Sweet Orange - Zejula (Niraparib Tosylate) Interaction
Herbal: Sweet Orange
Also Known As: Citrus sinensis, Blood Orange, Citri Sinensis, Citrus Peel Extract, Extrait de Zeste d'Agrume, Jaffa Orange, Naranja Dulce, Navel Orange, Orange, Orange de Jaffa, Orange Douce, Red Orange, Shamouti Orange, Shamouti Sweet Orange, Valencia Orange, Wild Orange, Wild Sweet O
Drug: Niraparib Tosylate
Brand names:
Zejula
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 22, 2025
Interaction Details
Niraparib Tosylate is classified as belonging to the following category: P-Glycoprotein Substrates
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
- Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9.
- Takanaga H, Ohnishi A, Yamada S, et al. Polymethoxylated flavones in orange juice are inhibitors of P-glycoprotein but not cytochrome P450 3A4. J Pharmacol Exp Ther 2000;293:230-6.
Sweet Orange Overview
Sweet orange, also known as Citrus sinensis, is a type of citrus fruit native to Southeast Asia. It is a good source of vitamin C and other nutrients, including folate, potassium, and dietary fiber. It is also a good source of antioxidants, which are substances that help to protect the body's cells from damage caused by free radicals.
Sweet orange is used in traditional medicine as both aromatherapy and herbal remedies. The essential oil is generally extracted from the sweet orange peel and is used for its purported relaxant properties. As a dietary supplement, it is most commonly used to treat digestive problems and to help reduce the severity of colds and other respiratory infections.
Niraparib Tosylate Overview
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Niraparib is used to help maintain the response of certain types of ovarian (female reproductive organs where eggs are formed), fallopian tube (tube that transports eggs released by the ovaries to the uterus), and peritoneal (layer of tissue that lines the stomach) cancer in people who have completely responded or partially responded to other chemotherapy medication(s). It is also used to treat certain types of ovarian, fallopian tube, or peritoneal cancer when the cancer has gotten worse after 3 or more chemotherapy treatments. Niraparib is in a class of medications called poly (ADP-ribose) polymerase (PARP) inhibitors. It works by killing cancer cells.
Sweet Orange - More Interactions
Sweet Orange interacts with 239 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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