Zejula (Niraparib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Zejula Used For?
Zejula contains niraparib, a type of anti-cancer medicine called a PARP inhibitor that helps control cancer by preventing cancer cells from repairing their damaged DNA.
Primary Uses
Zejula is used in adults to treat cancer of the ovary, fallopian tubes, or peritoneum (membrane lining the abdomen). It’s prescribed for cancer that has responded to first treatment with platinum-based chemotherapy, or cancer that has come back after responding to previous standard platinum-based chemotherapy treatment.
How It Works
Niraparib blocks an enzyme called PARP (poly adenosine diphosphate-ribose polymerase). Since PARP helps cells repair damaged DNA, blocking it means cancer cells cannot repair their DNA damage. This results in tumor cell death, helping to control the cancer.
How to Take Zejula
Take Zejula exactly as prescribed by your doctor. The capsules should be swallowed whole with water and can be taken with or without food.
Dosage Instructions
The recommended starting dose is 2 capsules taken together once daily (total daily dose of 200 mg). For some patients, a starting dose of 300 mg (3 capsules) may be appropriate based on clinical assessment. Take at approximately the same time each day. Taking at bedtime may help manage nausea. Your doctor may recommend a lower dose if you experience side effects or have liver problems.
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 unwanted side effects.
Important: Never double dose to make up for a missed dose – this increases the risk of 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)
- 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)
Important Warnings
Zejula has several important warnings and precautions that you should discuss with your doctor before starting treatment.
Who Should Not Take Zejula
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 may cause high blood pressure. Rarely, it may be associated with serious bone marrow problems or a neurological condition called PRES.
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 for 1 month after your last dose, as it’s unknown if the medicine passes into breast milk.
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. Always tell your doctor about all medicines you’re taking.
- Cyclosporin and tacrolimus (prevent organ transplant rejection)
- Alfentanil (pain management)
- Ergotamine (migraine treatment)
- Pimozide, quetiapine, and clozapine (mental disorders)
- Halofantrine (malaria treatment)
- Theophylline (asthma treatment)
- Ropinirole (Parkinson’s disease)
- Irinotecan (cancer treatment)
- Rosuvastatin, simvastatin, and atorvastatin (high cholesterol)
- Methotrexate (cancer, rheumatoid arthritis, psoriasis)
- Metformin (diabetes)
Alcohol & Driving
Zejula may affect your ability to drive or operate machinery safely due to potential side effects.
Alcohol
The source material does not provide specific information about alcohol interactions with Zejula. Consult your doctor about alcohol consumption while taking this medication.
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 the medication affects you.
Storage
Keep Zejula capsules in their original pack in a cool, dry place where the temperature stays below 25°C. Store away from moisture, heat, and sunlight – not in the bathroom, near a sink, in the car, or on windowsills. Keep in a locked cupboard at least one-and-a-half meters above the ground, away from children. Do not remove capsules from the pack until it’s time to take them.
Overdose Information
If you think you have taken too much Zejula, seek urgent medical attention immediately. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital, even if you have no symptoms of discomfort or poisoning.
Frequently Asked Questions
Continue taking Zejula for as long as your doctor tells you. Your doctor will check you regularly, and you will normally continue treatment until disease progression, as long as you don’t experience unacceptable side effects.
Yes, it doesn’t matter if you take Zejula with or without food. Swallow the capsules whole with a glass of water.
If you miss your dose at the usual time, take your next dose at its scheduled time. Do not take an additional dose or double dose to make up for the missed dose, as this may increase side effects.
Take Zejula at approximately the same time each day. Taking it at bedtime may help you manage nausea.
No, do not stop taking Zejula or change the dosage without checking with your doctor. If you stop suddenly, your condition may worsen. Your doctor may interrupt treatment or reduce your dose if you’re having unwanted side effects.
Your doctor will test your blood weekly for the first month, then monthly for 10 months, and periodically afterwards to monitor for side effects and ensure the medicine is working properly.
Contact your doctor immediately if you become pregnant while taking Zejula. The medication can harm your unborn baby and may cause miscarriage, so effective contraception is essential during treatment and for 6 months after your last dose.
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.