← All drugs
Drug · FAERS side-effect profile with label screen

Adapalene side effects: what 181,054 FDA adverse event reports show

Adapalene · 739 reaction terms · 428,164 drug–reaction co-reports · data 2026-09-14
Share: X Facebook Reddit Email

Drug class

Retinoid

FDA label (Established Pharmacologic Class) · compare the class

Who reports

181,054 reports · 1% serious · 33 with death outcome · 78% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Adapalene gel, 0.3% is indicated for the topical treatment of acne vulgaris in patients 12 years of age and older. Adapalene gel, 0.3%, is a retinoid, indicated for the topical treatment of acne vulgaris in patients 12 years of age and older. ( 1 )

FDA label, Indications and Usage

What it is

Adapalene is a naphthoic acid that is CD437 in which the phenolic hydroxy group has been converted to its methyl ether. It has a role as a non-steroidal anti-inflammatory drug, a dermatologic drug and an EC 2.7.11.22 (cyclin-dependent kinase) inhibitor.

PubChem CID 60164 (ChEBI)

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 4Labeled (related wording) 6Likely indication confounding 1Reporting / coding artifact 3Not in label — unassessed 26
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 699 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Chemical burn of skin1,801282.2
258.9–307.6ROR 285.0 · calibrated p 2e-11 ✓
81.5 EB05 78.4 · IC025 +6.2
3/3 methods agree
vs other Retinoids: PRR 582.4 (261.3–1,298.0)
Not in label — unassessedserious n=9 · 99% consumernot reported in cached trials
Chemical peel of skin18203.9
94.1–441.8ROR 203.9 · calibrated p 3e-8 ✓
68.4 EB05 45.8 · IC025 +3.8
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed–not reported in cached trials
Skin fragility1,480179.9
165.8–195.2ROR 181.4 · calibrated p 1e-9 ✓
70.1 EB05 67.1 · IC025 +6.0
3/3 methods agree
vs other Retinoids: PRR 130.5 (85.7–198.8)
Not in label — unassessed100% consumernot reported in cached trials
Skin burning sensation41,912167.8
165.5–170.3ROR 218.1 · calibrated p 2e-10 ✓
68.2 EB05 67.7 · IC025 +6.1
3/3 methods agree
vs other Retinoids: PRR 118.7 (110.1–128.0)
Not in label — unassessedage-adj. PRR 168.7 · serious PRR 49.3 · 99% consumernot reported in cached trials
Acne39,434125.0
123.3–126.7ROR 159.5 · calibrated p 3e-9 ✓
59.9 EB05 59.5 · IC025 +5.9
3/3 methods agree
vs other Retinoids: PRR 45.8 (43.7–48.1)
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 118.4 · serious PRR 39.1 · 100% consumernot reported in cached trials
Acne cystic1,447106.6
99.2–114.5ROR 107.4 · calibrated p 7e-8 ✓
55.4 EB05 53.0 · IC025 +5.7
3/3 methods agree
vs other Retinoids: PRR 31.2 (25.2–38.6)
Not in label — unassessedserious n=4 · 99% consumernot reported in cached trials
First degree chemical burn of skin1195.9
42.9–214.0ROR 95.9 · calibrated p 5e-6 ✓
48.3 EB05 28.8 · IC025 +3.0
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed–not reported in cached trials
Dilated pores3986.6
57.1–131.4ROR 86.7 · calibrated p 9e-7 ✓
48.4 EB05 37.0 · IC025 +4.4
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed100% consumernot reported in cached trials
Seborrhoea1,57586.5
81.0–92.3ROR 87.2 · calibrated p 3e-7 ✓
49.5 EB05 47.4 · IC025 +5.5
3/3 methods agree
vs other Retinoids: PRR 74.5 (54.7–101.6)
Not in label — unassessedserious n=2 · 100% consumernot reported in cached trials
Sensitive skin2,82474.0
70.6–77.6ROR 75.2 · calibrated p 9e-7 ✓
45.1 EB05 43.8 · IC025 +5.4
3/3 methods agree
vs other Retinoids: PRR 608.8 (316.4–1,171.2)
Not in label — unassessedserious n=4 · 100% consumernot reported in cached trials
Acne pustular28762.3
53.9–71.9ROR 62.4 · calibrated p 4e-6 ✓
40.4 EB05 36.7 · IC025 +5.1
3/3 methods agree
vs other Retinoids: PRR 24.2 (15.8–37.0)
Not in label — unassessedserious n=2 · 99% consumernot reported in cached trials
Skin hypopigmentation61061.6
55.9–68.0ROR 61.9 · calibrated p 4e-6 ✓
40.2 EB05 37.6 · IC025 +5.2
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed99% consumernot reported in cached trials
Dry skin45,42661.0
60.4–61.6ROR 81.1 · calibrated p 5e-7 ✓
40.0 EB05 39.7 · IC025 +5.3
3/3 methods agree
vs other Retinoids: PRR 24.2 (23.4–25.0)
Labeled adverse reaction
exact term
age-adj. PRR 47.5 · serious PRR 21.4 · 100% consumerNCT00421993: 60/418 (14.4%) on Adapalene
Skin discomfort86155.3
51.0–60.0ROR 55.6 · calibrated p 7e-6 ✓
37.5 EB05 35.4 · IC025 +5.1
3/3 methods agree
vs other Retinoids: PRR 278.4 (124.7–621.4)
Labeled adverse reaction
exact term
serious n=3 · 100% consumernot reported in cached trials
Skin hyperpigmentation2,74254.3
51.9–56.8ROR 55.1 · calibrated p 7e-6 ✓
37.0 EB05 35.9 · IC025 +5.1
3/3 methods agree
vs other Retinoids: PRR 126.7 (93.4–171.8)
Not in label — unassessedserious n=6 · 99% consumernot reported in cached trials
Skin exfoliation21,39540.0
39.4–40.6ROR 45.2 · calibrated p 2e-5 ✓
29.8 EB05 29.5 · IC025 +4.9
3/3 methods agree
vs other Retinoids: PRR 37.5 (35.3–39.8)
Not in label — unassessedage-adj. PRR 39.7 · serious PRR 15.1 · 99% consumernot reported in cached trials
Chemical burn24732.0
27.8–36.9ROR 32.1 · calibrated p 2e-4 ✓
25.1 EB05 22.6 · IC025 +4.4
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessedserious n=4 · 97% consumernot reported in cached trials
Skin tightness90327.5
25.5–29.5ROR 27.6 · calibrated p 4e-4 ✓
22.3 EB05 21.1 · IC025 +4.4
3/3 methods agree
vs other Retinoids: PRR 97.3 (61.0–155.2)
Not in label — unassessedserious n=6 · 99% consumernot reported in cached trials
Erythema (skin redness)38,58926.7
26.4–26.9ROR 33.6 · calibrated p 1e-4 ✓
21.8 EB05 21.6 · IC025 +4.4
3/3 methods agree
vs other Retinoids: PRR 61.6 (58.2–65.2)
Labeled adverse reaction
exact term
age-adj. PRR 27.3 · serious PRR 9.6 · 99% consumernot reported in cached trials
Rash papular4,14826.1
25.2–27.0ROR 26.7 · calibrated p 5e-4 ✓
21.4 EB05 20.8 · IC025 +4.4
3/3 methods agree
vs other Retinoids: PRR 141.2 (108.7–183.3)
Not in label — unassessedage-adj. PRR 29.8 · serious PRR 16.9 · 99% consumernot reported in cached trials
Periorbital irritation3815.5
11.0–21.7ROR 15.5 · calibrated p 0.008 ✓
13.5 EB05 10.1 · IC025 +3.0
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed100% consumernot reported in cached trials
Eyelid exfoliation9115.1
12.1–18.7ROR 15.1 · calibrated p 0.008 ✓
13.3 EB05 11.1 · IC025 +3.3
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessedserious n=2 · 99% consumernot reported in cached trials
Rash macular3,91514.6
14.1–15.1ROR 14.9 · calibrated p 0.007 ✓
13.0 EB05 12.7 · IC025 +3.6
3/3 methods agree
vs other Retinoids: PRR 79.1 (64.6–96.9)
Not in label — unassessedage-adj. PRR 16.7 · serious PRR 9.2 · 99% consumernot reported in cached trials
Skin fissures2,03813.9
13.3–14.6ROR 14.1 · calibrated p 0.009 ✓
12.5 EB05 12.0 · IC025 +3.6
3/3 methods agree
vs other Retinoids: PRR 28.2 (23.8–33.5)
Not in label — unassessedage-adj. PRR 12.2 · serious n=4 · 99% consumernot reported in cached trials
Dermatitis2,05812.7
12.1–13.3ROR 12.8 · calibrated p 0.013 ✓
11.5 EB05 11.1 · IC025 +3.4
3/3 methods agree
vs other Retinoids: PRR 17.0 (14.8–19.4)
Labeled adverse reaction
exact term
age-adj. PRR 11.1 · serious PRR 12.7 · 98% consumernot reported in cached trials
Skin warm56912.5
11.4–13.6ROR 12.5 · calibrated p 0.015 ✓
11.3 EB05 10.5 · IC025 +3.3
3/3 methods agree
vs other Retinoids: PRR 36.8 (25.5–53.1)
Not in label — unassessed99% consumernot reported in cached trials
Scar1,63212.1
11.5–12.7ROR 12.2 · calibrated p 0.016 ✓
11.0 EB05 10.6 · IC025 +3.4
3/3 methods agree
vs other Retinoids: PRR 11.5 (10.1–13.0)
Not in label — unassessedage-adj. PRR 13.9 · serious PRR 18.4 · 99% consumernot reported in cached trials
Inappropriate schedule of product administration16,23511.6
11.4–11.8ROR 12.7 · calibrated p 0.014 ✓
10.6 EB05 10.5 · IC025 +3.4
3/3 methods agree
vs other Retinoids: PRR 59.0 (54.1–64.3)
Reporting / coding artifactage-adj. PRR 16.2 · serious PRR 3.4 · 99% consumernot reported in cached trials
Scab1,03611.6
10.8–12.3ROR 11.6 · calibrated p 0.019 ✓
10.6 EB05 10.0 · IC025 +3.3
3/3 methods agree
vs other Retinoids: PRR 23.9 (19.2–29.9)
Not in label — unassessedage-adj. PRR 16.4 · serious n=7 · 99% consumernot reported in cached trials
Skin injury29011.1
9.8–12.5ROR 11.1 · calibrated p 0.023 ✓
10.1 EB05 9.2 · IC025 +3.1
3/3 methods agree
vs other Retinoids: only this drug
Not in label — unassessed100% consumernot reported in cached trials
Underdose4,9498.3
8.1–8.6ROR 8.6 · calibrated p 0.054
7.8 EB05 7.7 · IC025 +2.9
3/3 methods agree
vs other Retinoids: PRR 129.8 (103.1–163.2)
Reporting / coding artifactage-adj. PRR 14.7 · serious PRR 2.8 · 99% consumernot reported in cached trials
Skin texture abnormal628.1
6.3–10.5ROR 8.1 · calibrated p 0.068
7.3 EB05 5.9 · IC025 +2.4
3/3 methods agree
vs other Retinoids: PRR 15.0 (7.2–31.4)
Not in label — unassessed100% consumernot reported in cached trials
Skin haemorrhage8937.6
7.1–8.1ROR 7.6 · calibrated p 0.078
7.1 EB05 6.8 · IC025 +2.7
3/3 methods agree
vs other Retinoids: PRR 5.1 (4.5–5.7)
Not in label — unassessedage-adj. PRR 7.2 · 99% consumernot reported in cached trials
Overdose13,2107.5
7.3–7.6ROR 8.0 · calibrated p 0.067
7.1 EB05 7.0 · IC025 +2.8
3/3 methods agree
vs other Retinoids: PRR 179.2 (152.0–211.3)
Reporting / coding artifactage-adj. PRR 10.6 · serious PRR 1.3 · 99% consumernot reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Anaphylaxis / angioedema360.00.0–0.0lower than other drugs
Depression740.00.0–0.0lower than other drugs
Venous thromboembolism550.00.0–0.0lower than other drugs
Opportunistic infection290.00.0–0.0lower than other drugs
Rhabdomyolysis / myopathy130.00.0–0.0lower than other drugs
Osteonecrosis80.00.0–0.0lower than other drugs
Hyponatraemia110.00.0–0.0lower than other drugs
Severe cutaneous reaction100.00.0–0.0lower than other drugs
Pancreatitis80.00.0–0.0lower than other drugs
Suicidality240.00.0–0.0lower than other drugs
Serious infection730.00.0–0.0lower than other drugs
Liver injury260.00.0–0.0lower than other drugs
Seizure130.00.0–0.0lower than other drugs
Arrhythmia / qt120.00.0–0.0lower than other drugs
Malignancy230.00.0–0.0lower than other drugs
Fall / fracture230.00.0–0.0lower than other drugs

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Adapalene as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (2 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)52,9924.8
4.8–4.9ROR 6.4 · calibrated p 0.127
4.7 EB05 4.6 · IC025 +2.2
3/3 methods agree
vs other Retinoids: PRR 18.1 (17.6–18.6)
Reporting / coding artifactage-adj. PRR 3.1 · serious PRR 1.0 · 100% consumernot reported in cached trials
Dry skin45,42661.0
60.4–61.6ROR 81.1 · calibrated p 5e-7 ✓
40.0 EB05 39.7 · IC025 +5.3
3/3 methods agree
vs other Retinoids: PRR 24.2 (23.4–25.0)
Labeled adverse reaction
exact term
age-adj. PRR 47.5 · serious PRR 21.4 · 100% consumerNCT00421993: 60/418 (14.4%) on Adapalene
Skin burning sensation41,912167.8
165.5–170.3ROR 218.1 · calibrated p 2e-10 ✓
68.2 EB05 67.7 · IC025 +6.1
3/3 methods agree
vs other Retinoids: PRR 118.7 (110.1–128.0)
Not in label — unassessedage-adj. PRR 168.7 · serious PRR 49.3 · 99% consumernot reported in cached trials
Acne39,434125.0
123.3–126.7ROR 159.5 · calibrated p 3e-9 ✓
59.9 EB05 59.5 · IC025 +5.9
3/3 methods agree
vs other Retinoids: PRR 45.8 (43.7–48.1)
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 118.4 · serious PRR 39.1 · 100% consumernot reported in cached trials
Erythema (skin redness)38,58926.7
26.4–26.9ROR 33.6 · calibrated p 1e-4 ✓
21.8 EB05 21.6 · IC025 +4.4
3/3 methods agree
vs other Retinoids: PRR 61.6 (58.2–65.2)
Labeled adverse reaction
exact term
age-adj. PRR 27.3 · serious PRR 9.6 · 99% consumernot reported in cached trials
Skin exfoliation21,39540.0
39.4–40.6ROR 45.2 · calibrated p 2e-5 ✓
29.8 EB05 29.5 · IC025 +4.9
3/3 methods agree
vs other Retinoids: PRR 37.5 (35.3–39.8)
Not in label — unassessedage-adj. PRR 39.7 · serious PRR 15.1 · 99% consumernot reported in cached trials
Inappropriate schedule of product administration16,23511.6
11.4–11.8ROR 12.7 · calibrated p 0.014 ✓
10.6 EB05 10.5 · IC025 +3.4
3/3 methods agree
vs other Retinoids: PRR 59.0 (54.1–64.3)
Reporting / coding artifactage-adj. PRR 16.2 · serious PRR 3.4 · 99% consumernot reported in cached trials
Rash15,7284.3
4.3–4.4ROR 4.6 · calibrated p 0.277
4.2 EB05 4.1 · IC025 +2.0
3/3 methods agree
vs other Retinoids: PRR 20.4 (19.4–21.5)
Labeled adverse reaction
exact term
age-adj. PRR 4.6 · serious PRR 3.7 · 99% consumernot reported in cached trials
Overdose13,2107.5
7.3–7.6ROR 8.0 · calibrated p 0.067
7.1 EB05 7.0 · IC025 +2.8
3/3 methods agree
vs other Retinoids: PRR 179.2 (152.0–211.3)
Reporting / coding artifactage-adj. PRR 10.6 · serious PRR 1.3 · 99% consumernot reported in cached trials
Pruritus (itching)11,8813.7
3.7–3.8ROR 3.9 · calibrated p 0.393
3.6 EB05 3.6 · IC025 +1.8
3/3 methods agree
vs other Retinoids: PRR 22.6 (21.2–24.1)
Labeled adverse reaction
exact term
age-adj. PRR 4.4 · serious PRR 4.8 · 99% consumernot reported in cached trials
Hypersensitivity (allergic reaction)8,3945.4
5.3–5.6ROR 5.7 · calibrated p 0.174
5.2 EB05 5.1 · IC025 +2.4
3/3 methods agree
vs other Retinoids: PRR 31.8 (29.1–34.8)
Labeled adverse reaction
exact term
age-adj. PRR 4.5 · serious PRR 11.3 · 99% consumernot reported in cached trials
Condition aggravated5,2722.0
2.0–2.1ROR 2.1 · calibrated p 0.983
2.0 EB05 2.0 · IC025 +1.0
vs other Retinoids: PRR 7.4 (7.0–7.8)
Reporting / coding artifactage-adj. PRR 1.0 · serious PRR 1.5 · 99% consumernot reported in cached trials
Underdose4,9498.3
8.1–8.6ROR 8.6 · calibrated p 0.054
7.8 EB05 7.7 · IC025 +2.9
3/3 methods agree
vs other Retinoids: PRR 129.8 (103.1–163.2)
Reporting / coding artifactage-adj. PRR 14.7 · serious PRR 2.8 · 99% consumernot reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Adapalene?

In FDA FAERS, the most frequently co-reported reaction terms for Adapalene are dry skin, skin burning sensation, acne, erythema, skin irritation, skin exfoliation. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Adapalene have an FDA boxed warning?

No. The FDA label retrieved for Adapalene has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Adapalene causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.