Niraparib (Zejula) side effects can be effectively managed through preventive measures, symptomatic treatment, and regular monitoring, with a focus on hematologic toxicity, gastrointestinal reactions, and photosensitivity management.

1 Hematologic Toxicity Management

(1) Myelosuppression: Monitor complete blood count weekly during initial treatment. For grade 3 or higher anemia or thrombocytopenia, withhold medication and consider transfusion or growth factor support.

(2) Bleeding risk: Avoid concomitant use of anticoagulants. Seek immediate medical attention for gingival bleeding or unusual ecchymosis, and adjust dosage if necessary.

2 Gastrointestinal Reaction Control

(1) Nausea and vomiting: Take medication after meals; prophylactic use of 5-HT3 receptor antagonists is recommended; eat small, frequent meals of bland foods.

(2) Diarrhea and constipation: Replenish electrolytes during diarrhea; increase dietary fiber for constipation; seek medical evaluation if symptoms persist >48 hours.

3 Skin Photoprotection

(1) Sun protection: Use SPF≥30 sunscreen, wear protective clothing, and avoid going outdoors during peak UV hours (10:00-15:00).

(2) Dry skin: Use alcohol-free moisturizers; for rash, short-term topical corticosteroids may be applied for relief.

4 Systemic Symptom Management

(1) Fatigue: Adjust activity pacing, ensure adequate nighttime sleep; for anemia-related fatigue, correct hemoglobin levels.

(2) Taste disturbances: Suck on peppermint candies or lemon slices to improve taste; avoid using metal utensils.

5 Special Population Precautions

(1) Fertility preservation: Women of childbearing age should use effective contraception until 6 months after the last dose; male patients should use contraception for 3 months.

(2) Drug interactions: Avoid concomitant use of strong CYP3A4 inducers/inhibitors; dose adjustments, if needed, should be evaluated by a physician.