Zejula (niraparib)

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Different classes of drugs are used to treat ovarian cancer, including targeted therapy. Targeted therapy is a type of cancer treatment that targets proteins in cancer cells that help the cancer grow, divide, and spread. Targeted therapy drugs identify these specific proteins and attack the cancer cells while trying to minimize damage to healthy cells.1

Zejula (niraparib) is a targeted therapy drug. It is used as a maintenance therapy drug for certain forms of advanced or recurrent (returned after treatment) epithelial ovarian cancer in people who have had a complete or partial response to platinum-based chemotherapy.2

Zejula is also used to treat other cancers. These include certain forms of fallopian tube and primary peritoneal cancer.2

What are the ingredients in Zejula?

The active ingredient in Zejula is niraparib.3

How does Zejula work?

Zejula is a targeted therapy drug that belongs to the drug class of PARP inhibitors. PARP (poly(ADP)-ribose polymerase) proteins play an important part in the life of a cell. When DNA in cells is damaged, PARPs help fix the damage, allowing the cell to live.2

BRCA genes also play a role in repairing damaged DNA. However, some types of ovarian cancer are caused by mutations in the BRCA genes. When this happens, the cancer cells need the PARP to grow and divide.2

PARP inhibitor drugs like Zejula make it hard for tumors to repair DNA that has been damaged. This can result in cancer cell death, instead of more cancer cells. Zejula works in ovarian cancer cells with and without BRCA mutations.2

What are the possible side effects of Zejula?

The most common side effects of Zejula include:3,4

  • Fatigue
  • Irregular heart beat
  • Decreased appetite
  • Shortness of breath
  • Headache
  • Dizziness
  • Anxiety
  • Mouth sores
  • Urinary tract infection
  • Rash
  • Low white blood cell, red blood cell (anemia), and platelet counts
  • Insomnia
  • Nausea, vomiting
  • Diarrhea, constipation
  • Indigestion/heartburn
  • Muscle pain
  • Cough
  • Hypertension

There are less common but very serious side effects that can occur with Zejula. These include bone marrow problems, including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Your doctor will do regular blood tests before and during treatment with Zejula to monitor you for any bone marrow problems.4

These are not all the possible side effects of Zejula. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with Zejula.

Things to know about Zejula

Zejula is not right for everyone. If you have heart problems or high blood pressure, tell your doctor. They will go over your medical history and general health situation to evaluate whether this drug may be right for you.

High blood pressure is common while taking Zejula, and this can become serious in some people. Your blood pressure and heart rate will usually be checked by your doctor at least weekly for the first 2 months, monthly for the first year, and then as needed while taking Zejula.4

Zejula can cause harm to an unborn baby and should not be given to people who are pregnant. If you can become pregnant, you should use birth control (contraception) during treatment and for a period of time after the last dose of Zejula. Talk to your doctor about the right birth control options and how long you need to use them.4

You should not also breastfeed during treatment with Zejula and for a period of time after the last dose. Talk to your doctor about the right breastfeeding options.4

Before beginning treatment with Zejula, talk to your doctor about any other health issues you have. Also tell your doctor about any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Zejula (niraparib).

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