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Generic name: niraparibnih-RAP-a-rib ]
Drug class: PARP inhibitors

Medically reviewed by Judith Stewart, BPharm. Last updated on Aug 25, 2022.

What is Zejula?

Zejula is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Zejula is used as a maintenance treatment to keep certain types of cancer from coming back. This includes ovarian cancer, fallopian tube cancer, or peritoneal cancer (the peritoneum is the membrane that lines the inside of your abdomen and covers some of your internal organs).

Zejula is given after you have received platinum-based chemotherapy (with cisplatin, oxaliplatin, carboplatin, or similar) and your cancer has responded to that medicine.

Zejula is sometimes used only if your cancer has a specific genetic marker (an abnormal "BRCA" gene) or other gene mutations. Your doctor will test you for this gene to determine if Zejula is right for you.


Stop taking Zejula and call your doctor at once if you have fever, frequent infections, weakness, tiredness, shortness of breath, weight loss, blood in your urine or stools, easy bruising or bleeding. These may be symptoms of bone marrow disorder and may lead to death.

You should not use Zejula if you are pregnant. Avoid pregnancy for at least 6 months after you stop using this medicine.

You should not breast-feed while using Zejula and for at least 1 month after your last dose.

Before taking this medicine

To make sure Zejula is safe for you, tell your doctor if you have ever had:

You may need to have a negative pregnancy test before starting this treatment.

Do not use Zejula if you are pregnant. It could harm the unborn baby or cause a miscarriage. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.

This medicine may affect fertility (the ability to have children) in men. Talk with your doctor about your individual risk.

Do not breastfeed while using this medicine and for at least 1 month after your last dose.

Zejula is not approved for use by anyone younger than 18 years old.

How should I take Zejula?

Take Zejula exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Do not share this medicine with another person, even if they have the same symptoms you have.

Take the medicine at the same time each day, with or without food.

Zejula is usually taken once a day until your body no longer responds to the medication.

Zejula may be taken at bedtime if it upsets your stomach.

Swallow the capsule whole and do not crush, chew, break, or open it.

If you vomit shortly after taking this medicine, do not take another dose. Wait until your next scheduled dose time to take the medicine again.

Niraparib can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

Your blood pressure and heart rate will also need to be checked often.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Fallopian Tube Cancer, Ovarian Cancer, or Peritoneal Cancer:

300 mg orally once a day until disease progression or unacceptable toxicity.

-Initiate therapy with this drug no later than 8 weeks after a patient's most recent platinum-containing regimen.

-For maintenance therapy of recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy
-For treatment of adult patients with advanced ovarian, fallopian tube, or primary peritoneal cancer who have been treated with 3 or more prior chemotherapy regimens and whose cancer is associated with homologous recombination deficiency (HRD) positive status defined by either:
a deleterious or suspected deleterious BRCA mutation
genomic instability and who have progressed more than 6 months after response to the last platinum-based chemotherapy

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Zejula side effects

Get emergency medical help if you have signs of an allergic reaction to Zejula: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and call your doctor at once if you have signs of a bone marrow disorder: fever, frequent infections, weakness, tiredness, feeling short of breath, weight loss, blood in your urine or stools, easy bruising or bleeding.

Call your doctor at once if you have:

  • pounding heartbeats or fluttering in your chest;

  • sores or white patches in or around your mouth, trouble swallowing or talking, dry mouth, bad breath, altered sense of taste;

  • pain or burning when you urinate; or

  • severe headache, blurred vision, pounding in your neck or ears.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common Zejula side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Zejula?

Other drugs may interact with niraparib, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zejula only for the indication prescribed.

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.