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Niraparib (Zejula®)

About This Drug

Niraparib is used to treat cancer. It is given orally.

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak, and raise your risk of bleeding.
  • Abnormal heart beat or palpitations.
  • Changes in your liver function. Your doctor will check your liver function as needed.
  • Nausea and vomiting (throwing up)
  • Loose bowel movements (diarrhea) that may last for a few days
  • Constipation (not able to move bowels)
  • Soreness of the mouth and throat. You may have red areas, white patches or sores that hurt.
  • Indigestion or heartburn
  • Dry mouth, change in the way food tastes
  • Loss of appetite
  • Pain in your abdomen
  • Bloating (distention)
  • Tiredness
  • Pain in your joints, muscles and back
  • Headache
  • Feeling dizzy
  • Cough and trouble breathing
  • Inflammation of the nose/pharynx. Symptoms may include cough and runny nose.
  • High blood pressure. Your doctor will monitor your blood pressure as needed
  • Rash
  • Urinary tract infection. Symptoms may include:
    • Pain or burning when you pass urine
    • Feeling like you have to pass urine often, but not much comes out when you do.
    • Tender or heavy feeling in your lower abdomen
    • Cloudy urine and/or urine that smells bad
    • Feeling nervous or worried (anxiety)
    • ​Trouble sleeping

Note: Each of the side effects above was reported in 10% or greater of patients treated with niraparib. Not all possible side effects are included above.

Warnings and Precautions

  • ​This drug may raise your risk of getting a second cancer.

How to Take Your Medication

  • Swallow the medicine whole with or without food. Take your medicine at approximately the same time every day. Taking your medicine in the evening may help lessen nausea.
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time. Do not take 2 doses at the same time.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease your risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • To decrease your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help increase your appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Avoid gas producing foods, such as Brussels sprouts, cabbage, cauliflower, carrots, prunes and apricots.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • Sugar-free hard candies and chewing gum can keep your mouth moist
  • Taking good care of your mouth may help food taste better and improve your appetite.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you are feeling anxious, talk to your nurse or doctor about it and they may be able to offer you some stress-relief techniques and/or support groups that may help relieve your anxiety.

​​Food and Drug Interactions

  • There are no known interactions of niraparib with food.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • A headache that does not go away
  • Blurry vision or other changes in eyesight
  • Easy bleeding or bruising
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Wheezing or trouble breathing
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • No bowel movement in 3 days or when you feel uncomfortable
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Pain that does not go away, or is not relieved by prescribed medicines
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • Pain or burning when you pass urine
  • Difficulty urinating
  • Feeling like you have to pass urine often, but not much comes out when you do
  • Tender or heavy feeling in your lower abdomen
  • Cloudy urine and/or urine that smells bad
  • Pain on one side of your back under your ribs. This is where your kidneys are
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • If you think you are pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. It is recommended that effective methods of birth control should be used women of child bearing potential during cancer treatment and for at least 6 months after treatment.
  • Breast feeding warning: Women should not breast feed during treatment and for 1 month after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

New: June 2017

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