Zejula (niraparib) is a prescription drug that’s used to treat ovarian cancer. Zejula comes as an oral tablet or capsule.
Zejula is prescribed for adults who have epithelial cancer of the ovaries, fallopian tubes, or peritoneum (the lining of the abdominal cavity). All three cancers are similar and are treated the same way. (Epithelial refers to the tissue that covers the surface of organs and body cavities.)
Zejula is prescribed as a maintenance treatment. It belongs to a group of drugs called poly ADP-ribose polymerase inhibitors. Zejula is prescribed after the cancer has responded to platinum-based chemotherapy.
Zejula is usually prescribed once the cancer is advanced. Or it may also be prescribed for recurrent (repeat) cancer in adults who have a BRCA gene mutation.
To learn more about Zejula’s uses, see the “What is Zejula used for?” section below.
Zejula basics
Zejula is a brand-name medication. It contains the active ingredient niraparib. (An active ingredient is what makes a drug work.) A generic version of the drug isn’t currently available.
Like most drugs, Zejula may cause mild or serious side effects. The lists below describe some of the more common side effects that Zejula may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Zejula. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Zejula can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read the prescribing information for Zejula’s oral capsule and oral tablet.
Mild side effects of Zejula that have been reported include:
- digestion problems, including nausea, vomiting, diarrhea, constipation, and abdominal pain
- loss of appetite
- low blood magnesium level
- increased blood sugar level
- shortness of breath and cough
- fatigue (low energy)
- musculoskeletal pain
- insomnia (difficulty sleeping)
- headache
- skin rash
- dizziness
- urinary tract infection (UTI)
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Zejula can occur, but they aren’t common. If you have serious side effects from Zejula, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Zejula that have been reported include:
- high blood pressure
- cancers of the blood marrow, including myelodysplastic syndrome and acute myeloid leukemia
- low blood cell levels, including low platelet level, anemia (low red blood cell level), and low white blood cell level
- posterior reversible encephalopathy syndrome (brain injury that causes headache, seizures, decreased consciousness, and vision problems)
- obstruction of the small intestine
- heart problems, like palpitations (a feeling of skipped or extra heartbeats)
- severe allergic reaction*
* To learn more about this side effect, see the “Allergic reaction” section below.
Allergic reactionSome people may have an allergic reaction to Zejula. Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Zejula. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Zejula that’s right for you. Below are commonly prescribed dosages, but always follow the dosage your doctor prescribes.
Forms and strengths
Zejula is available as:
- a capsule in a strength of 100 milligrams (mg)
- a tablet in a strength of 100 mg, 200 mg, or 300 mg
Recommended dosages
Zejula may be prescribed for the treatment of advanced ovarian cancer or for recurrent (repeat) ovarian cancer in adults who have the BRCA gene mutation. Fallopian tube and peritoneal cancer follow the same dosing guidelines.
Dosage for advanced ovarian cancer
For maintenance treatment of advanced ovarian cancer, your dosage of Zejula depends on your body weight and platelet count, as shown in the table below. Dosages are measured in mg, body weight in kilograms (kg), and platelet counts in billions of platelets per liter of blood (× 109/L).
| Platelet count | Body weight less than 77 kg* | Body weight equal to or greater than 77 kg |
| less than 150 × 109/L | 200 mg once per day | 200 mg once per day |
| equal to or greater than 150 × 109/L | 200 mg once per day | 300 mg once per day |
* For reference, 1 kg is about 2.2 pounds (lb), so 77 kg is about 170 lb.
Your maintenance treatment with Zujula will begin within 12 weeks of your most recent platinum-based chemotherapy treatment.
Dosage for recurrent ovarian cancer
For maintenance treatment of recurrent (repeat) ovarian cancer that has a BRCA gene mutation, your doctor will likely recommend that you take 300 mg of Zejula once per day.
Your maintenance treatment with Zejula will begin within 8 weeks of your most recent platinum-based chemotherapy treatment.
Questions about taking Zejula
Below are some common questions about taking Zejula.
- Can Zejula be chewed, crushed, or split? No, you should not chew, crush, or split Zejula. You should swallow Zejula tablets or capsules whole. If you have trouble swallowing pills, you can ask your doctor or pharmacist for advice.
- Should I take Zejula with food? You can take your dose of Zejula with or without food.
- Is there a best time of day to take Zejula? Zejula can be taken at any time of day. If you experience nausea as a side effect, you may find that taking Zejula at bedtime helps prevent that feeling. Whatever time you choose to take Zejula, it’s best to take it around the same time each day. This helps keep a consistent level of the drug in your body, which helps Zejula work effectively.
- What if I miss a dose of Zejula? If you miss a dose of Zejula, take it as soon as you remember. But if it’s almost time to take your next dose, skip the missed dose and take the next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
- Will I need to take Zejula long term? Yes, you’ll usually take Zejula long term. But if your cancer gets worse or you have serious side effects, your doctor will recommend that you stop taking Zejula.
Overdose
Do not take more Zejula than your doctor prescribes. Taking more than this can lead to harmful effects.
What to do in case you take too much Zejula
Call your doctor if you think you’ve taken too much Zejula. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Find answers to some commonly asked questions about Zejula.
Does Zejula cause weight gain or hair loss?
No, neither weight gain nor hair loss were reported as side effects in studies of Zejula.
However, some people with ovarian cancer do report weight gain. Sometimes the tumor itself is the cause of the weight gain, and sometimes, it’s from constipation or fluid buildup in the abdomen.
Also, some side effects of Zejula may indirectly lead to weight gain. For example, one of Zejula’s side effects is insomnia (difficulty sleeping). When people are sleep-deprived, they tend to eat more calories than they use.
Although Zejula isn’t known to cause hair loss, chemotherapy does cause hair loss. Zejula is prescribed within 8–12 weeks of the most recent round of platinum-based chemotherapy.
If you’re experiencing weight gain or hair loss, talk with your doctor.
How does Zejula compare with Lynparza?
Both Zejula and Lynparza (olaparib) are prescribed to treat ovarian, fallopian tube, and peritoneal cancers. Lynparza is also prescribed to treat breast, pancreatic, and prostate cancers. (Zejula isn’t prescribed for these other cancers.)
Zejula and Lynparza belong to the same group of drugs and work in similar ways. Both drugs come in oral forms. Zejula comes as a tablet or a capsule, and Lynparza is available as a tablet.
They have similar side effects. For example, both drugs can cause low blood cell levels, nausea, and fatigue (low energy). But they may also have different side effects as well.
If you have other questions about how Zejula and Lynparza compare, talk with your doctor.
How does Zejula work?
Zejula works by blocking a protein called poly ADP-ribose polymerase (PARP). This protein works to repair damaged cells within your body.
Zejula stops PARP from repairing cancer cells, so the damaged cancer cells die. By blocking PARP, Zejula can help to slow or prevent cancer growth.
If you have more questions about how Zejula works, talk with your doctor or pharmacist.
Below is important information you should consider before taking Zejula.
Interactions
Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Zejula is not known to interact with other medications, herbs, supplements, foods, or alcohol. The manufacturer of Zejula didn’t look at interactions in studies of the drug.
Before starting Zejula treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Pregnancy and breastfeeding
Zejula is not safe to take during pregnancy or while breastfeeding.
At this time, there aren’t any studies to determine what effects Zejula may cause if the drug is taken during pregnancy or while breastfeeding. However, based on how Zejula works, it’s not recommended to take the drug during pregnancy or while breastfeeding.
If you can become pregnant, your doctor will recommend that you take a pregnancy test before you start treatment with Zejula. Your doctor will also recommend that you use birth control to help prevent pregnancy during your treatment with Zejula and for at least 6 months after your last dose of Zejula.
It’s not recommended to breastfeed while taking Zejula and for at least 1 month after your last dose of the medication.
Warnings
Zejula can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Zejula is a good treatment option for you.
Talk with your doctor about your health history before you take Zejula. Be sure to tell them if any of the following factors apply to you:
- heart problems
- liver problems
- high blood pressure
- past allergic reaction to Zejula or yellow 5 (a dye used to color food)
- pregnancy
- breastfeeding
Zejula is prescribed as a maintenance treatment for adults with advanced epithelial ovarian, fallopian tube, and peritoneal cancers. (Epithelial refers to the tissue that covers organ surfaces and lines body cavities.) Zejula is also prescribed for recurrent (repeat) ovarian, fallopian tube, and peritoneal cancers in adults who have a BRCA gene mutation.
Since fallopian tube and peritoneal cancers are similar to ovarian cancer, you may hear them all referred to as ovarian cancer. These cancers develop when the genetic material inside epithelial cells is damaged.
Usually, cells with genetic damage die. But with cancer cells, the damaged genetic material causes the cells to multiply (grow) rapidly. Eventually, a tumor forms. With time, the cancer cells may spread to other areas of the body.
Zejula is prescribed within 8–12 weeks of treatment with platinum-based chemotherapy. With this kind of chemotherapy, platinum-based drugs damage the cancer cells and cause them to die. It’s also thought that these drugs help to teach the immune system to attack and kill cancer cells. Zejula works by blocking a protein that repairs cancer cells.
The cause of ovarian cancer isn’t known, but risk factors include having a BRCA gene mutation and a family history of breast, uterine, ovarian, or colon cancer.
Early symptoms of ovarian cancer are often subtle and may be overlooked. Early symptoms to watch out for include bloating and digestive issues, back pain, weight loss, and menstrual changes.
If you have questions about the cancers Zejula is prescribed to treat, talk with your doctor.
Whether you have health insurance or not, cost may be a factor when you’re considering Zejula. What you’ll pay for Zejula may depend on several things, such as your treatment plan and the pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Together with GSK Oncology may also be available.
You can also check out this article to learn more about saving money on prescriptions.
Other drugs are available that can treat your condition. The following drugs are also poly ADP-ribose polymerase inhibitors and are similar to Zejula:
If you’d like to explore alternatives to Zejula, talk with your doctor. They can tell you about other medications that might work well for you.
If you have questions about taking Zejula, talk with your doctor or pharmacist. Questions you may want to ask include:
- How can I manage side effects that I experience from Zejula?
- If this medication isn’t working for me, can you increase my dose of Zejula?
- Do any of my other medications interact with Zejula?
- What should I do if I become pregnant while taking Zejula?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.