Zejula Tablets (Niraparib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Zejula Tablets Used For?
Zejula contains niraparib, a type of anti-cancer medicine called a PARP inhibitor used to treat certain types of cancer in adults.
Primary Uses
Zejula is used to treat cancer of the ovary, fallopian tubes, or peritoneum (membrane lining the abdomen) that has responded to first treatment with platinum-based chemotherapy, or has come back (recurred) after responding to previous standard platinum-based chemotherapy treatment.
How It Works
Niraparib blocks an enzyme called PARP (poly adenosine diphosphate-ribose polymerase). PARP helps cells repair damaged DNA, so blocking it means that cancer cell DNA cannot be repaired. This results in tumor cell death, helping to control the cancer.
Good to know: This medicine is available only with a doctor’s prescription and your doctor will check you regularly while you’re taking it.
How to Take Zejula Tablets
Follow all directions given by your doctor or pharmacist carefully. Take Zejula at approximately the same time each day.
Dosage Instructions
The recommended starting dose is 2 tablets taken together once a day (total daily dose of 200 mg). For some patients, a starting dose of 300 mg (3 tablets) may be appropriate. Your doctor may recommend a lower dose if you experience side effects. Swallow tablets whole with water – do not open, chew or crush them. You can take with or without food. Taking at bedtime may help manage nausea.
What If You Miss a Dose?
If you miss your dose at the usual time, take your next dose at its scheduled time. Do not take an additional dose if you miss a dose or vomit after taking Zejula. Do not take a double dose to make up for the missed dose as this may increase the chance of side effects.
Important: Never double dose if you miss a dose or vomit after taking Zejula – this increases the risk of unwanted side effects.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Tiredness and weakness
- Nausea, stomach pain, vomiting
- Constipation, diarrhea, indigestion
- Decreased appetite
- Inability to sleep
- Headache, dizziness
- Runny or stuffy nose
- Shortness of breath, cough
- High blood pressure
- Urinary tract infection
- Heart palpitations
- Back pain and joint pain
Seek immediate medical attention if you experience:
- Bruising or bleeding for longer than usual (low platelet count)
- Shortness of breath, extreme tiredness, pale skin, fast heartbeat (low red blood cell count/anemia)
- Fever or infection (low white blood cell count)
- Low blood cell counts due to bone marrow problems or blood cancer (MDS or AML)
- Kidney problems: fatigue, weakness, nausea, vomiting, loss of appetite, changes in urination, swelling in legs/ankles/feet
- Allergic reactions including life-threatening anaphylaxis (difficulty breathing, low blood pressure, organ failure)
- Posterior Reversible Encephalopathy Syndrome (PRES): headache, vision changes, confusion, seizure
Important Warnings
There are several important warnings and precautions to be aware of before and while taking Zejula.
Who Should Not Take Zejula Tablets
Do not use Zejula if you are allergic to niraparib, lactose, or any ingredients in the medicine. Do not take if you are pregnant, intend to become pregnant, or are breastfeeding.
Medical Conditions to Discuss
Tell your doctor if you have low blood counts, high blood pressure, myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), or posterior reversible encephalopathy syndrome (PRES). Zejula can lower blood cell counts and cause high blood pressure. Your doctor will monitor your blood regularly and blood pressure throughout treatment.
Pregnancy and Breastfeeding
Zejula can harm your unborn baby and may cause miscarriage. Women who could become pregnant must use highly effective contraception while taking Zejula and for 6 months after the last dose. Do not breastfeed while taking Zejula and do not begin breastfeeding until 1 month after your last dose.
Blood Count Monitoring: Your doctor will test your blood weekly for the first month, then monthly for 10 months, and periodically afterwards to monitor for serious blood-related side effects.
Drug Interactions
Some medicines may interfere with Zejula and affect how it works. Tell your doctor about all medicines you’re taking.
- Cyclosporin and tacrolimus (organ transplant medicines)
- Alfentanil (pain medicine)
- Ergotamine (migraine medicine)
- Pimozide, quetiapine, and clozapine (mental disorder medicines)
- Halofantrine (malaria medicine)
- Theophylline (asthma medicine)
- Ropinirole (Parkinson’s disease medicine)
- Irinotecan (cancer medicine)
- Rosuvastatin, simvastatin, and atorvastatin (cholesterol medicines)
- Methotrexate (cancer, arthritis, or psoriasis medicine)
- Metformin (diabetes medicine)
Alcohol & Driving
Zejula may affect your ability to drive or operate machinery safely.
Alcohol
No specific alcohol interactions mentioned in the source material. Consult your doctor about alcohol consumption while taking Zejula.
Driving and Operating Machinery
Zejula may cause dizziness, tiredness, difficulty concentrating, or weakness. If you experience any of these symptoms, do not drive, operate machinery, or do anything else that could be dangerous until you know how Zejula affects you.
Storage
Keep Zejula tablets in the original pack in a cool, dry place where the temperature stays below 30°C. Keep away from moisture, heat, and sunlight. Do not store in the bathroom, near a sink, in the car, or on windowsills. Keep where children cannot reach it – a locked cupboard at least one-and-a-half meters above the ground is recommended.
Overdose Information
If you think you have taken too much Zejula, you may need urgent medical attention. Immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital, even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
Zejula works by blocking cancer cell DNA repair, leading to tumor cell death. Your doctor will monitor your progress regularly and you will normally continue taking Zejula until disease progression, as long as you don’t suffer unacceptable side effects.
Yes, it doesn’t matter if you take Zejula with or without food. You can take it either way according to your preference.
If you miss your dose at the usual time, take your next dose at its scheduled time. Do not take an additional dose if you miss a dose or vomit after taking Zejula. Never take a double dose to make up for a missed dose.
Do not stop taking Zejula suddenly or change the dosage without checking with your doctor. If you stop taking it suddenly, your condition may worsen. Your doctor may interrupt your treatment or reduce your dose if you are having unwanted side effects.
Take Zejula at approximately the same time each day. Taking it at bedtime may help you manage nausea, which is a common side effect.
Your doctor will test your blood weekly for the first month, then monthly for 10 months, and periodically afterwards to monitor for blood-related side effects and ensure the medicine is working safely.
No, Zejula can harm your unborn baby and may cause miscarriage. Women who could become pregnant must use highly effective contraception while taking Zejula and for 6 months after the last dose. Contact your doctor immediately if you become pregnant while taking this medicine.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.