Zejula (niraparib)

Targeted therapy pill (PARP inhibitor) · Used for: Ovarian cancer

💊 Taken by mouth · Targeted therapy pill (PARP inhibitor)

Cliff notes

What it is: Targeted therapy pill (PARP inhibitor).

How it's given: A tablet by mouth once a day, often as maintenance after platinum chemo.

How it works: Like Lynparza, Zejula blocks PARP, a protein that helps cells repair DNA, which helps keep ovarian cancer from coming back after chemo has worked.

Common side effects and what helps at home

Side effect	What can help
Low platelets, red and white blood cells	Very common, especially early. You'll have frequent blood tests.
Nausea	Taking it at bedtime may help; ask your team.
Tiredness	Pace yourself.
Constipation	Fluids and fiber.
Trouble sleeping	Keep a regular bedtime.
High blood pressure	Your team will check it weekly at first, then regularly.

Not everyone gets these. Your team may suggest other ways to manage them.

Call your care team now if you have:

Bleeding or bruising easily, fever or infections (possible bone marrow problems)
Severe headache, blurry vision or confusion (possible very high blood pressure)
Pounding heartbeat or chest pain
Severe headache, confusion, seizures or vision loss (a rare brain swelling condition called PRES)

Call 911 for trouble breathing, chest pain or signs of stroke.

🗓 What to expect

1️⃣ Before you start

Ask your team for a written schedule and an after-hours phone number.
Blood counts and blood pressure checks.
Bring a list of all your medicines and supplements.

2️⃣ Each day on treatment

Take it exactly as prescribed, at about the same time each day.
Don't crush or split pills unless your team says it's OK.
If you miss a dose, follow the label instructions or call your pharmacist.

3️⃣ Between doses

Watch for the side effects below and use the checklist.
Keep up with blood tests and visits.
Call your team for anything in the red box.

✅ Side-effect checklist

Print this and check off what you notice so you can tell your team.

Side effect	Noticed?	Notes for my team
Low platelets, red and white blood cells	☐
Nausea	☐
Tiredness	☐
Constipation	☐
Trouble sleeping	☐
High blood pressure	☐

Help paying for Zejula

Official manufacturer program:

Together with GSK Oncology: Benefits checks and copay help; GSK patient assistance for those in need.

Copay cards are usually only for people with commercial (job or marketplace) insurance. If you have Medicare or Medicaid, look at free-drug programs and these independent foundations:

PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
Good Days: Copay help and some travel costs.
NeedyMeds: Free database of assistance programs, open to anyone.

📋 Medicare: Pills you take at home are usually covered by Medicare drug coverage (Part D). Part B covers some cancer drugs taken by mouth if the same drug comes in an injectable form. See Medicare and your cancer drugs.

More: Our guide to paying for cancer treatment.

🏷 Tips from the maker's patient site

If you can become pregnant, expect a pregnancy test before starting. Use birth control during treatment and for 6 months after your last dose.

Summarized in our words from zejula.com, which follows the FDA-approved patient information.

💬 What experts are saying

An ovarian cancer expert on OncLive says nausea is the most common side effect of PARP inhibitors like Lynparza and Zejula and often fades over about 4 to 8 weeks. Low platelets are more common with Zejula, and doctors may pick a lower starting dose for people with lower body weight or platelet counts.

Source: Management of PARP Inhibitor AEs in Ovarian Cancer (OncLive, April 29, 2019)

In an OncLive patient-and-doctor conversation, the doctor explains that Zejula is taken once a day and that blood counts, especially platelets, are checked weekly at first. Anemia can happen with any PARP inhibitor.

Source: PARP Inhibitor Side Effect Management in Ovarian Cancer (OncLive, December 23, 2017)

❓ Questions to ask your doctor

What is the goal of this treatment for me?
How will we know if it's working?
Which side effects should I call about right away, and what number do I call after hours?
Which medicines, vitamins or supplements should I avoid?
Will this affect my ability to work, drive or care for my family?
What will this cost me, and who can help me with coverage?

Support groups

Ovarian Cancer Research Alliance (OCRA): Woman to Woman peer support, education and research
National Ovarian Cancer Coalition (NOCC): Support groups, the Teal Hearts Network and education
CancerCare: Free counseling, support groups and financial help
Cancer Support Community: Support groups, a helpline and the MyLifeLine online community

Common questions

Why does Zejula need so many blood tests?

It often lowers blood counts in the first months, so your team checks weekly at first and may adjust the dose.

What is maintenance therapy?

Medicine taken after chemo has worked, to help keep the cancer from growing back.

📄 The official FDA label for Zejula, including its patient information section, is on DailyMed.

Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write

Not medical advice. This page is general information to help you talk with your care team. It can't replace advice from your doctor or nurse. If you have a fever of 100.4°F (38°C) or higher during treatment, or any symptom that worries you, call your care team now. In an emergency, call 911.