Why is this medication prescribed?

Zejula (niraparib) is prescribed primarily for the treatment of ovarian cancer. It belongs to a class of medications known as poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors interfere with the ability of cancer cells to repair their damaged DNA, leading to the death of these cells. Zejula is typically used in the maintenance treatment of recurrent ovarian, fallopian tube, or primary peritoneal cancer.

How should this medicine be used?

Here are some key points on how Zejula is typically used:

• Indication: Zejula is used as maintenance therapy in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who have responded to platinum-based chemotherapy.
• Dosage: The dosage of Zejula can vary based on individual factors, and it is determined by the prescribing healthcare provider. Dosage adjustments may be made based on the patient’s weight, blood counts, and other factors.
• Administration: Zejula is usually taken orally in the form of capsules. It can be taken with or without food.
• Treatment Duration: Zejula is often used for an extended period as maintenance therapy. The duration of treatment is determined by the treating oncologist and is based on individual patient factors.
• Monitoring: Regular monitoring, including blood tests to check hematologic parameters (platelet count, hemoglobin, and white blood cell count), is typically conducted to assess the impact of Zejula on the patient’s blood cells.
• Contraception: Due to the potential risk of harm to a developing fetus, effective contraception is usually recommended during treatment with Zejula and for a period after its discontinuation. The specific duration of contraception should be discussed with the healthcare provider.
• Side Effects Management: Patients should be aware of potential side effects, and any side effects should be promptly reported to the healthcare provider. Common side effects include hematologic abnormalities (thrombocytopenia, anemia, neutropenia), gastrointestinal symptoms (nausea, vomiting, constipation, diarrhea), fatigue, and others.
• Individualized Treatment Plans: Treatment plans with Zejula are individualized based on the patient’s medical history, disease characteristics, and response to prior treatments.

It’s important for patients to closely follow their healthcare provider’s instructions, attend scheduled appointments, and communicate any concerns or side effects experienced during treatment. Additionally, since medical information can change, it’s advisable to consult with a healthcare professional or refer to updated prescribing information for the most current details regarding Zejula.

Other uses for this medicine

Apart from its primary use as a maintenance treatment for certain types of cancer, Zejula may be investigated for use in other cancer types or treatment settings. However it’s essential to consult with a healthcare professional for the latest information on approved uses.

What special precautions should I follow?

As for special precautions when using Zejula, here are some general considerations:

• Hematologic Monitoring: Zejula can affect blood cell counts, leading to thrombocytopenia, anemia, and neutropenia. Regular blood tests are often performed to monitor these counts. It’s crucial to promptly report any signs of bleeding, unusual fatigue, or infections to your healthcare provider.
• Hypertension Monitoring: Zejula may cause an increase in blood pressure. Blood pressure should be monitored regularly during treatment. If hypertension develops, it may need to be managed with medications.
• Liver Function Monitoring: Periodic monitoring of liver function tests is usually recommended while on Zejula. If there are significant changes, the healthcare provider may adjust the treatment plan accordingly.
• Pregnancy and Contraception: Zejula can harm an unborn baby, so it is essential to avoid becoming pregnant while taking this medication. Adequate contraception should be used during treatment and for some time after discontinuation. Consult with your healthcare provider regarding appropriate contraceptive methods.
• Other Medication Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as they could interact with Zejula. Certain medications may need to be adjusted or avoided.
• Allergic Reactions: Report any signs of allergic reactions, such as rash, itching, swelling, severe dizziness, or difficulty breathing, to your healthcare provider immediately.
• Kidney Function: While Zejula is primarily metabolized in the liver, it’s important to monitor kidney function as well, as some medications can have effects on multiple organ systems.
• Other Pre-existing Conditions: Inform your healthcare provider about any pre-existing medical conditions, especially if you have a history of cardiovascular disease, hypertension, or other significant health issues.

Always follow your healthcare provider’s instructions and attend all scheduled appointments for monitoring and follow-up. These precautions are general in nature, and the specific guidance for your situation may vary. It’s important to have open and ongoing communication with your healthcare team to ensure the safe and effective use of Zejula or any other medication.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Zejula. However, it’s generally advisable to maintain a healthy and well-balanced diet. If you have specific dietary concerns or restrictions, discuss them with your healthcare provider or a registered dietitian.

What should I do if I forget a dose?

If you forget to take a dose of Zejula, follow these general guidelines:

• If it is within 48 hours of the missed dose, take the missed dose as soon as you remember.
• If it is more than 48 hours since the missed dose, skip the missed dose and take the next scheduled dose.
• Do not take a double dose to make up for a missed dose.

What side effects can this medication cause?

Zejula (niraparib) is associated with various side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary. Common side effects of Zejula include:

• Thrombocytopenia: Low platelet counts, which can increase the risk of bleeding.
• Anemia: Reduced red blood cell counts, leading to fatigue and weakness.
• Neutropenia: Decreased white blood cell counts, increasing the risk of infection.
• Hypertension (High Blood Pressure): Zejula can cause an increase in blood pressure, and regular monitoring is required during treatment.
• Nausea and Vomiting: Common digestive system side effects.
• Constipation or Diarrhea: Changes in bowel habits may occur.
• Fatigue: Feeling tired or weak is a common side effect.
• Headache: Some individuals may experience headaches.
• Pain in the Joints and Muscles: Arthralgia and myalgia are reported side effects.
• Decreased Appetite: Loss of appetite may occur.
• Insomnia: Difficulty sleeping or staying asleep may be observed.
• Dizziness: Some people may experience dizziness.
• Shortness of Breath: Difficulty breathing may occur.
• Liver Enzyme Elevation: Elevated liver enzymes can occur, and liver function should be monitored.
• Renal Impairment: Some patients may experience changes in kidney function.
• Allergic Reactions: Serious allergic reactions to Zejula are rare but can occur.

It’s important to promptly report any unusual or severe side effects to your healthcare provider. Additionally, routine monitoring of blood counts, liver function, and blood pressure is typically part of the management plan for individuals taking Zejula.

This list is not exhaustive, and the side effects mentioned may not encompass all possible adverse reactions. Always consult with your healthcare provider for a complete understanding of potential side effects, especially in the context of your individual health and medical history.

What should I know about storage and disposal of this medication?

Storage:

• Store at Room Temperature: Zejula is usually stored at room temperature, away from excessive heat and moisture.
• Keep in Original Container: Store Zejula in its original container to protect it from light.
• Avoid Exposure to Children and Pets: Keep the medication out of reach of children and pets.

Disposal:

• Dispose of Unused Medication Properly: When you no longer need Zejula or it reaches its expiration date, it’s important to dispose of it properly. Do not flush medications down the toilet or pour them down the drain unless instructed to do so.
• Consult with Pharmacist or Healthcare Provider: Ask your pharmacist or healthcare provider for guidance on the proper disposal of Zejula. They may provide information on local medication disposal programs or offer specific instructions.

In case of emergency/overdose

In case of an emergency or suspected overdose, it’s important to take the following steps:

• Seek Immediate Medical Attention: Call your local emergency number (such as 911 in the United States) or go to the nearest emergency room.
• Provide Information: Have information ready about the medication, including the name (Zejula or niraparib), the strength of the medication, and the amount ingested.
• Contact Poison Control Center: If available in your region, contact the poison control center for guidance.

What other information should I know?

• Regular Monitoring: During Zejula treatment, your healthcare provider may schedule regular check-ups and blood tests to monitor your response to the medication and detect any potential side effects.
• Inform Healthcare Providers: Inform all healthcare providers involved in your care, including dentists and specialists, that you are taking Zejula. This is important for comprehensive and coordinated care.
• Pregnancy and Contraception: If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your healthcare provider. Effective contraception is often recommended during Zejula treatment and for a specified period after the last dose.
• Follow Prescribed Regimen: Take Zejula exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking the medication without consulting your healthcare provider.
• Communicate with Healthcare Team: Report any new or worsening symptoms, side effects, or concerns to your healthcare provider promptly.

Always follow the specific instructions provided by your healthcare team, as they may tailor recommendations based on your individual health status and needs. If you have any questions or concerns, do not hesitate to reach out to your healthcare provider or pharmacist for clarification.