Nausea and Vomiting, when and why

Time-Trend Analysis and Risk Factors for Niraparib-Induced Nausea and Vomiting in Ovarian Cancer: A Prospective Study

https://tinyurl.com/6wauzndb

Niraparib (zejula) is one of two PARP inhibitor drugs approved by the TGA in Australia for maintenance therapy of ovarian cancer. A common side effect affecting up to 60% of patients is nausea and vomiting. Occasionally this may be so severe as to be life-threatening.

This prospective survey looked at the treatment course for 53 patients who underwent maintenance therapy with niraparib. 31 had treatment induced nausea and vomiting, for 3 of them this was severe with weight loss, dehydration, and malnutrition.

The adverse effect was greatest 8 hours after taking the oral medication, which is when the plasma concentration is greatest. The severity of the reaction decreased over time with less severe reactions being reported after 8 weeks. This may be due to dose manipulation which is common.

The authors note that nausea and vomiting are often causes for patients to cease treatment. Monitoring this side effect and correct timing for anti-emetic treatment with dose modification may avoid discontinuation.