Nerandomilast side effects: what 1,136 FDA adverse event reports show

Nerandomilast · Jascayd · 14 reaction terms · 577 drug–reaction co-reports · data 2026-09-14

Drug class

Phosphodiesterase 4 (pde4) inhibitor

FDA label, Indications wording

Brand names

Jascayd

openFDA label

Who reports

1,136 reports · 31% serious · 92 with death outcome · 41% female

openFDA FAERS counts, all years, deduplication not applied

Used for

JASCAYD is a phosphodiesterase 4 (PDE4) inhibitor indicated for: The treatment of idiopathic pulmonary fibrosis in adult patients. ( 1.1 ) The treatment of progressive pulmonary fibrosis in adult patients. ( 1.2 ) 1.1 Idiopathic Pulmonary Fibrosis JASCAYD is indicated for the treatment of idiopathic pulmonary fibrosis (IPF) in adult patients.

FDA label, Indications and Usage

What it is

JASCAYD (nerandomilast tablets), for oral administration, contain nerandomilast, a phosphodiesterase 4 (PDE4) inhibitor.

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 12 strongest signals

Labeled adverse reaction 1Likely indication confounding 1Lab value / disease marker 1Not in label — unassessed 9

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.
Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
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. 2 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
Prescribed underdose	52	47.1 36.1–61.5ROR 49.3 · χ² 2,298 / p <1e-300	46.3 EB05 36.6 · IC025 +4.6 3/3 methods agree	Not in label — unassessed	serious PRR 32.3 · 81% consumer	no trial data cached
Oxygen saturation decreased	43	13.9 10.4–18.6ROR 14.4 · χ² 503 / p 1e-111	13.7 EB05 10.4 · IC025 +3.1 3/3 methods agree	Lab value / disease marker	serious PRR 18.3 · ♀ 21% (drug 41%) · 95% consumer	no trial data cached
Pulmonary fibrosis	14	13.2 7.8–22.2ROR 13.4 · χ² 146 / p 6e-34	12.0 EB05 6.9 · IC025 +2.3 3/3 methods agree	Likely indication confounding term in indications; also in warnings	serious PRR 20.0	no trial data cached
Productive cough (cough with phlegm)	33	12.6 9.0–17.6ROR 12.9 · χ² 341 / p 2e-76	12.2 EB05 8.8 · IC025 +2.8 3/3 methods agree	Not in label — unassessed	serious PRR 14.0 · 100% consumer	no trial data cached
Frequent bowel movements	18	12.1 7.6–19.1ROR 12.2 · χ² 172 / p 1e-39	11.1 EB05 6.9 · IC025 +2.4 3/3 methods agree	Not in label — unassessed	serious PRR 7.9	no trial data cached
Dyspnoea exertional	25	12.0 8.2–17.7ROR 12.3 · χ² 242 / p 8e-55	11.4 EB05 7.7 · IC025 +2.6 3/3 methods agree	Not in label — unassessed	serious PRR 18.5 · 96% consumer	no trial data cached
Brain fog	8	9.9 5.0–19.7ROR 10.0 · χ² 55 / p 5e-14	7.4 EB05 3.7 · IC025 +1.5 3/3 methods agree	Not in label — unassessed	serious PRR 9.1	no trial data cached
Diarrhoea (diarrhea)	337	9.5 8.6–10.3ROR 12.9 · χ² 2,617 / p <1e-300	9.4 EB05 8.6 · IC025 +3.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 6.0 · 89% consumer	no trial data cached
Head discomfort	9	9.2 4.8–17.7ROR 9.3 · χ² 58 / p 1e-14	7.0 EB05 3.7 · IC025 +1.5 3/3 methods agree	Not in label — unassessed	serious PRR 6.9	no trial data cached
Respiratory tract congestion	7	7.9 3.8–16.6ROR 8.0 · χ² 36 / p 1e-9	5.7 EB05 2.9 · IC025 +1.1 3/3 methods agree	Not in label — unassessed	serious PRR 10.0	no trial data cached
Coronary artery occlusion	6	7.9 3.5–17.4ROR 7.9 · χ² 29 / p 3e-8	5.4 EB05 2.6 · IC025 +0.9 3/3 methods agree	Not in label — unassessed	serious PRR 15.0	no trial data cached
Throat irritation	19	7.7 4.9–12.0ROR 7.8 · χ² 104 / p 1e-24	6.7 EB05 4.4 · IC025 +1.9 3/3 methods agree	Not in label — unassessed	serious PRR 14.2	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
Diarrhoea (diarrhea)	337	9.5 8.6–10.3ROR 12.9 · χ² 2,617 / p <1e-300	9.4 EB05 8.6 · IC025 +3.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 6.0 · 89% consumer	no trial data cached
Prescribed underdose	52	47.1 36.1–61.5ROR 49.3 · χ² 2,298 / p <1e-300	46.3 EB05 36.6 · IC025 +4.6 3/3 methods agree	Not in label — unassessed	serious PRR 32.3 · 81% consumer	no trial data cached
Oxygen saturation decreased	43	13.9 10.4–18.6ROR 14.4 · χ² 503 / p 1e-111	13.7 EB05 10.4 · IC025 +3.1 3/3 methods agree	Lab value / disease marker	serious PRR 18.3 · ♀ 21% (drug 41%) · 95% consumer	no trial data cached
Productive cough (cough with phlegm)	33	12.6 9.0–17.6ROR 12.9 · χ² 341 / p 2e-76	12.2 EB05 8.8 · IC025 +2.8 3/3 methods agree	Not in label — unassessed	serious PRR 14.0 · 100% consumer	no trial data cached
Dyspnoea exertional	25	12.0 8.2–17.7ROR 12.3 · χ² 242 / p 8e-55	11.4 EB05 7.7 · IC025 +2.6 3/3 methods agree	Not in label — unassessed	serious PRR 18.5 · 96% consumer	no trial data cached
Throat irritation	19	7.7 4.9–12.0ROR 7.8 · χ² 104 / p 1e-24	6.7 EB05 4.4 · IC025 +1.9 3/3 methods agree	Not in label — unassessed	serious PRR 14.2	no trial data cached
Frequent bowel movements	18	12.1 7.6–19.1ROR 12.2 · χ² 172 / p 1e-39	11.1 EB05 6.9 · IC025 +2.4 3/3 methods agree	Not in label — unassessed	serious PRR 7.9	no trial data cached
Pulmonary fibrosis	14	13.2 7.8–22.2ROR 13.4 · χ² 146 / p 6e-34	12.0 EB05 6.9 · IC025 +2.3 3/3 methods agree	Likely indication confounding term in indications; also in warnings	serious PRR 20.0	no trial data cached
Head discomfort	9	9.2 4.8–17.7ROR 9.3 · χ² 58 / p 1e-14	7.0 EB05 3.7 · IC025 +1.5 3/3 methods agree	Not in label — unassessed	serious PRR 6.9	no trial data cached
Brain fog	8	9.9 5.0–19.7ROR 10.0 · χ² 55 / p 5e-14	7.4 EB05 3.7 · IC025 +1.5 3/3 methods agree	Not in label — unassessed	serious PRR 9.1	no trial data cached
Respiratory tract congestion	7	7.9 3.8–16.6ROR 8.0 · χ² 36 / p 1e-9	5.7 EB05 2.9 · IC025 +1.1 3/3 methods agree	Not in label — unassessed	serious PRR 10.0	no trial data cached
Coronary artery occlusion	6	7.9 3.5–17.4ROR 7.9 · χ² 29 / p 3e-8	5.4 EB05 2.6 · IC025 +0.9 3/3 methods agree	Not in label — unassessed	serious PRR 15.0	no trial data cached
Gynaecomastia (male breast enlargement)	3	1.7 0.6–5.3ROR 1.7 · χ² 0 / p 0.281	1.6 EB05 0.7 · IC025 -1.4 PRR-only: not supported by EBGM or IC	Not in label — unassessed	–	no trial data cached
Decreased immune responsiveness	3	5.5 1.8–17.1ROR 5.5 · χ² 7 / p 0.004	3.4 EB05 1.3 · IC025 -0.3 PRR-only: not supported by EBGM or IC	Not in label — unassessed	serious PRR 13.1	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.

Prescribed underdose — n=52, PRR 47.1
Productive cough — n=33, PRR 12.6
Dyspnoea exertional — n=25, PRR 12.0

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 Nerandomilast?

In FDA FAERS, the most frequently co-reported reaction terms for Nerandomilast are diarrhoea, prescribed underdose, oxygen saturation decreased, productive cough, dyspnoea exertional, throat irritation. 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 Nerandomilast have an FDA boxed warning?

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

Do FAERS signals prove that Nerandomilast 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 fa1b14c6-957f-d326-5099-911bfe33e391, effective 20260814; matched on openfda.generic_name.exact:"NERANDOMILAST")
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, 14 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.