Side Effects of Niraparib (ZEJULA)?

[Benkaymel]

While I await the results of my genetic test to see if I have the DNA repair defect to allow me to participate in the AMPLITUDE clinical trial, I have been looking at the SEs for Niraparib and they don’t look very pleasant, so I wondered if anyone has used it and has personal experience to share?

Here is the list of common SEs:

Very Common ≥10% occurrence (happens in greater than 10 out of 100 patients):

• Decrease in red blood cells that carry oxygen; this may make you feel tired or short of

breath (anaemia)

• Decrease in a type of blood cell called platelets that help stop bleeding; this may increase

your risk of bleeding (thrombocytopenia)

• Decrease in all types of white blood cells which fight infection (leukopenia)

• Decrease in a type of white blood cell called neutrophils that fight infection

• Difficulty with emptying the bowels, often because of hard stools (constipation)

• Feeling sick to your stomach (nausea)

• Vomiting

• Reduced desire to eat (decreased appetite)

• Pain in your belly (abdominal pain)

• Frequent watery stools (diarrhoea)

• Indigestion (dyspepsia)

• Sleeplessness, trouble sleeping (insomnia)

• Headache

• Feeling tired, lack of energy (asthenia/fatigue)

• Pain or burning when urinating which may indicate an infection (Urinary tract infection)

• Back pain

• Joint pain (arthralgia)

• Breathlessness or difficulty breathing (dyspnoea)

• Common cold (nasopharyngitis)

• Increased blood pressure (hypertension)

• Feeling lightheaded or like you are about to faint (dizziness)

• Cough

• Noticeably rapid, strong, or irregular heartbeat (palpitations)

Common < 10%, but ≥ 1% occurrence (happens in less than 10, but more than 1 out of every 100

patients) :

• An abnormally rapid heart rate (tachycardia)

• Infection related to a decrease in white blood cell called neutrophils that fight

infection (neutropenic infection)

• Reduced potassium in blood

• Dry mouth

• Altered sense of taste; this means that foods might taste differently than you are used to

(dysgeusia)

• Feeling anxious (anxiety)

• Mood changes to feeling sad/discouraged, listless

• Difficulty remembering, learning new things, concentrating, or making decisions

(cognitive impairment)

• Nosebleed (epistaxis)

• Rash

• Muscle pain (myalgia)

• An accumulation of fluid that causes swelling in lower extremities such as lower legs,

hands and feet (peripheral oedema)

• Swelling or irritation of the mouth (stomatitis) or of the lining of the throat, oesophagus,

stomach, intestines (mucositis)

• Inflammation of the lining of the airways (bronchitis)

• Increased liver enzymes in the blood; aspartate transaminase (“AST”), alanine

aminotransferase (“ALT”), gamma glutamyl transferase increased (“GGT”), or alkaline

phosphatase (ALP); this may be a sign of damage to liver cells

• Increase level of creatinine in your blood; this may be a sign of kidney damage (blood

creatinine increase)

• Decrease in weight

• Inflammation of the white area of the eye (conjunctivitis)

• An immune system reaction that is triggered by sunlight (photosensitivity). People

develop itchy eruptions or areas of redness and inflammation on patches of sunexposed

skin. These reactions typically resolve without treatment

• Hypersensitivity, including anaphylaxis: Hypersensitivity is when your body has an

exaggerated immune response to a drug. Anaphylaxis is a severe, life-threatening

allergic reaction.

Thanks in advance.

[kaptank]

I am in the MAGNITUDE trial of abiraterone (+prednisone) plus niraparib. I am BRCA2. The 2 most notable side effects were the mother of all constipations (I used magnesium sulphate- epsom salts) and dry mouth. There is a mouth gel called Oral 7 that gets the salivary glands going again. After about 18 months, neither is a problem anymore.

[addicted2cycling in reply to kaptank]

kaptank wrote --- " ... most notable side effects were the mother of all constipations (I used magnesium sulphate- epsom salts) ... "

The following is NO JOKE --- MANY decades ago my PCP required me to drink 16oz of Magnesium Citrate as part of the cleansing prep for my Sigmoidoscopy AND my Gastro wanted me to drink it for Colonoscopy prep so I figured if I sprayed it on my skin it would be absorbed into bloodstream thus bypassing digestion and go RIGHT TO WORK AND MAN DID IT WORK.!!!!

I put some in a spray bottle and sprayed on my wrists above palms on inner elbows on back of knees and earlobes. Rubbed it in a bit and waited. MIGHT TAKE 6 HOURS OR 12 but every time I've needed some extra movement it does the job. No more drinking stuff or extra pills just a spray n go.

[Benkaymel in reply to kaptank]

Thanks kap, although unpleasant it sounds like you're getting on pretty well looking at all the other potential SEs. At least you know you're on the niraparib arm! I hope it proves successful in helping deal with your PCa.