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Drug · FAERS side-effect profile with label screen

Niraparib side effects: what 22,064 FDA adverse event reports show

Niraparib · Zejula · 1,067 reaction terms · 138,147 drug–reaction co-reports · data 2026-09-14
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Drug class

Poly (adp-ribose) polymerase (parp) inhibitor

FDA label, Indications wording

Brand names

Zejula

openFDA label

Who reports

22,064 reports · 66% serious · 1,428 with death outcome · 98% female

openFDA FAERS counts, all years, deduplication not applied

Used for

ZEJULA is a poly (ADP-ribose) polymerase (PARP) inhibitor indicated: • for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to first-lin.

FDA label, Indications and Usage

What it is

Niraparib is an orally available poly (ADP-ribose) polymerase (PARP) inhibitor.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Likely indication confounding 9Reporting / coding artifact 4Lab value / disease marker 12Not in label — unassessed 14
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,027 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Carbohydrate antigen 125 increased1,8481,118.4
1,046.7–1,194.9ROR 1,220.5 · calibrated p 2e-18 ✓
507.6 EB05 488.5 · IC025 +8.7
3/3 methods agree
Lab value / disease markerserious n=1,410 · 85% consumernot reported in cached trials
Computerised tomogram pelvis abnormal101,040.9
423.0–2,561.4ROR 1,041.4 · calibrated p 6e-13 ✓
254.2 EB05 147.6 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=9not reported in cached trials
Eastern cooperative oncology group performance status36602.2
396.3–915.2ROR 603.2 · calibrated p 9e-14 ✓
307.1 EB05 231.7 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=27 · 81% consumernot reported in cached trials
Carbohydrate antigen 12510468.4
219.3–1,000.6ROR 468.6 · calibrated p 5e-11 ✓
196.2 EB05 113.9 · IC025 +3.2
3/3 methods agree
Lab value / disease markerserious n=7not reported in cached trials
Ovarian cancer recurrent495427.4
384.6–474.9ROR 437.2 · calibrated p 3e-13 ✓
290.5 EB05 269.7 · IC025 +7.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=491not reported in cached trials
Ovarian epithelial cancer recurrent11239.6
123.6–464.7ROR 239.8 · calibrated p 4e-9 ✓
143.9 EB05 85.8 · IC025 +3.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=11not reported in cached trials
Recurrent cancer774224.8
208.0–242.8ROR 232.9 · calibrated p 1e-10 ✓
180.7 EB05 170.2 · IC025 +7.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=771 · 72% consumernot reported in cached trials
Drug monitoring procedure not performed257160.5
140.7–183.1ROR 162.4 · calibrated p 3e-9 ✓
135.8 EB05 122.4 · IC025 +6.6
3/3 methods agree
Reporting / coding artifactserious n=179 · 89% consumernot reported in cached trials
Scan abnormal53159.6
119.3–213.6ROR 160.0 · calibrated p 5e-9 ✓
130.2 EB05 103.4 · IC025 +5.5
3/3 methods agree
Lab value / disease markerserious n=41 · 89% consumernot reported in cached trials
Lymph nodes scan abnormal18159.1
96.5–262.1ROR 159.2 · calibrated p 2e-8 ✓
119.2 EB05 79.8 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious n=15not reported in cached trials
Lymphangioleiomyomatosis15151.1
87.6–260.6ROR 151.2 · calibrated p 4e-8 ✓
112.1 EB05 72.1 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=15not reported in cached trials
Liver scan abnormal22148.3
94.6–232.4ROR 148.4 · calibrated p 2e-8 ✓
115.5 EB05 80.4 · IC025 +4.4
3/3 methods agree
Reporting / coding artifactserious n=19 · 100% consumernot reported in cached trials
Positron emission tomogram abnormal85133.4
106.3–167.3ROR 133.9 · calibrated p 2e-8 ✓
113.9 EB05 95.0 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=65 · 88% consumernot reported in cached trials
Eastern cooperative oncology group performance status worsened127108.2
90.1–129.9ROR 108.8 · calibrated p 8e-8 ✓
95.7 EB05 82.5 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=103 · 89% consumernot reported in cached trials
Coronavirus test positive9494.4
76.4–116.6ROR 94.8 · calibrated p 2e-7 ✓
84.4 EB05 71.0 · IC025 +5.5
3/3 methods agree
Lab value / disease markerserious n=59 · 85% consumernot reported in cached trials
Intentional underdose65894.3
87.2–102.1ROR 97.2 · calibrated p 1e-7 ✓
85.6 EB05 80.2 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=434 · 85% consumernot reported in cached trials
Computerised tomogram abnormal18081.3
69.9–94.6ROR 82.0 · calibrated p 6e-7 ✓
74.3 EB05 65.6 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=146 · 85% consumernot reported in cached trials
Ovarian cancer metastatic6579.6
61.8–102.5ROR 79.8 · calibrated p 9e-7 ✓
72.0 EB05 58.4 · IC025 +5.2
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=63not reported in cached trials
Tumour marker increased36076.9
69.1–85.5ROR 78.1 · calibrated p 7e-7 ✓
70.8 EB05 64.9 · IC025 +5.8
3/3 methods agree
Lab value / disease markerserious n=254 · 80% consumernot reported in cached trials
Malignant peritoneal neoplasm4374.2
54.4–101.2ROR 74.3 · calibrated p 2e-6 ✓
66.9 EB05 51.7 · IC025 +4.8
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=43 · 100% cliniciannot reported in cached trials
Drug monitoring procedure incorrectly performed4873.6
54.9–98.7ROR 73.8 · calibrated p 2e-6 ✓
66.6 EB05 52.2 · IC025 +4.9
3/3 methods agree
Reporting / coding artifactserious n=28 · 92% consumernot reported in cached trials
Fallopian tube cancer1072.1
37.9–137.1ROR 72.1 · calibrated p 1e-5 ✓
59.7 EB05 34.7 · IC025 +2.9
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=9not reported in cached trials
Ovarian cancer61968.0
62.8–73.8ROR 70.0 · calibrated p 2e-6 ✓
63.4 EB05 59.3 · IC025 +5.8
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 55.1 · 96% cliniciannot reported in cached trials
Fluid replacement2162.3
40.0–96.8ROR 62.3 · calibrated p 9e-6 ✓
55.6 EB05 38.4 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=21 · 81% consumernot reported in cached trials
Tumour marker abnormal2060.2
38.3–94.7ROR 60.3 · calibrated p 1e-5 ✓
53.9 EB05 36.9 · IC025 +3.8
3/3 methods agree
Lab value / disease markerserious n=14 · 70% consumernot reported in cached trials
Tumour marker decreased1055.4
29.3–104.9ROR 55.5 · calibrated p 4e-5 ✓
47.9 EB05 27.8 · IC025 +2.8
3/3 methods agree
Lab value / disease marker–not reported in cached trials
Decreased activity58454.8
50.4–59.5ROR 56.2 · calibrated p 7e-6 ✓
51.7 EB05 48.3 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious PRR 45.5 · 82% consumernot reported in cached trials
Central venous catheter removal2553.1
35.5–79.4ROR 53.2 · calibrated p 2e-5 ✓
48.6 EB05 34.6 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=17 · 76% consumernot reported in cached trials
Red blood cell count decreased1,35247.1
44.6–49.6ROR 50.1 · calibrated p 1e-5 ✓
44.8 EB05 42.9 · IC025 +5.4
3/3 methods agree
Lab value / disease markerserious PRR 37.7 · 84% consumerNCT03602859: 1/745 (0.1%) on Niraparib (serious AE)
Pelvic neoplasm1542.7
25.5–71.6ROR 42.7 · calibrated p 1e-4 ✓
39.0 EB05 25.1 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Mean cell volume abnormal2042.4
27.1–66.3ROR 42.4 · calibrated p 8e-5 ✓
39.2 EB05 26.8 · IC025 +3.6
3/3 methods agree
Lab value / disease markerserious n=18not reported in cached trials
White coat hypertension2342.2
27.8–64.0ROR 42.2 · calibrated p 8e-5 ✓
39.2 EB05 27.5 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=14 · 100% consumernot reported in cached trials
Ovarian cancer stage iii1439.4
23.1–67.2ROR 39.4 · calibrated p 2e-4 ✓
36.1 EB05 22.9 · IC025 +3.2
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=14not reported in cached trials
Mean cell haemoglobin increased6538.7
30.2–49.6ROR 38.8 · calibrated p 8e-5 ✓
36.8 EB05 29.9 · IC025 +4.5
3/3 methods agree
Lab value / disease markerserious n=57not reported in cached trials
Platelet count decreased4,13038.3
37.2–39.4ROR 46.9 · calibrated p 2e-5 ✓
36.8 EB05 35.9 · IC025 +5.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 28.4 · 73% consumerNCT03602859: 28/745 (3.8%) on Niraparib (serious AE)
Abdominal cavity drainage1637.3
22.6–61.4ROR 37.3 · calibrated p 2e-4 ✓
34.6 EB05 22.5 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=15not reported in cached trials
Red blood cell count abnormal5235.0
26.5–46.1ROR 35.1 · calibrated p 1e-4 ✓
33.4 EB05 26.5 · IC025 +4.2
3/3 methods agree
Lab value / disease markerserious n=27 · 80% consumerNCT03602859: 1/745 (0.1%) on Niraparib (serious AE)
Mean cell volume increased9034.5
28.0–42.6ROR 34.6 · calibrated p 1e-4 ✓
33.1 EB05 27.7 · IC025 +4.5
3/3 methods agree
Lab value / disease markerserious n=77 · 71% consumernot reported in cached trials
Ovarian cancer stage iv1432.6
19.2–55.6ROR 32.6 · calibrated p 4e-4 ✓
30.4 EB05 19.2 · IC025 +3.0
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=14not reported in cached trials
Stoma closure1032.5
17.3–61.1ROR 32.5 · calibrated p 6e-4 ✓
29.8 EB05 17.2 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=10not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Niraparib as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (3 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Nausea5,7857.0
6.9–7.2ROR 9.1 · calibrated p 0.043 ✓
7.0 EB05 6.8 · IC025 +2.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 7.5 · 82% consumerNCT03602859: 5/745 (0.7%) on Niraparib (serious AE)
Fatigue (tiredness)5,2336.4
6.3–6.6ROR 8.1 · calibrated p 0.063
6.4 EB05 6.3 · IC025 +2.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 6.9 · 84% consumerNCT03602859: 1/745 (0.1%) on Niraparib (serious AE)
Platelet count decreased4,13038.3
37.2–39.4ROR 46.9 · calibrated p 2e-5 ✓
36.8 EB05 35.9 · IC025 +5.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 28.4 · 73% consumerNCT03602859: 28/745 (3.8%) on Niraparib (serious AE)
Constipation4,10518.4
17.9–18.9ROR 22.3 · calibrated p 0.001 ✓
18.0 EB05 17.6 · IC025 +4.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 18.8 · 86% consumerNCT03602859: 6/745 (0.8%) on Niraparib (serious AE)
Insomnia (trouble sleeping)2,84110.2
9.9–10.6ROR 11.6 · calibrated p 0.019 ✓
10.1 EB05 9.8 · IC025 +3.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 10.4 · 85% consumerNCT03602859: 143/745 (19.2%) on Niraparib
Headache2,3703.6
3.5–3.7ROR 3.9 · calibrated p 0.393
3.6 EB05 3.5 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.0 · 83% consumerNCT03602859: 2/745 (0.3%) on Niraparib (serious AE)
Off label use (used outside approved label)2,2472.5
2.4–2.6ROR 2.6 · calibrated p 0.759
2.5 EB05 2.4 · IC025 +1.2
3/3 methods agree
Reporting / coding artifactserious PRR 2.4 · 70% consumernot reported in cached trials
Vomiting2,0354.1
4.0–4.3ROR 4.5 · calibrated p 0.303
4.1 EB05 4.0 · IC025 +2.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.9 · 81% consumerNCT03602859: 9/745 (1.2%) on Niraparib (serious AE)
Decreased appetite (loss of appetite)1,8817.8
7.4–8.1ROR 8.4 · calibrated p 0.057
7.7 EB05 7.4 · IC025 +2.9
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 7.6 · 82% consumerNCT03602859: 2/745 (0.3%) on Niraparib (serious AE)
Asthenia (weakness)1,8564.7
4.5–4.9ROR 5.0 · calibrated p 0.229
4.7 EB05 4.5 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.3 · 83% consumerNCT03602859: 7/745 (0.9%) on Niraparib (serious AE)
Product dose omission issue1,8556.2
6.0–6.5ROR 6.7 · calibrated p 0.111
6.2 EB05 5.9 · IC025 +2.6
3/3 methods agree
Reporting / coding artifactserious PRR 11.6 · 85% consumernot reported in cached trials
Carbohydrate antigen 125 increased1,8481,118.4
1,046.7–1,194.9ROR 1,220.5 · calibrated p 2e-18 ✓
507.6 EB05 488.5 · IC025 +8.7
3/3 methods agree
Lab value / disease markerserious n=1,410 · 85% consumernot reported in cached trials
Haemoglobin decreased1,75016.4
15.7–17.2ROR 17.8 · calibrated p 0.003 ✓
16.2 EB05 15.5 · IC025 +3.9
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 12.0 · 80% consumerNCT03602859: 1/745 (0.1%) on Niraparib (serious AE)
Dizziness1,6023.1
2.9–3.2ROR 3.2 · calibrated p 0.557
3.1 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.2 · 82% consumerNCT03602859: 2/745 (0.3%) on Niraparib (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Niraparib?

In FDA FAERS, the most frequently co-reported reaction terms for Niraparib are nausea, fatigue, platelet count decreased, constipation, insomnia, blood pressure increased. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Niraparib have an FDA boxed warning?

No. The FDA label retrieved for Niraparib has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Niraparib causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.