Dosing | Zejula® (niraparib)

Once-Daily Oral Dosing for Maintenance Treatment in Recurrent Ovarian Cancer1

Recommended dosage

  • The recommended starting dose of ZEJULA as monotherapy is 300 mg (three 100-mg capsules) taken orally once daily
  • Instruct patients to take their dose of ZEJULA at approximately the same time each day and to swallow each capsule whole. ZEJULA may be taken with or without food. Taking ZEJULA at bedtime may help to manage nausea
  • Start treatment with ZEJULA no later than 8 weeks after patients’ most recent platinum-containing regimen. Continue treatment with ZEJULA until disease progression or unacceptable toxicity
  • In the case of a missed dose of ZEJULA, instruct patients to take their next dose at its regularly scheduled time. If they vomit or miss a dose of ZEJULA, they should not take an additional dose

Dose adjustments for adverse reactions (ARs)

  • To manage ARs, consider interruption of treatment, dose reduction, or dose discontinuation
  • ARs in the NOVA trial led to dose reduction or interruption in 69% of patients, most frequently from thrombocytopenia (41%) and anemia (20%)
  • Modify dose for non-hematologic ARs of CTCAE grade ≥3 when prophylaxis is not considered feasible or when ARs persist despite treatment
  • Modify dose for hematologic ARs requiring transfusion or for platelet count <100,000/µL, neutrophil <1,000/µL, or hemoglobin <8 g/dL

Recommended dose modifications for ARs

ARs, adverse reactions; CTCAE, Common Terminology Criteria for Adverse Events.
a If dose reduction below 100 mg/day is required, discontinue ZEJULA.


For complete information on dose adjustments, download ZEJULA’s detailed Dosing Guide or see section 2.2 of the full Prescribing Information.

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Please see Important Safety Information below and full Prescribing Information.

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