Niraparib (niraparib)
Niraparib is a parp inhibitor (poly (adp-ribose) polymerase inhibitor) from GlaxoSmithKline (GSK); originally developed by Tesaro (Tesaro UK Limited), marketed originally as Zejula. This monograph covers approved indications, mechanism, dosing, side effects, the generic manufacturer landscape and verified list prices.
How much does niraparib cost?
4 manufacturers produce generic niraparib 100 mg in Bangladesh, with list unit prices from BDT 850 to BDT 1,095 (US$6.92–US$8.91); a 30-unit month costs about US$207.54–US$267.36. The cheapest listed brand is Paribac (Ziska Pharmaceuticals Ltd.).
Source: MedEx Bangladesh registry (DGDA-registered brands), updated September 2026. Prices move with FX, pack size and pharmacy margin — confirm current stock and price with a licensed importer.
Overview
Niraparib (Zejula) is an oral inhibitor of PARP1 and PARP2, the enzymes that detect and initiate repair of single-strand DNA breaks. In tumour cells that cannot perform homologous recombination repair - most importantly those with germline BRCA mutations, but also a wider group with homologous recombination deficiency - blocking PARP produces an accumulation of unrepaired DNA damage that is lethal to the cancer cell. Niraparib is used as maintenance treatment after platinum-based chemotherapy has shrunk an advanced ovarian, fallopian tube or primary peritoneal cancer, both in the first-line setting (regardless of BRCA status) and in recurrent germline BRCA-mutated disease.
Its distinguishing feature within the class is a weight- and platelet-count-based starting dose derived from the PRIMA and NOVA studies: 300 mg once daily for patients weighing at least 77 kg with a baseline platelet count of at least 150,000/mL, and 200 mg once daily for lighter patients or those with a lower platelet count. This individualised dosing was introduced to reduce the haematological toxicity seen with fixed dosing. Even so, thrombocytopenia remains the hallmark adverse effect - grade 3 or worse in 39% of PRIMA patients - followed by anaemia (grade 3 or worse in 31%) and neutropenia. Nausea, fatigue, constipation and musculoskeletal pain are common. Niraparib is also the PARP inhibitor most clearly associated with hypertension, which is why blood pressure and heart rate must be measured weekly for the first two months, then monthly for the first year. Complete blood counts are checked weekly for the first month and monthly for the following eleven. Rare but serious complications include myelodysplastic syndrome/acute myeloid leukaemia and posterior reversible encephalopathy syndrome (PRES).
Niraparib is patent-protected in the regulated markets, so no FDA/EMA-approved generic exists. Bangladeshi manufacturers including Beacon (Nirova/Niraparix), Everest (Niranib), Ziska (Paribac) and Jenphar (Ovaxa) supply 100 mg capsules under the TRIPS least-developed-country exemption at about BDT 850-1,095 per capsule; these are nationally registered copies, not FDA/EMA generics, and no bioequivalence study against Zejula has been published.
Niraparib price list — Bangladesh
Every DGDA-registered brand of this molecule with its list unit price, including the originator for comparison. Bangladesh is the most transparent reference market for on-patent generics.
| Brand | Manufacturer | Strength | Unit price | ≈ USD | Pack |
|---|---|---|---|---|---|
| Paribac Lowest | Ziska Pharmaceuticals Ltd. | 100 mg Capsule | BDT 850 | US$6.92 | 1 x 30: ৳ 25,500.00 |
| Niranib | Everest Pharmaceuticals Ltd. | 100 mg Capsule | BDT 1,000 | US$8.14 | 1 x 30: ৳ 30,000.00 |
| Ovaxa | Jenphar Bangladesh Ltd. | 100 mg Capsule | BDT 1,000 | US$8.14 | 1 x 14: ৳ 14,000.00 |
| Nirova | Beacon Pharmaceuticals PLC | 100 mg Capsule | BDT 1,095 | US$8.91 | 1 x 6: ৳ 6,570.00 |
Source: MedEx Bangladesh drug registry (list prices of DGDA-registered brands). Unit prices move with pack size, pharmacy and exchange rate — reference only. Original registry page
How it works
Niraparib blocks PARP, an enzyme that helps cancer cells repair damaged DNA. With PARP blocked, ovarian cancer cells - especially those with BRCA gene faults - accumulate DNA damage and die. It is taken once daily as maintenance (keep-it-at-bay) treatment after the cancer has shrunk with platinum chemotherapy.
Niraparib is an orally available poly (ADP-ribose) polymerase (PARP) inhibitor. It inhibits PARP1 and PARP2, enzymes involved in DNA repair; in tumour cells with deficient homologous recombination repair (e.g. BRCA mutations) this leads to accumulation of DNA damage and cell death. Chemical name of niraparib tosylate monohydrate: 2-{4-[(3S)-piperidin-3-yl]phenyl}-2H-indazole-7-carboxamide 4-methylbenzenesulfonate hydrate (1:1:1); molecular formula C26H30N4O5S, MW 510.61. (FDA label, sections 11 and 12.1)
Approved indications
- Maintenance treatment of adults with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy
- Maintenance treatment of adults with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm) recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy
Dosage & administration
First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or unacceptable toxicity.
Dose adjustment
Dose level reductions - from a 200 mg starting dose: first reduction 100 mg/day, then discontinue. From a 300 mg starting dose: first reduction 200 mg/day, second reduction 100 mg/day, then discontinue. Moderate hepatic impairment: reduce starting dosage to 200 mg once daily. No dose adjustment for mild hepatic impairment. Not established for severe hepatic impairment.
Side effects
Nausea (65%) · Anemia (56%; Grade >=3 in 31% in PRIMA) · Fatigue (55%) · Constipation (39%) · Musculoskeletal pain (36%) · Abdominal pain (35%) · Vomiting (33%) · Neutropenia (31%) · Decreased appetite (24%) · Leukopenia (24%) · Insomnia (23%) · Headache (23%) · Dyspnea (22%) · Rash (21%) · Diarrhea (18%) · Hypertension (17%) · Cough (16%) · Dizziness (14%) · Acute kidney injury (13%) · Hypomagnesemia (11%)
- Thrombocytopenia (60%; Grade >=3 in 39% in PRIMA)
- Myelodysplastic syndrome / acute myeloid leukemia
- Posterior reversible encephalopathy syndrome (PRES, 0.1% of trial patients)
Monitoring
- Complete blood counts weekly for the first month, monthly for the next 11 months of treatment, and periodically after this time
- Blood pressure and heart rate at least weekly for the first 2 months, then monthly for the first year, and periodically thereafter
- Monitoring for signs and symptoms of PRES (seizure, headache, altered mental status, visual disturbance or cortical blindness, with or without hypertension)
- Do not start until patients have recovered from haematological toxicity caused by previous chemotherapy (<=Grade 1)
- For suspected MDS/AML or prolonged haematological toxicity, refer to a haematologist; discontinue if MDS/AML is confirmed
Generic and biosimilar landscape
Bangladeshi niraparib products (Beacon Niraparix/Nirova, Everest Niranib, Ziska Paribac) are DGDA-registered products made under the TRIPS least-developed-country patent exemption, not FDA/EMA-approved generics; Beacon states explicitly that it manufactures patented drugs under Bangladeshi patent exemptions. Beacon's Niraparix carries a Bangladesh marketing authorisation number (341-383-010) and a per-box QR authenticity code. No published bioequivalence study against Zejula was found for these brands.
Who makes it
| Manufacturer | Country | Brand | Strength | Notes |
|---|---|---|---|---|
| Beacon Pharmaceuticals PLC | Bangladesh | Niraparix (also listed as Nirova on MedEx) | 100 mg capsule | Once-daily PARP inhibitor; Beacon marketing authorisation number 341-383-010; QR-code product authentication; global patient support programme |
| Everest Pharmaceuticals Ltd. | Bangladesh | Niranib | 100 mg capsule | Sold in 15- and 30-capsule packs on Everest's own store |
| Ziska Pharmaceuticals Ltd. | Bangladesh | Paribac | 100 mg capsule | Listed on MedEx at BDT 850 per capsule |
| Jenphar Bangladesh Ltd. | Bangladesh | Ovaxa | 100 mg capsule | Listed on MedEx |
Availability in Southeast Asia
| Country | Status | Notes |
|---|---|---|
| Singapore | approved | HSA approved Zejula (niraparib) tablet for first-line and recurrent monotherapy maintenance of advanced ovarian cancer (announced 29 June 2022); described as the only PARP inhibitor approved in Singapore as monotherapy for platinum-responsive advanced and recurrent ovarian cancer regardless of BRCA status |
| Malaysia | No public source confirming niraparib registration with NPRA found in this research | |
| Thailand | No public source confirming niraparib registration found in this research | |
| Philippines | No public source confirming niraparib registration found in this research | |
| Indonesia | No public source confirming niraparib registration found in this research | |
| Vietnam | No public source confirming niraparib registration found in this research |
Price by country
Reference prices by market
| Market | Product | Listed price | Source |
|---|---|---|---|
| Bangladesh | Niranib (Everest) 100 mg capsule | BDT 1,000.00 per capsule (1 x 30 pack: BDT 30,000.00) | medex.com.bd |
| Bangladesh | Nirova (Beacon) 100 mg capsule | BDT 1,095.00 per capsule (1 x 6 pack: BDT 6,570.00) | medex.com.bd |
| Bangladesh | Paribac (Ziska) 100 mg capsule | BDT 850.00 per capsule (1 x 30 pack: BDT 25,500.00) | medex.com.bd |
| Bangladesh | Niranib 100 (Everest) retail box | BDT 23,987.50 per box | arogga.com |
Frequently asked questions
How much does niraparib (Zejula) cost in Bangladesh?
Bangladesh benchmark: 4 manufacturers sell generic niraparib 100 mg; unit prices range from BDT 850 (US$6.92) to BDT 1,095 (US$8.91), i.e. about US$207.54–US$267.36 per 30 units. Cheapest listed brand: Paribac (Ziska Pharmaceuticals Ltd.) at BDT 850 per unit. Prices move with pack size, pharmacy and the exchange rate — confirm current stock and price with a licensed importer before ordering.
Is there a generic niraparib and who makes it?
Bangladeshi niraparib products (Beacon Niraparix/Nirova, Everest Niranib, Ziska Paribac) are DGDA-registered products made under the TRIPS least-developed-country patent exemption, not FDA/EMA-approved generics; Beacon states explicitly that it manufactures patented drugs under Bangladeshi patent exemptions. Beacon's Niraparix carries a Bangladesh marketing authorisation number (341-383-010) and a per-box QR authenticity code. No published bioequivalence study against Zejula was found for these brands. Manufacturers supplying niraparib generic versions include Beacon Pharmaceuticals PLC, Everest Pharmaceuticals Ltd., Jenphar Bangladesh Ltd., Ziska Pharmaceuticals Ltd.. Brands registered in Bangladesh include Niranib, Nirova, Ovaxa, Paribac.
What is the difference between niraparib and olaparib?
Niraparib (PARP inhibitor (poly (ADP-ribose) polymerase inhibitor), originally Zejula by GlaxoSmithKline (GSK); originally developed by Tesaro (Tesaro UK Limited)) Niraparib blocks PARP, an enzyme that helps cancer cells repair damaged DNA. With PARP blocked, ovarian cancer cells - especially those with BRCA gene faults - accumulate DNA damage and die. It is taken once daily as maintenance (keep-it-at-bay) treatment after the cancer has shrunk with platinum chemotherapy. First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or un
Why does niraparib dosing depend on body weight and platelet count?
Standard dosing for niraparib: First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or unacceptable toxicity. Dose adjustments: Dose level reductions - from a 200 mg starting dose: first reduction 100 mg/day, then discontinue. From a 300 mg starting dose: first reduction 200 mg/day, second reduction 100 mg/day, then discontinue. Moderate hepatic impairment: reduce starting dosage to 200 mg once daily. No dose adjustment for mild hepatic impairment. Not established for severe hepatic impairment.
How often do you need blood tests on niraparib?
Standard dosing for niraparib: First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or unacceptable toxicity. Dose adjustments: Dose level reductions - from a 200 mg starting dose: first reduction 100 mg/day, then discontinue. From a 300 mg starting dose: first reduction 200 mg/day, second reduction 100 mg/day, then discontinue. Moderate hepatic impairment: reduce starting dosage to 200 mg once daily. No dose adjustment for mild hepatic impairment. Not established for severe hepatic impairment.
Does niraparib raise blood pressure?
Recommended monitoring for niraparib: Complete blood counts weekly for the first month, monthly for the next 11 months of treatment, and periodically after this time; Blood pressure and heart rate at least weekly for the first 2 months, then monthly for the first year, and periodically thereafter; Monitoring for signs and symptoms of PRES (seizure, headache, altered mental status, visual disturbance or cortical blindness, with or without hypertension); Do not start until patients have recovered from haematological toxicity caused by previous chemotherapy (<=Grade 1); For suspected MDS/AML or prolonged haematological toxicity, refer to a haematologist; discontinue if MDS/AML is confirmed
Is niraparib approved in Singapore?
Niraparib (PARP inhibitor (poly (ADP-ribose) polymerase inhibitor), originally Zejula by GlaxoSmithKline (GSK); originally developed by Tesaro (Tesaro UK Limited)) Niraparib blocks PARP, an enzyme that helps cancer cells repair damaged DNA. With PARP blocked, ovarian cancer cells - especially those with BRCA gene faults - accumulate DNA damage and die. It is taken once daily as maintenance (keep-it-at-bay) treatment after the cancer has shrunk with platinum chemotherapy. First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or un
Do you need a BRCA test before starting niraparib?
Recommended monitoring for niraparib: Complete blood counts weekly for the first month, monthly for the next 11 months of treatment, and periodically after this time; Blood pressure and heart rate at least weekly for the first 2 months, then monthly for the first year, and periodically thereafter; Monitoring for signs and symptoms of PRES (seizure, headache, altered mental status, visual disturbance or cortical blindness, with or without hypertension); Do not start until patients have recovered from haematological toxicity caused by previous chemotherapy (<=Grade 1); For suspected MDS/AML or prolonged haematological toxicity, refer to a haematologist; discontinue if MDS/AML is confirmed
How long can you stay on niraparib maintenance?
Niraparib (PARP inhibitor (poly (ADP-ribose) polymerase inhibitor), originally Zejula by GlaxoSmithKline (GSK); originally developed by Tesaro (Tesaro UK Limited)) Niraparib blocks PARP, an enzyme that helps cancer cells repair damaged DNA. With PARP blocked, ovarian cancer cells - especially those with BRCA gene faults - accumulate DNA damage and die. It is taken once daily as maintenance (keep-it-at-bay) treatment after the cancer has shrunk with platinum chemotherapy. First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or un
What is PRES and is it a risk with niraparib?
Niraparib (PARP inhibitor (poly (ADP-ribose) polymerase inhibitor), originally Zejula by GlaxoSmithKline (GSK); originally developed by Tesaro (Tesaro UK Limited)) Niraparib blocks PARP, an enzyme that helps cancer cells repair damaged DNA. With PARP blocked, ovarian cancer cells - especially those with BRCA gene faults - accumulate DNA damage and die. It is taken once daily as maintenance (keep-it-at-bay) treatment after the cancer has shrunk with platinum chemotherapy. First-line maintenance of advanced ovarian cancer: 200 mg once daily for patients weighing <77 kg (<170 lbs) OR with a platelet count <150,000/mcL; 300 mg once daily for patients weighing >=77 kg (>=170 lbs) AND platelet count >=150,000/mcL. Maintenance of recurrent germline BRCA-mutated ovarian cancer: 300 mg once daily. Tablets taken with or without food; continue until disease progression or un
Sources
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/214876s000lbl.pdf
- https://zejulahcp.com/dosing
- https://medex.com.bd/generics/1858/niraparib
- https://medex.com.bd/generics/1858/niraparib/brand-names
- https://www.niraparix.com
- https://www.everestpharmabdestore.com/product/niranib
- https://www.biopharmaapac.com/news/33/1723/-gsks-zejula-niraparib-tablet-approved-in-singapore-for-first-line-and-recurrent-monotherapy-maintenance-treatment-in-advanced-ovarian-cancer.html
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