Akeega (niraparib/abiraterone) - Uses, Side Effects, and More

What are the most common side effects of Akeega?

The most common side effects of Akeega are listed below. Tell your health care provider if you have any of these side effects that bother you.

• Blood disorders (see below)
• Low potassium levels (see below)
• Muscle or joint pain
• Tiredness and trouble sleeping
• Increased blood pressure (see below)
• Fluid retention (see below)
• Lung problems, such as shortness of breath and coughing
• Reduced appetite and weight loss
• Dizziness and falls
• Fever and infections, such as COVID-19 and bladder or kidney infections
• Headache
• Stomach pain, nausea, vomiting, and constipation
• Bleeding, such as nosebleeds
• Abnormal heart rhythm

There may be other side effects of Akeega that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Akeega?

While less common, the most serious side effects of Akeega are described below, along with what to do if they happen.

Severe Allergic Reactions. Akeega may cause allergic reactions, which can be serious. Stop taking Akeega and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Blood Disorders. Akeega may cause your bone marrow to not make enough cells. This can lead to low blood levels of important cells, such as red blood cells, white blood cells, and platelets. Bone marrow suppression can lead to infections or bleeding. This can be serious or even life-threatening. Keep all appointments to have your blood checked. Tell your health care provider right away if you have any of the following symptoms of bone marrow suppression.

• Unusual weakness or tiredness
• Unusual bleeding or bruising
• Tiny red or purple spots on your skin
• Looking pale
• Cold hands and feet
• Shortness of breath
• Headache
• Fever
• Weight loss or loss of appetite
• Swollen gums
• Frequent infections
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Fast or abnormal heartbeat

Bone Marrow Problems or Blood Cancer. Akeega may cause a bone marrow problem called myelodysplastic syndrome (MDS) or a type of blood cancer, acute myeloid leukemia (AML). These problems may be life-threatening. Your health care provider can monitor for MDS/AML by testing your blood regularly during treatment with Akeega. Keep all appointments to have your blood checked.

Reduced Adrenal Function. Akeega can raise the risk of adrenal insufficiency, which is when your adrenal glands make less stress hormone (cortisol) than usual. This side effect may happen if your body is under more stress than usual (because of fever, surgery, trauma, etc.), or if you stop or reduce your dosage of a steroid medicine, such as prednisone. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

• Nausea or vomiting
• Weakness or unusual tiredness
• Low blood pressure or feeling dizzy or lightheaded

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Akeega. Your health care provider may do blood tests to check the health of your liver. Keep all appointments to check your bloodwork before starting Akeega and during and after treatment. Call your health care provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Low Potassium Levels. Akeega can lead to low potassium levels (hypokalemia), which can be serious and may lead to death. Keep all appointments to have your blood checked. Call your health care provider if you have any of the following symptoms of a low potassium level.

• Weakness
• Unusual tiredness
• Muscle cramps or twitching
• Constipation
• Heart palpitations or heart rhythm problems

Fluid Retention. Akeega can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms. 

• Chest pain
• Irregular heartbeat
• Shortness of breath
• Stretched or shiny skin
• Swollen body parts, such as the belly or ankles

Increased Blood Pressure. Akeega may increase your blood pressure or make it worse if you already have a history of high blood pressure (hypertension). Keep all appointments to have your blood pressure checked. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry vision or other changes to your vision
• Buzzing in the ears
• Nosebleeds
• Feeling of skipped heartbeats

Posterior Reversible Encephalopathy Syndrome (PRES). Akeega may cause a rare but serious brain disorder called PRES. PRES involves swelling and narrowing of blood vessels in your brain. If PRES is not treated, it can lead to a stroke. Call your health care provider right away if you have any of the following symptoms of PRES.

• Changes in thinking or behavior
• Confusion or hallucinations
• Sudden decrease or change in vision 
• Sudden severe headache
• Seizures