Akeega (niraparib and abiraterone acetate)
Janssen Oncology (Johnson & Johnson) · PARP Inhibitor + CYP17 Inhibitor Combination
What is Akeega? Akeega (niraparib and abiraterone acetate) is the first FDA-approved combination of a PARP inhibitor and an androgen biosynthesis inhibitor in a single tablet, approved for BRCA-mutated metastatic castration-resistant prostate cancer (mCRPC) with methylprednisolone.
About Akeega
| Brand Name | Akeega |
| Generic / INN | niraparib and abiraterone acetate |
| Drug Class | PARP Inhibitor + CYP17 Inhibitor Combination |
| Manufacturer | Janssen Oncology (Johnson & Johnson) |
| Administration | Oral tablet |
| FDA Approval | 2023 |
FDA-Approved Uses for Akeega
Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.
- BRCA-mutated (germline and/or somatic) metastatic castration-resistant prostate cancer (mCRPC) — in combination with methylprednisolone and androgen deprivation therapy
How Does Akeega Work?
Niraparib inhibits PARP1 and PARP2 enzymes — exploiting the synthetic lethality of BRCA1/2-deficient tumor cells (DNA repair impairment). Abiraterone acetate inhibits CYP17 to block androgen biosynthesis. The combination targets both androgen signaling and DNA repair, providing synergistic activity in BRCA-mutated mCRPC.
Dosage & Administration
Two tablets daily (niraparib 100 mg / abiraterone acetate 500 mg = two 50/250 mg tablets orally once daily) on an empty stomach (no food 2 hours before or 1 hour after). Taken with methylprednisolone 4 mg twice daily (not prednisone — methylprednisolone is required with Akeega).
Warnings, Precautions & Side Effects
General Warning
Myelosuppression (niraparib component) — CBC monitoring required. MDS/AML risk (niraparib). Adrenocortical insufficiency (abiraterone). Mineralocorticoid excess — managed with methylprednisolone. Hepatotoxicity — LFT monitoring. Embryo-fetal toxicity. Hypertension. Cardiac disorders.
Common Side Effects
- Fatigue
- Anemia
- Nausea
- Constipation
- Thrombocytopenia
- Hypertension
- Arthralgia
- Peripheral edema
This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.
Storage & Handling
Store at room temperature 20°C to 25°C (68°F to 77°F).
BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.
Insurance Coverage, Prior Authorization & Patient Assistance
🛡️ Commercial Insurance
Akeega is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.
✅ Prior Authorization
Prior authorization is required by virtually all insurance plans for Akeega. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.
🏥 Medicare Coverage
Medicare Part D covers this oral specialty medication. Medicaid coverage varies by state.
🆓 Patient Assistance
Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.
Prior Authorization Patient Assistance Insurance & Savings Medication Costs
Frequently Asked Questions — Akeega
Akeega combines niraparib (PARP inhibitor) and abiraterone acetate (CYP17 inhibitor) in a single daily tablet for BRCA-mutated metastatic castration-resistant prostate cancer (mCRPC). It targets both DNA repair pathways and androgen production simultaneously.
No — Akeega must be taken with methylprednisolone 4 mg twice daily, not prednisone. This is different from standard abiraterone regimens and is important to follow correctly.
Yes. BRCA1 or BRCA2 mutation testing (germline and/or somatic) using an FDA-approved companion diagnostic is required before starting Akeega.
Akeega is covered by most commercial insurance and Medicare Part D with prior authorization and BRCA mutation documentation.
Related Medications & Conditions
Related Medications
Lynparza (olaparib) · Abiraterone Acetate · Erleada (apalutamide) · Xtandi (enzalutamide)
Related Conditions
BRCA-mutated mCRPC · Metastatic castration-resistant prostate cancer · Prostate cancer