Dose Adjustments

Once-daily Dosing and Appropriate Dose Modification Supports Long-term Treatment1

The starting dose of ZEJULA is 300 mg. Expect to interrupt dose and modify in ~50% of patients in the first month to quickly achieve the optimal dose.2

  • In the NOVA study, dose reductions tended to occur early, with most patients reaching their individually optimized dose at the end of month 3; only 28% of patients remained at a dose of 300 mg at month 4

ZEJULA is the only once-daily PARP inhibitor with 1 capsule strength for ease of dose modification1,3,4

  • Dose reduction does not require an additional prescription or additional co-pay1

Interrupt treatment prior to dose adjustment1

In the NOVA Trial, the ZEJULA Dose for Each Patient Was Often Determined Within the First Few Months of Treatment2

  • The most commonly administered dose of ZEJULA in the NOVA trial was 200 mg/day5
  • 28% of patients remained at a dose of 300 mg at month 42

No starting dose adjustment necessary for1,6:

§There are no data in patients with severe renal impairment or end-stage renal disease undergoing hemodialysis.1
||There are no data in patients with moderate to severe hepatic impairment.1

AR, adverse reaction; AST, aspartate aminotransferase; CBC, complete blood count;  CrCl, creatinine clearance; ULN, upper limit of normal.

References: 1. ZEJULA (niraparib) [package insert]. Waltham, MA: GSK, Inc; October 2019. 2. Data on file. TESARO, Inc. 3. Rubraca (rucaparib) [package insert]. Boulder, CO: Clovis Oncology, Inc; April 2018. 4. Lynparza (olaparib) [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; July 2019. 5. Berek JS, Matulonis UA, Peen U, et al. Safety and dose modification for patients receiving niraparib. Ann Oncol. 2018 Aug 13. doi: 10.1093/annonc/mdy255. 6. Ramalingam SS, Kummar S, Sarantopoulos J, et al. Phase I study of vorinostat in patients with advanced solid tumors and hepatic dysfunction: a National Cancer Institute Organ Dysfunction Working Group study. J Clin Oncol. 2010;28(29):4507-4512. doi: 10.1200/JCO.2010.30.2307.

Information on hematologic adverse reactions


See hematologic ARs

See Incidence Rates
Considerations for dose modification


Identify patients likely to require early dose modification

See the Data
Back to Top