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This medication comes with several important warnings to ensure its safe use. It is crucial to understand these risks and precautions and discuss any concerns with your healthcare provider.

• Bone Marrow and Blood Cancer Risks: Although infrequent, treatment with Zejula (niraparib) has been linked to a condition called myelodysplastic syndrome (MDS) and a type of blood cancer known as acute leukemia. These issues may occur months or even years after beginning treatment. If you have any concerns about cancer risks, please consult your healthcare provider.

• Low Blood Cell Counts: Zejula (niraparib) may lead to decreased levels of red blood cells, white blood cells, and platelets, increasing the risk of anemia, infections, and bleeding. Regular monitoring of blood cell counts is advised.

• High Blood Pressure and Cardiac Concerns: This medication can elevate blood pressure, potentially requiring urgent medical attention. Regular blood pressure monitoring is essential, particularly at the start of treatment. If you have heart conditions like coronary artery disease or arrhythmias, closer monitoring may be necessary. Symptoms such as irregular heartbeat, severe headaches, fatigue, or dizziness should be reported to your provider immediately.

• Posterior Reversible Encephalopathy Syndrome (PRES): There have been rare reports of a brain condition known as PRES in patients using Zejula (niraparib). Immediate medical attention is required if you experience symptoms such as sudden severe headaches, confusion, vision changes, or seizures. Discontinuation of the medication is necessary if PRES is diagnosed.

• Pregnancy Risks: This medication can cause harm to an unborn child due to its DNA-damaging effects. If you are of childbearing potential, use effective birth control during treatment and for at least 6 months after stopping the medication. Notify your healthcare provider immediately if you or your partner becomes pregnant during this period.

Please ensure to discuss these points with your healthcare provider to manage and mitigate any potential risks effectively.

When taking this medication, you might experience some common side effects such as nausea, vomiting, loss of appetite, constipation, dry mouth, mouth sores, dizziness, headache, and trouble sleeping. These effects are often mild and manageable, but if they continue or worsen, consult your healthcare provider for advice. To ease nausea, consider taking the medication at bedtime or eating smaller meals.

There are more serious side effects that, although rare, require immediate medical attention. These include bone marrow issues, which might lead to low blood cell counts, causing fatigue, easy bruising, or increased susceptibility to infections. Symptoms to watch for include persistent sore throat, fever, unusual tiredness, pale skin, or abnormal bleeding. Additionally, this medication can occasionally cause high blood pressure and heart rate, so regular monitoring is advised.

In rare instances, the medication may lead to posterior reversible encephalopathy syndrome (PRES), characterized by severe headaches, seizures, or sudden changes in vision or mental state. Seek urgent care if these symptoms occur. Allergic reactions are also rare but serious; signs include rash, swelling, severe dizziness, or difficulty breathing. Lastly, kidney problems and other side effects such as diarrhea, rash, and cough might occur, and any unusual symptoms should be reported to your healthcare provider.