Drug & supplement interaction

Chiropractic + Niraparib Tosylate

Niraparib Tosylate brand name: Zejula.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Chiropractic and Niraparib Tosylate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Chiropractic and Niraparib Tosylate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Niraparib Tosylate and Chiropractic in our sources. This does not guarantee that the combination is completely free of risk — research on Chiropractic alongside specific medications may be limited.

Chiropractic is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Chiropractic safety at a glance

Chiropractic overall Use caution Generally safe for most people when done by a licensed provider, but serious risks exist for certain neck procedures and high-risk patients.
Pregnancy Possibly Safe When used appropriately, short-term. Chiropractic treatment has been administered during pregnancy with apparent safety for up to 10 weeks. Read the full pregnancy detail
Breastfeeding Generally safe Chiropractic care does not involve substances passed through breast milk and is generally considered acceptable while breastfeeding.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Niraparib Tosylate and Chiropractic? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Niraparib Tosylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Niraparib Tosylate is filed under 2 classifications — p-glycoprotein substrates, oral drugs. Chiropractic has documented interactions with 1 drug class — the most serious being warfarin (coumadin) (moderate) — and none of Niraparib Tosylate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Chiropractic Does Interact With Other Medications

Chiropractic has 2 moderate known drug interactions in our database — Niraparib Tosylate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 2 No known interaction 2,828 (incl. Niraparib Tosylate)
Taking anything else?

Check Another of Your Medications Against Chiropractic

Covers the 2,830 medications we’ve checked against Chiropractic. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Chiropractic and Niraparib Tosylate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Chiropractic while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Shortness of breath Worth acting on Additional detail

    Chiropractic

    “In one case report, a tall, thin patient with a significant smoking history presented with sudden onset dyspnea at rest and associated chest pain two days after chiropractic manipulation of the chest and back. The patient was found to have developed a life-threatening spontaneous primary hemopneumothorax requiring hospitalization and chest tube insertion.”

    Chiropractic · Natural Medicines adverse-effect record, reported in pain.

    1 source cited
    1. 106822. Khatib S, Sabobeh T, Abdalla K, Kulkarni S. A Case Report of Life-Threatening Hemopneumothorax as a Result of Spinal Manipulation Performed by Chiropractor. Cureus 2021;13(9):e18031. PubMed

    Niraparib Tosylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Niraparib Tosylate. Read the label on DailyMed ›

  • Back pain Additional detail

    Chiropractic

    “Adverse reactions are common in patients with neck pain who receive cervical spine manipulation. Reported adverse events occur in about 30% to 56% of patients receiving treatment for neck pain. About 13% of side effects are reported to be of severe intensity. Increased neck pain or neck stiffness occurred in 25% of patients.”

    Chiropractic · Natural Medicines adverse-effect record, reported in back pain.

    4 sources cited
    1. 15960. Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine 2005;30:1477-84. PubMed
    2. 15969. Rubinstein SM, Leboeuf-Yde C, Knol DL, et al. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther 2007;30:408-18. PubMed
    3. 15968. Vohra S, Johnston BC, Cramer K, Humphreys K. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics 2007;119:e275-83. PubMed
    4. 16855. Sozio MS, Cave M. Boerhaave's syndrome following chiropractic manipulation. Am Surg 2008;74:428-9. DOI

    Niraparib Tosylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Niraparib Tosylate. Read the label on DailyMed ›

  • Tiredness reported in 7.8% of FDA reports for Niraparib Tosylate Additional detail

    Chiropractic

    “Upper spinal manipulation has also been linked to at least 14 reports of ophthalmologic adverse effects. These include loss of vision, diplopia, Horner's syndrome, ophthalmoplegia, and others. In many of these cases, the cause of the adverse outcome was cervical artery wall dissection due to chiropractic manipulation.”

    Chiropractic · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 15962. Ernst E. Ophthalmological adverse effects of (chiropractic) upper spinal manipulation: evidence from recent case reports. Acta Ophthalmol Scand 2005;83:581-5. PubMed
    2. 15969. Rubinstein SM, Leboeuf-Yde C, Knol DL, et al. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther 2007;30:408-18. PubMed
    3. 101498. Regan KA, Youn TS, Iyer SSR. Ophthalmic artery occlusion after chiropractic neck manipulation. Acta Ophthalmol. 2018 Aug;96(5):e663-e664. available. PubMed

    Niraparib Tosylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Niraparib Tosylate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Dizziness / Nausea reported in 7.8% of FDA reports for Niraparib Tosylate Additional detail

    Chiropractic

    “After chiropractic treatment for neck pain: ringing in the ears, tiredness, nausea, or dizziness occur in less than 8% of patients. Radiating pain and headache occur infrequently. In one case report, a 36-year-old female reported to the emergency room with severe postural headaches.”

    Chiropractic · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 15960. Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine 2005;30:1477-84. PubMed
    2. 15968. Vohra S, Johnston BC, Cramer K, Humphreys K. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics 2007;119:e275-83. PubMed
    3. 15969. Rubinstein SM, Leboeuf-Yde C, Knol DL, et al. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther 2007;30:408-18. PubMed
    4. 98267. Lin SF, Weng HY. Postural headaches due to cerebrospinal fluid leakage through subarachnoid-pleural fistula: a case report. Headache 2017;57(3):467-71. PubMed
    5. 15967. Whedon JM, Quebada PB, Roberts DW, Radwan TA. Spinal epidural hematoma after spinal manipulative therapy in a patient undergoing anticoagulant therapy: a case report. J Manipulative Physiol Ther 2006;29:582-5. PubMed
    6. 15970. Klougart N, Leboeuf-Yde C, Rasmussen LR. Safety in chiropractic practice, part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988. J Manipulative Physiol Ther 1996;19:371-7.

    Niraparib Tosylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Niraparib Tosylate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Headache Additional detail

    Chiropractic

    Recorded for Chiropractic in the same Natural Medicines adverse-effect record shown under Tiredness above.

    Niraparib Tosylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Niraparib Tosylate. Read the label on DailyMed ›

Reported for Chiropractic but not commonly for Niraparib Tosylate: ringing in the ears, a stroke or mini-stroke, loss of vision and low blood pressure.

Effects for Niraparib Tosylate come from the ADVERSE REACTIONS section of its FDA label; effects for Chiropractic come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 51 voluntary FDA FAERS reports for Niraparib Tosylate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Chiropractic in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used appropriately, short-term. Chiropractic treatment has been administered during pregnancy with apparent safety for up to 10 weeks.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Niraparib Tosylate

This page covers Chiropractic only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Niraparib Tosylate page lists 54 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Bitter Melon (moderate), Black Pepper (moderate) and Bulbine Natalensis (moderate).

By severity: 2 major · 35 moderate · 17 minor.

From our pharmacist’s overview on the Niraparib Tosylate page

“Activated charcoal, popular for bloating and so-called detox routines, can trap niraparib (Zejula) in the gut before it absorbs, and St. John's wort can drive levels of the drug down another way.”

Reviewed by 2 · Jul 18, 2026

Open the Niraparib Tosylate interaction page

How much people look this up

Where Chiropractic and Niraparib Tosylate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Chiropractic
Steady interest

#1,111 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Niraparib Tosylate
Steady interest

#2,584 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Chiropractic reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Chiropractic and Niraparib Tosylate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Chiropractic

What is Chiropractic?

  • Low back pain
  • Neck pain
  • Tension and certain headaches
  • Joint and muscle pain
  • Posture and mobility concerns

Chiropractic is a licensed health profession that treats muscle and joint problems mostly through hands-on spinal manipulation, not a dietary supplement or herb. There is reasonable evidence it can help short-term low back pain and neck pain in many people, but it is not a cure-all, and you should see a qualified provider and rule out serious causes of pain first.

Not applicable (Chiropractic is a hands-on health profession, not a plant or supplement) · In-person treatment, including spinal manipulation (adjustments), mobilization, soft-tissue therapy, and exercise advice

An interaction check asks whether these two react with each other — it does not ask whether Chiropractic is a good idea for someone in your situation. Here is what our Chiropractic record says about it on its own.

Chiropractic: dosing

There is no "dose" for chiropractic the way there is for a supplement. Instead, a chiropractor recommends a treatment plan — how many visits, how often, and which techniques — based on your condition.A common approach for back or neck pain is a short series of visits with a planned re-check; if you are not improving after a few weeks, the plan should be reconsidered. Be cautious of providers who recommend long, open-ended packages of frequent visits without clear goals.

From our Chiropractic monograph — the full record covers uses, side effects and every documented interaction.

Read the full Chiropractic monograph & all interactions
Medication

About Niraparib

What Is Niraparib Used For?

Brand name: Zejula

Zejula is used as maintenance therapy — meaning it is taken after chemotherapy to help keep the cancer from coming back — for adults with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer. For first-line maintenance, Zejula is approved for patients whose cancer is HRD-positive (has certain DNA-repair defects, including BRCA mutations or genomic instability) and who have responded to their first round of platinum-based chemotherapy.

Zejula is also approved for maintenance treatment in adults with recurrent ovarian, fallopian tube, or primary peritoneal cancer that carries a germline BRCA mutation (an inherited change in the BRCA gene), when the cancer has responded to platinum-based chemotherapy. In both cases, a companion diagnostic test is required to confirm eligibility before starting Zejula.

Most-Reported Side Effects for Niraparib Tosylate

From FAERS, the FDA’s public side-effect reporting system (51 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Constipation 4 reports
Decreased appetite 4 reports
Fatigue 4 reports
Nausea 4 reports
Prostatic specific antigen increased 4 reports
See full Niraparib drug information
Keep checking

Other Drugs & Chiropractic

Browse every other medication we’ve checked against Chiropractic — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
2Moderate
0Minor
2,827No known interaction
2 Moderate 2,827 No interaction
Moderate

2 interactions

No interaction 2,827 drugs checked — show the list

We also checked Chiropractic against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,827 medications checked with no known interaction — see the full Chiropractic list.

See the full Chiropractic interactions page
See every supplement checked against Niraparib Tosylate, ranked by severity
Evidence & sources

Chiropractic References

The 19 references that drive our Chiropractic monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Meeker WC, Haldeman S. Chiropractic: A profession at the crossroads of mainstream and alternative medicine. Ann Intern Med 2002;136:216-27. PubMed
  2. Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine 2005;30:1477-84. PubMed
  3. Ernst E. Ophthalmological adverse effects of (chiropractic) upper spinal manipulation: evidence from recent case reports. Acta Ophthalmol Scand 2005;83:581-5. PubMed
  4. Reuter U, Hämling M, Kavuk I, et al. Vertebral artery dissections after chiropractic neck manipulation in Germany over three years. J Neurol 2006;253:724-30. PubMed
  5. Whedon JM, Quebada PB, Roberts DW, Radwan TA. Spinal epidural hematoma after spinal manipulative therapy in a patient undergoing anticoagulant therapy: a case report. J Manipulative Physiol Ther 2006;29:582-5. PubMed
  6. Vohra S, Johnston BC, Cramer K, Humphreys K. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics 2007;119:e275-83. PubMed
  7. Rubinstein SM, Leboeuf-Yde C, Knol DL, et al. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther 2007;30:408-18. PubMed
  8. Klougart N, Leboeuf-Yde C, Rasmussen LR. Safety in chiropractic practice, part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988. J Manipulative Physiol Ther 1996;19:371-7.
  9. Hurwitz EL, Aker PD, Adams AH, et al. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine 1996;21:1746-59. PubMed
  10. Dvorak J, Orelli F. How dangerous is manipulation of the cervical spine: case report and results of a survey. Manual Medicine 1985;2:1-4.
  11. Sozio MS, Cave M. Boerhaave's syndrome following chiropractic manipulation. Am Surg 2008;74:428-9. DOI
  12. Church EW, Sieg EP, Zalatimo O, et al. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus. 2016 Feb 16;8(2):e498. PubMed
  13. Gausel AM, Kjærmann I, Malmqvist S, et al. Chiropractic management of dominating one-sided pelvic girdle pain in pregnant women; a randomized controlled trial. BMC Pregnancy Childbirth 2017;17(1):331. PubMed
  14. Lin SF, Weng HY. Postural headaches due to cerebrospinal fluid leakage through subarachnoid-pleural fistula: a case report. Headache 2017;57(3):467-71. PubMed
  15. Regan KA, Youn TS, Iyer SSR. Ophthalmic artery occlusion after chiropractic neck manipulation. Acta Ophthalmol. 2018 Aug;96(5):e663-e664. available. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Chiropractic While Taking Niraparib Tosylate: Common Questions

Is it safe to have Chiropractic while taking Niraparib Tosylate?
We do not list a known interaction between Chiropractic and Niraparib Tosylate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Chiropractic and Niraparib Tosylate have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Chiropractic and Niraparib Tosylate combination checked?
Interactions in our licensed database are recorded against drug classes. Niraparib Tosylate is filed under 2 classifications, and Chiropractic has documented interactions with 1 drug class — none of Niraparib Tosylate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Chiropractic interact with any other medications?
Yes. Chiropractic has 2 documented drug interactions in our database — Niraparib Tosylate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Niraparib Tosylate interact with any supplements?
Yes. Niraparib Tosylate has documented interactions with 54 supplements in our database — Chiropractic is not one of them. The Niraparib Tosylate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Chiropractic monograph Uses, safety profile, and every drug interaction in one place Niraparib drug information The full plain-English guide to this medication Niraparib Tosylate supplement interactions Every supplement checked against Niraparib Tosylate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 19 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Niraparib Tosylate and Chiropractic?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.