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Azacitidine For side effects: what 18,083 FDA adverse event reports show

Azacitidine For · Azacitidine · 1,025 reaction terms · 50,531 drug–reaction co-reports · data 2026-09-14
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Drug class

Nucleoside Metabolic Inhibitor

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Azacitidine

openFDA label

Who reports

18,083 reports · 97% serious · 5,996 with death outcome · 40% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Azacitidine for injection is a nucleoside metabolic inhibitor indicated for the treatment of: Adult patients with the following FAB myelodysplastic syndrome (MDS) subtypes: Refractory anemia (RA) or refractory anemia with ringed sideroblasts (RARS) (if.

FDA label, Indications and Usage

What it is

Azacitidine for injection contains azacitidine, which is a nucleoside metabolic inhibitor. Azacitidine is 4-amino-1-β-D-ribofuranosyl-s-triazin-2(1H)-one.

FDA label, Description section

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 1Labeled (related wording) 1Likely indication confounding 10Reporting / coding artifact 1Lab value / disease marker 3Not in label — unassessed 24
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 flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 985 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
Flt3 gene mutation124,573.3
1,290.6–16,205.0ROR 4,576.3 · χ² 10,075 / p <1e-300
371.7 EB05 226.6 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Allogenic stem cell transplantation50549.7
392.4–769.9ROR 551.2 · χ² 18,124 / p <1e-300
325.2 EB05 256.4 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=49not reported in cached trials
Acute myeloid leukaemia refractory51507.0
364.7–704.9ROR 508.5 · χ² 17,495 / p <1e-300
310.6 EB05 245.4 · IC025 +5.9
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=51not reported in cached trials
Protothecosis25420.3
265.8–664.6ROR 420.9 · χ² 7,343 / p <1e-300
249.1 EB05 177.5 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=25 · ♀ 100% (drug 40%) · 100% cliniciannot reported in cached trials
Emphysematous cholecystitis13401.7
213.6–755.6ROR 402.0 · χ² 3,554 / p <1e-300
207.3 EB05 128.9 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Corynebacterium bacteraemia20368.8
222.8–610.4ROR 369.2 · χ² 5,272 / p <1e-300
220.5 EB05 150.7 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=20 · 100% cliniciannot reported in cached trials
Acute myeloid leukaemia recurrent454314.8
284.0–348.9ROR 322.9 · χ² 111,111 / p <1e-300
244.5 EB05 226.2 · IC025 +7.4
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=453 · 91% cliniciannot reported in cached trials
Parainfluenza virus infection12298.3
158.0–562.9ROR 298.5 · χ² 2,589 / p <1e-300
172.4 EB05 105.1 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Cord blood transplant therapy17285.8
168.0–486.2ROR 286.1 · χ² 3,635 / p <1e-300
182.3 EB05 120.6 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious n=17not reported in cached trials
Chimerism14216.3
122.2–382.9ROR 216.5 · χ² 2,345 / p <1e-300
146.2 EB05 92.6 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Bacillus bacteraemia17211.3
126.0–354.4ROR 211.5 · χ² 2,828 / p <1e-300
149.0 EB05 98.5 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=17not reported in cached trials
Blastic plasmacytoid dendritic cell neoplasia10168.1
86.6–326.5ROR 168.2 · χ² 1,306 / p 2e-286
115.1 EB05 66.8 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=10not reported in cached trials
Leukostasis syndrome16164.8
97.6–278.3ROR 164.9 · χ² 2,136 / p <1e-300
123.3 EB05 80.5 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Minimal residual disease51141.5
105.8–189.3ROR 141.9 · χ² 6,208 / p <1e-300
120.5 EB05 95.2 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=51 · 94% cliniciannot reported in cached trials
Transformation to acute myeloid leukaemia69136.0
106.0–174.5ROR 136.5 · χ² 8,144 / p <1e-300
117.8 EB05 96.2 · IC025 +5.6
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=69not reported in cached trials
Differentiation syndrome67119.9
93.2–154.1ROR 120.3 · χ² 7,042 / p <1e-300
105.4 EB05 85.9 · IC025 +5.5
3/3 methods agree
Labeled adverse reaction
exact term
serious n=67 · 99% clinicianNCT03416179: 2/160 (1.2%) control (serious AE)
Acute myeloid leukaemia1,299105.6
99.9–111.5ROR 113.7 · χ² 123,173 / p <1e-300
96.6 EB05 92.3 · IC025 +6.5
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious PRR 57.5 · 93% cliniciannot reported in cached trials
Congenital aplasia23100.0
65.3–153.1ROR 100.1 · χ² 1,983 / p <1e-300
85.7 EB05 60.1 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=23 · ♀ 10% (drug 40%) · 100% cliniciannot reported in cached trials
Geotrichum infection1694.3
56.6–157.0ROR 94.4 · χ² 1,279 / p 2e-280
79.2 EB05 51.7 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Blast cell count increased7690.4
71.6–114.2ROR 90.8 · χ² 6,146 / p <1e-300
82.2 EB05 67.8 · IC025 +5.4
3/3 methods agree
Lab value / disease markerserious n=75not reported in cached trials
Aeromonas infection1285.2
47.4–153.2ROR 85.3 · χ² 853 / p 1e-187
70.8 EB05 43.2 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Pneumonia adenoviral1384.4
48.1–148.3ROR 84.5 · χ² 922 / p 8e-203
70.9 EB05 44.1 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Red blood cell transfusion2577.3
51.5–115.8ROR 77.4 · χ² 1,692 / p <1e-300
68.8 EB05 49.0 · IC025 +4.2
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=25not reported in cached trials
Adenoviral hepatitis1474.4
43.4–127.8ROR 74.5 · χ² 885 / p 1e-194
64.1 EB05 40.6 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Chronic myelomonocytic leukaemia3666.3
47.4–92.7ROR 66.4 · χ² 2,127 / p <1e-300
60.8 EB05 45.9 · IC025 +4.5
3/3 methods agree
Likely indication confounding
term in indications
serious n=36 · ♀ 13% (drug 40%)not reported in cached trials
Bacillus infection3364.6
45.5–91.7ROR 64.7 · χ² 1,896 / p <1e-300
59.2 EB05 44.1 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=33 · 100% cliniciannot reported in cached trials
Chloroma2263.7
41.5–97.8ROR 63.8 · χ² 1,227 / p 4e-269
57.5 EB05 40.0 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=22 · 95% cliniciannot reported in cached trials
Blood product transfusion dependent2160.3
38.9–93.5ROR 60.4 · χ² 1,108 / p 3e-243
54.7 EB05 37.7 · IC025 +3.9
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=21 · 90% cliniciannot reported in cached trials
Graft versus host disease in lung2153.6
34.6–83.0ROR 53.7 · χ² 986 / p 1e-216
49.1 EB05 33.9 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=21 · 100% cliniciannot reported in cached trials
Myelosuppression1,50253.5
51.0–56.3ROR 58.3 · χ² 74,052 / p <1e-300
51.2 EB05 49.0 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 30.4 · 98% cliniciannot reported in cached trials
Refractory anaemia with an excess of blasts1453.5
31.3–91.5ROR 53.6 · χ² 640 / p 2e-141
48.1 EB05 30.4 · IC025 +3.3
3/3 methods agree
Likely indication confounding
term in indications
serious n=14not reported in cached trials
Anorectal infection1152.4
28.6–95.9ROR 52.4 · χ² 482 / p 3e-107
46.4 EB05 27.6 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=11NCT03416179: 1/201 (0.5%) control (serious AE)
Platelet transfusion5552.1
39.8–68.3ROR 52.3 · χ² 2,590 / p <1e-300
49.1 EB05 39.2 · IC025 +4.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=55 · ♀ 61% (drug 40%)not reported in cached trials
Primary myelofibrosis1349.5
28.4–86.3ROR 49.6 · χ² 547 / p 3e-121
44.6 EB05 27.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Pneumonia fungal15748.9
41.7–57.3ROR 49.3 · χ² 7,016 / p <1e-300
46.7 EB05 40.8 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=157 · 91% clinicianNCT03416179: 2/162 (1.2%) on Azacitidine For; 2/201 (1.0%) control (serious AE)
Blast cells present1947.8
30.2–75.7ROR 47.9 · χ² 792 / p 1e-174
44.1 EB05 29.8 · IC025 +3.6
3/3 methods agree
Lab value / disease markerserious n=19not reported in cached trials
Granulocyte count decreased6745.3
35.5–57.8ROR 45.4 · χ² 2,748 / p <1e-300
43.1 EB05 35.1 · IC025 +4.6
3/3 methods agree
Lab value / disease markerserious n=67 · 99% cliniciannot reported in cached trials
Cytopenia44945.2
41.2–49.7ROR 46.4 · χ² 18,657 / p <1e-300
43.5 EB05 40.2 · IC025 +5.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 26.2 · 91% clinicianNCT03416179: 1/160 (0.6%) on Azacitidine For; 3/201 (1.5%) control (serious AE)
Periorbital cellulitis2045.0
28.8–70.4ROR 45.1 · χ² 786 / p 3e-173
41.8 EB05 28.5 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=20 · 100% cliniciannot reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Azacitidine For 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 (4 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
Febrile neutropenia1,99536.0
34.5–37.5ROR 40.3 · χ² 65,990 / p <1e-300
34.9 EB05 33.7 · IC025 +5.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 20.8 · 95% clinicianNCT03416179: 20/160 (12.5%) on Azacitidine For; 17/201 (8.5%) control (serious AE)
Death1,8472.5
2.4–2.6ROR 2.7 · χ² 1,712 / p <1e-300
2.5 EB05 2.4 · IC025 +1.2
3/3 methods agree
Outcome field, not a reactionserious PRR 1.5NCT03416179: 4/162 (2.5%) on Azacitidine For; 2/160 (1.2%) control (serious AE)
Off label use (used outside approved label)1,5282.0
1.9–2.1ROR 2.1 · χ² 847 / p 2e-186
2.0 EB05 2.0 · IC025 +0.9Reporting / coding artifactserious PRR 2.1not reported in cached trials
Myelosuppression1,50253.5
51.0–56.3ROR 58.3 · χ² 74,052 / p <1e-300
51.2 EB05 49.0 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 30.4 · 98% cliniciannot reported in cached trials
Neutropenia (low neutrophils (infection-fighting cells))1,35911.7
11.2–12.4ROR 12.6 · χ² 13,293 / p <1e-300
11.6 EB05 11.1 · IC025 +3.4
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 7.1 · 95% clinicianNCT03416179: 20/160 (12.5%) on Azacitidine For; 17/201 (8.5%) control (serious AE)
Acute myeloid leukaemia1,299105.6
99.9–111.5ROR 113.7 · χ² 123,173 / p <1e-300
96.6 EB05 92.3 · IC025 +6.5
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious PRR 57.5 · 93% cliniciannot reported in cached trials
Pneumonia (lung infection)1,0583.8
3.6–4.0ROR 4.0 · χ² 2,212 / p <1e-300
3.8 EB05 3.6 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.3 · 93% clinicianNCT03416179: 36/160 (22.5%) on Azacitidine For; 11/201 (5.5%) control (serious AE)
Drug ineffective (drug did not work)1,0060.9
0.8–0.9ROR 0.9 · χ² 16 / p 4e-5
0.9 EB05 0.8 · IC025 -0.3
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 1.5 · 93% cliniciannot reported in cached trials
Pyrexia (fever)9983.3
3.2–3.6ROR 3.5 · χ² 1,665 / p <1e-300
3.3 EB05 3.2 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.5NCT03416179: 11/160 (6.9%) on Azacitidine For; 6/201 (3.0%) control (serious AE)
Thrombocytopenia (low platelets)98110.3
9.7–10.9ROR 10.8 · χ² 8,183 / p <1e-300
10.2 EB05 9.7 · IC025 +3.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 6.2 · 96% clinicianNCT03416179: 1/160 (0.6%) on Azacitidine For; 3/201 (1.5%) control (serious AE)
Anaemia (low red blood cells)7924.8
4.5–5.2ROR 5.0 · χ² 2,412 / p <1e-300
4.8 EB05 4.5 · IC025 +2.1
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 3.1 · 95% clinicianNCT03416179: 5/160 (3.1%) on Azacitidine For; 1/201 (0.5%) control (serious AE)
Infection6845.5
5.1–5.9ROR 5.7 · χ² 2,534 / p <1e-300
5.5 EB05 5.1 · IC025 +2.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.1 · 91% clinicianNCT03416179: 1/162 (0.6%) on Azacitidine For; 5/160 (3.1%) control (serious AE)
Sepsis (blood infection)6606.9
6.4–7.4ROR 7.1 · χ² 3,317 / p <1e-300
6.8 EB05 6.4 · IC025 +2.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.1 · 93% clinicianNCT03416179: 5/160 (3.1%) on Azacitidine For; 2/201 (1.0%) control (serious AE)
Pancytopenia (all blood cells low)63613.4
12.4–14.4ROR 13.8 · χ² 7,206 / p <1e-300
13.2 EB05 12.4 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 7.8 · 93% cliniciannot 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 Azacitidine For?

In FDA FAERS, the most frequently co-reported reaction terms for Azacitidine For are febrile neutropenia, myelosuppression, neutropenia, acute myeloid leukaemia, pneumonia, pyrexia. 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 Azacitidine For have an FDA boxed warning?

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

Do FAERS signals prove that Azacitidine For 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 2026-10-08. 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.