Cysteamine Bitartrate side effects: what 1,034 FDA adverse event reports show

Cysteamine Bitartrate · Procysbi · 18 reaction terms · 254 drug–reaction co-reports · data 2026-09-14

Drug class

Cystine-depleting agent

FDA label, Indications wording

Brand names

Procysbi

openFDA label

Who reports

1,034 reports · 56% serious · 69 with death outcome · 49% female

openFDA FAERS counts, all years, deduplication not applied

Used for

PROCYSBI is indicated for the treatment of nephropathic cystinosis in adults and pediatric patients 1 year of age and older. PROCYSBI is a cystine-depleting agent indicated for the treatment of nephropathic cystinosis in adults and pediatric patients 1 year of age and older. ( 1 )

FDA label, Indications and Usage

What it is

PROCYSBI, for oral administration, is a cystine-depleting agent that lowers the cystine content of cells in patients with nephropathic cystinosis, an inherited defect of lysosomal transport. PROCYSBI contains the bitartrate salt of cysteamine.

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 14 strongest signals

Labeled adverse reaction 1Labeled (related wording) 2Reporting / coding artifact 6Not in label — unassessed 5

What the badges mean

Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.

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. 4 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show: hide coding/lab/outcome terms hide indication terms unlabeled only hide PRR-only

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Product odour abnormal	13	25.4 14.8–43.6ROR 25.7 · χ² 281 / p 2e-63	24.5 EB05 15.1 · IC025 +2.8 3/3 methods agree	Reporting / coding artifact	serious n=11	no trial data cached
Eye irritation	61	22.2 17.4–28.3ROR 23.5 · χ² 1,216 / p 8e-267	22.1 EB05 17.8 · IC025 +3.8 3/3 methods agree	Not in label — unassessed	serious PRR 13.1	no trial data cached
Dialysis	15	21.4 12.9–35.4ROR 21.7 · χ² 272 / p 2e-61	20.8 EB05 13.1 · IC025 +2.8 3/3 methods agree	Not in label — unassessed	serious PRR 23.1	no trial data cached
Product use complaint	12	15.7 8.9–27.6ROR 15.9 · χ² 151 / p 6e-35	14.5 EB05 7.9 · IC025 +2.3 3/3 methods agree	Reporting / coding artifact	serious n=3	no trial data cached
Appendicitis	6	13.1 5.9–29.1ROR 13.2 · χ² 55 / p 5e-14	9.5 EB05 3.8 · IC025 +1.3 3/3 methods agree	Not in label — unassessed	serious PRR 13.7	no trial data cached
Conjunctivitis	11	12.1 6.7–21.9ROR 12.3 · χ² 102 / p 3e-24	10.3 EB05 5.4 · IC025 +2.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 8.4	no trial data cached
Ocular hyperaemia	26	11.3 7.7–16.5ROR 11.6 · χ² 234 / p 4e-53	10.6 EB05 7.3 · IC025 +2.6 3/3 methods agree	Not in label — unassessed	serious PRR 2.6	no trial data cached
Product administration error	11	11.2 6.2–20.1ROR 11.3 · χ² 92 / p 4e-22	9.3 EB05 5.0 · IC025 +1.9 3/3 methods agree	Reporting / coding artifact	serious PRR 12.8	no trial data cached
Impaired gastric emptying	7	11.1 5.3–23.3ROR 11.2 · χ² 55 / p 7e-14	8.1 EB05 3.7 · IC025 +1.4 3/3 methods agree	Not in label — unassessed	serious PRR 11.1	no trial data cached
Treatment noncompliance	29	10.8 7.6–15.5ROR 11.1 · χ² 249 / p 2e-56	10.2 EB05 7.2 · IC025 +2.6 3/3 methods agree	Reporting / coding artifact	serious PRR 13.8	no trial data cached
Eye pain	29	10.7 7.4–15.3ROR 10.9 · χ² 245 / p 2e-55	10.0 EB05 7.1 · IC025 +2.6 3/3 methods agree	Labeled (related wording) related wording	serious PRR 4.4	no trial data cached
Product physical issue	9	9.2 4.8–17.6ROR 9.2 · χ² 58 / p 2e-14	7.0 EB05 3.7 · IC025 +1.5 3/3 methods agree	Reporting / coding artifact	serious n=9	no trial data cached
Device occlusion	6	8.8 3.9–19.4ROR 8.8 · χ² 34 / p 3e-9	5.9 EB05 2.8 · IC025 +1.0 3/3 methods agree	Reporting / coding artifact	serious n=5	no trial data cached
Complication associated with device	5	7.7 3.2–18.4ROR 7.7 · χ² 23 / p 9e-7	5.0 EB05 2.3 · IC025 +0.7 3/3 methods agree	Labeled (related wording) related wording	serious PRR 7.7	no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

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

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Eye irritation	61	22.2 17.4–28.3ROR 23.5 · χ² 1,216 / p 8e-267	22.1 EB05 17.8 · IC025 +3.8 3/3 methods agree	Not in label — unassessed	serious PRR 13.1	no trial data cached
Eye pain	29	10.7 7.4–15.3ROR 10.9 · χ² 245 / p 2e-55	10.0 EB05 7.1 · IC025 +2.6 3/3 methods agree	Labeled (related wording) related wording	serious PRR 4.4	no trial data cached
Treatment noncompliance	29	10.8 7.6–15.5ROR 11.1 · χ² 249 / p 2e-56	10.2 EB05 7.2 · IC025 +2.6 3/3 methods agree	Reporting / coding artifact	serious PRR 13.8	no trial data cached
Ocular hyperaemia	26	11.3 7.7–16.5ROR 11.6 · χ² 234 / p 4e-53	10.6 EB05 7.3 · IC025 +2.6 3/3 methods agree	Not in label — unassessed	serious PRR 2.6	no trial data cached
Dialysis	15	21.4 12.9–35.4ROR 21.7 · χ² 272 / p 2e-61	20.8 EB05 13.1 · IC025 +2.8 3/3 methods agree	Not in label — unassessed	serious PRR 23.1	no trial data cached
Product odour abnormal	13	25.4 14.8–43.6ROR 25.7 · χ² 281 / p 2e-63	24.5 EB05 15.1 · IC025 +2.8 3/3 methods agree	Reporting / coding artifact	serious n=11	no trial data cached
Product use complaint	12	15.7 8.9–27.6ROR 15.9 · χ² 151 / p 6e-35	14.5 EB05 7.9 · IC025 +2.3 3/3 methods agree	Reporting / coding artifact	serious n=3	no trial data cached
Product administration error	11	11.2 6.2–20.1ROR 11.3 · χ² 92 / p 4e-22	9.3 EB05 5.0 · IC025 +1.9 3/3 methods agree	Reporting / coding artifact	serious PRR 12.8	no trial data cached
Conjunctivitis	11	12.1 6.7–21.9ROR 12.3 · χ² 102 / p 3e-24	10.3 EB05 5.4 · IC025 +2.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 8.4	no trial data cached
Product physical issue	9	9.2 4.8–17.6ROR 9.2 · χ² 58 / p 2e-14	7.0 EB05 3.7 · IC025 +1.5 3/3 methods agree	Reporting / coding artifact	serious n=9	no trial data cached
Impaired gastric emptying	7	11.1 5.3–23.3ROR 11.2 · χ² 55 / p 7e-14	8.1 EB05 3.7 · IC025 +1.4 3/3 methods agree	Not in label — unassessed	serious PRR 11.1	no trial data cached
Device occlusion	6	8.8 3.9–19.4ROR 8.8 · χ² 34 / p 3e-9	5.9 EB05 2.8 · IC025 +1.0 3/3 methods agree	Reporting / coding artifact	serious n=5	no trial data cached
Appendicitis	6	13.1 5.9–29.1ROR 13.2 · χ² 55 / p 5e-14	9.5 EB05 3.8 · IC025 +1.3 3/3 methods agree	Not in label — unassessed	serious PRR 13.7	no trial data cached
Complication associated with device	5	7.7 3.2–18.4ROR 7.7 · χ² 23 / p 9e-7	5.0 EB05 2.3 · IC025 +0.7 3/3 methods agree	Labeled (related wording) related wording	serious PRR 7.7	no trial data cached
Hair colour changes	4	6.5 2.4–17.2ROR 6.5 · χ² 13 / p 1e-4	4.1 EB05 1.8 · IC025 +0.2	Not in label — unassessed	serious n=4	no trial data cached

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.

Eye irritation — n=61, PRR 22.2
Ocular hyperaemia — n=26, PRR 11.3

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 Cysteamine Bitartrate?

In FDA FAERS, the most frequently co-reported reaction terms for Cysteamine Bitartrate are eye irritation, eye pain, ocular hyperaemia, dialysis, conjunctivitis, impaired gastric emptying. 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 Cysteamine Bitartrate have an FDA boxed warning?

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

Do FAERS signals prove that Cysteamine Bitartrate 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

FDA label via openFDA (set ID d3a3ec28-f746-463a-bb92-3bc8826db09e, effective 20260625; matched on openfda.generic_name.exact:"CYSTEAMINE BITARTRATE")
Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA count= aggregation, field patient.drug.openfda.generic_name.exact, 18 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction
Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
Seriousness and sex counts from openFDA count=serious, patient.patientsex, seriousnessdeath

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.