid to become the first player to win three straight Madrid Open titles also failed as he suffered a 4-6, 6-3, 6-2 loss to Russian Andrey Rublev in the quarter-finals on Wednesday.

"I felt some pain after playing in Madrid, some discomfort in my arm," Alcaraz posted on social media platform X. "Today I did some.

"Unfortunately, I will not be able to play in Rome. I need to rest so I can recover and play 100% pain free. I am very sorry, I will see you next year."

The Italian Open, an ATP Tour Masters 1000 event, runs from May 8-19.