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Peginterferon Alfa-2A side effects: what 53,742 FDA adverse event reports show

Peginterferon Alfa-2A · Pegasys · 1,166 reaction terms · 206,433 drug–reaction co-reports · data 2026-09-14
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Drug class

Interferon alpha

FDA label (Established Pharmacologic Class)

Brand names

Pegasys

openFDA label

Who reports

53,742 reports · 43% serious · 1,798 with death outcome · 46% female

openFDA FAERS counts, all years, deduplication not applied

Used for

PEGASYS is an inducer of the innate immune response indicated for the treatment of Chronic Hepatitis C (CHC) ( 1.1 ) Adult Patients: In combination therapy with other hepatitis C virus drugs for adults with compensated liver disease. PEGASYS monotherapy is indicated only if patient has contraindication or significant intolerance to other HCV drugs.

FDA label, Indications and Usage

What it is

Peginterferon alfa-2a, is a covalent conjugate of recombinant alfa-2a interferon (approximate molecular weight [MW] 20,000 daltons) with a single branched bis-monomethoxy polyethylene glycol (PEG) chain (approximate MW 40,000 daltons).

FDA label, Description section

Boxed warning

RISK OF SERIOUS DISORDERS WARNING: RISK OF SERIOUS DISORDERS See full prescribing information for complete boxed warning. Risk of Serious Disorders May cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders.

FDA 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 5Labeled (related wording) 3Likely indication confounding 6Reporting / coding artifact 2Lab value / disease marker 4Not in label — unassessed 20
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). 1,126 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
Anal pruritus896295.3
270.8–322.1ROR 300.3 · calibrated p 1e-11 ✓
166.8 EB05 157.8 · IC025 +7.1
3/3 methods agree
Not in label — unassessedserious n=121 · 85% consumernot reported in cached trials
Anorectal discomfort1,845206.3
195.1–218.2ROR 213.6 · calibrated p 2e-10 ✓
134.4 EB05 129.3 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=221 · 89% consumernot reported in cached trials
Viral load decreased40144.9
100.7–208.5ROR 145.0 · calibrated p 2e-8 ✓
100.5 EB05 77.0 · IC025 +5.0
3/3 methods agree
Lab value / disease marker100% consumernot reported in cached trials
Exposure via direct contact222118.2
101.8–137.4ROR 118.7 · calibrated p 4e-8 ✓
90.0 EB05 80.5 · IC025 +6.0
3/3 methods agree
Reporting / coding artifact–not reported in cached trials
Hepatitis c rna increased73105.0
81.1–136.0ROR 105.1 · calibrated p 1e-7 ✓
81.0 EB05 66.5 · IC025 +5.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=46NCT00922779: 1/6,661 (0.0%) on Peginterferon Alfa-2A (serious AE)
Viral load2359.3
38.2–92.0ROR 59.3 · calibrated p 1e-5 ✓
49.5 EB05 34.7 · IC025 +3.9
3/3 methods agree
Labeled adverse reaction
exact term
–not reported in cached trials
Painful defaecation8251.4
40.8–64.7ROR 51.4 · calibrated p 1e-5 ✓
45.0 EB05 37.4 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=11 · 87% consumernot reported in cached trials
Hepatitis c rna positive1742.1
25.5–69.5ROR 42.1 · calibrated p 1e-4 ✓
36.6 EB05 24.2 · IC025 +3.4
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=15not reported in cached trials
Viral load increased37841.8
37.6–46.4ROR 42.0 · calibrated p 4e-5 ✓
37.7 EB05 34.6 · IC025 +5.0
3/3 methods agree
Lab value / disease markerserious n=207not reported in cached trials
Retinal exudates8036.4
28.9–45.8ROR 36.5 · calibrated p 1e-4 ✓
33.1 EB05 27.4 · IC025 +4.4
3/3 methods agree
Labeled adverse reaction
exact term
serious n=55not reported in cached trials
Proctalgia46230.2
27.5–33.2ROR 30.5 · calibrated p 2e-4 ✓
28.0 EB05 26.0 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=84 · 82% consumernot reported in cached trials
Essential thrombocythaemia2629.9
20.1–44.6ROR 29.9 · calibrated p 4e-4 ✓
27.3 EB05 19.6 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Porphyria non-acute3028.5
19.7–41.3ROR 28.5 · calibrated p 5e-4 ✓
26.2 EB05 19.2 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=25 · 100% cliniciannot reported in cached trials
Hepatitis c73124.8
23.0–26.7ROR 25.1 · calibrated p 7e-4 ✓
23.3 EB05 21.9 · IC025 +4.4
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 22.9NCT00922779: 1/6,661 (0.0%) on Peginterferon Alfa-2A (serious AE)
Haemorrhoids1,07122.6
21.2–24.0ROR 23.0 · calibrated p 0.001 ✓
21.4 EB05 20.3 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious PRR 7.1 · 82% consumerNCT00081770: 1/1,035 (0.1%) on Peginterferon Alfa-2A (serious AE)
Remission not achieved3221.2
14.8–30.2ROR 21.2 · calibrated p 0.002 ✓
19.9 EB05 14.7 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=32 · 100% cliniciannot reported in cached trials
Red blood cell count decreased1,39019.9
18.8–21.0ROR 20.4 · calibrated p 0.002 ✓
18.9 EB05 18.1 · IC025 +4.1
3/3 methods agree
Lab value / disease markerserious PRR 15.1 · 76% consumerNCT00081770: 1/1,019 (0.1%) on Peginterferon Alfa-2A (serious AE)
Chronic hepatitis c1818.6
11.6–29.8ROR 18.6 · calibrated p 0.004 ✓
17.3 EB05 11.2 · IC025 +2.8
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=11NCT00922779: 1/6,661 (0.0%) on Peginterferon Alfa-2A (serious AE)
Cryoglobulinaemia3218.5
13.0–26.4ROR 18.5 · calibrated p 0.004 ✓
17.5 EB05 12.9 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=29not reported in cached trials
Viral test positive1617.8
10.8–29.3ROR 17.8 · calibrated p 0.006 ✓
16.4 EB05 10.2 · IC025 +2.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
–not reported in cached trials
Basedow's disease2017.0
10.9–26.6ROR 17.0 · calibrated p 0.006 ✓
15.9 EB05 10.5 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=20not reported in cached trials
Hepatic neoplasm malignant7914.9
11.9–18.7ROR 14.9 · calibrated p 0.008 ✓
14.3 EB05 11.8 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=79 · ♀ 19% (drug 46%)NCT00081770: 2/1,035 (0.2%) on Peginterferon Alfa-2A (serious AE)
Hepatitis c virus test positive2114.3
9.3–22.1ROR 14.3 · calibrated p 0.012 ✓
13.2 EB05 8.7 · IC025 +2.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
–not reported in cached trials
Rash generalised92914.3
13.4–15.2ROR 14.5 · calibrated p 0.008 ✓
13.8 EB05 13.1 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious PRR 11.2not reported in cached trials
Anaemia (low red blood cells)6,62814.0
13.7–14.3ROR 15.8 · calibrated p 0.006 ✓
13.5 EB05 13.3 · IC025 +3.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 11.8NCT00922779: 459/6,661 (6.9%) on Peginterferon Alfa-2A
Anorectal disorder6913.9
10.9–17.6ROR 13.9 · calibrated p 0.011 ✓
13.3 EB05 10.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=32not reported in cached trials
Influenza like illness (flu-like illness)2,73813.3
12.9–13.8ROR 14.0 · calibrated p 0.009 ✓
12.9 EB05 12.5 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 8.6 · 83% consumerNCT00922779: 833/6,661 (12.5%) on Peginterferon Alfa-2A
Therapy responder1613.0
7.9–21.5ROR 13.0 · calibrated p 0.018 ✓
11.6 EB05 7.0 · IC025 +2.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Alpha 1 foetoprotein increased2313.0
8.5–19.6ROR 13.0 · calibrated p 0.016 ✓
11.9 EB05 7.9 · IC025 +2.6
3/3 methods agree
Lab value / disease markerserious n=18not reported in cached trials
Anal haemorrhage8311.9
9.6–14.8ROR 11.9 · calibrated p 0.019 ✓
11.4 EB05 9.4 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=20 · 85% consumernot reported in cached trials
Bleeding varicose vein1611.8
7.2–19.5ROR 11.8 · calibrated p 0.025 ✓
10.3 EB05 6.2 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Haemorrhoidal haemorrhage14411.7
9.9–13.9ROR 11.8 · calibrated p 0.019 ✓
11.3 EB05 9.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=34 · 82% consumerNCT00081770: 1/1,019 (0.1%) on Peginterferon Alfa-2A (serious AE)
No therapeutic response34711.2
10.1–12.5ROR 11.3 · calibrated p 0.021 ✓
10.9 EB05 10.0 · IC025 +3.3
3/3 methods agree
Reporting / coding artifactserious PRR 7.1not reported in cached trials
Pruritus generalised60010.9
10.1–11.9ROR 11.1 · calibrated p 0.023 ✓
10.6 EB05 9.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious PRR 5.9 · 80% consumernot reported in cached trials
Retinopathy10010.7
8.8–13.1ROR 10.7 · calibrated p 0.027 ✓
10.3 EB05 8.6 · IC025 +3.0
3/3 methods agree
Labeled adverse reaction
exact term
serious n=82not reported in cached trials
Rash pruritic1,43810.7
10.1–11.2ROR 10.9 · calibrated p 0.024 ✓
10.4 EB05 9.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious PRR 5.9 · 83% consumernot reported in cached trials
Angular cheilitis1810.5
6.6–16.8ROR 10.5 · calibrated p 0.036 ✓
9.1 EB05 5.8 · IC025 +2.2
3/3 methods agree
Not in label — unassessed–not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Peginterferon Alfa-2A 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 (10 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
Fatigue (tiredness)9,2604.7
4.6–4.8ROR 5.5 · calibrated p 0.190
4.6 EB05 4.6 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.4 · 80% consumerNCT00081770: 1/1,019 (0.1%) on Peginterferon Alfa-2A (serious AE)
Nausea7,1653.6
3.5–3.6ROR 4.0 · calibrated p 0.385
3.5 EB05 3.5 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.6 · 79% consumerNCT00081770: 1/1,016 (0.1%) on Peginterferon Alfa-2A (serious AE)
Anaemia (low red blood cells)6,62814.0
13.7–14.3ROR 15.8 · calibrated p 0.006 ✓
13.5 EB05 13.3 · IC025 +3.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 11.8NCT00922779: 459/6,661 (6.9%) on Peginterferon Alfa-2A
Rash4,8784.4
4.3–4.5ROR 4.8 · calibrated p 0.261
4.4 EB05 4.3 · IC025 +2.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.4NCT00081770: 225/1,019 (22.1%) on Peginterferon Alfa-2A
Headache4,4542.8
2.7–2.9ROR 2.9 · calibrated p 0.643
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.0 · 81% consumerNCT00081770: 508/1,019 (49.9%) on Peginterferon Alfa-2A
Pruritus (itching)4,2244.4
4.3–4.5ROR 4.7 · calibrated p 0.271
4.4 EB05 4.2 · IC025 +2.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.0 · 78% consumerNCT00081770: 163/1,019 (16.0%) on Peginterferon Alfa-2A
Pyrexia (fever)3,4773.9
3.8–4.1ROR 4.2 · calibrated p 0.350
3.9 EB05 3.8 · IC025 +1.9
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.7 · 71% consumerNCT00922779: 1/6,661 (0.0%) on Peginterferon Alfa-2A (serious AE)
Diarrhoea (diarrhea)3,3852.1
2.0–2.1ROR 2.1 · calibrated p 0.987
2.1 EB05 2.0 · IC025 +1.0Labeled adverse reaction
exact term
serious PRR 1.6 · 78% consumerNCT00081770: 1/1,019 (0.1%) on Peginterferon Alfa-2A (serious AE)
Vomiting3,3362.8
2.7–2.9ROR 2.9 · calibrated p 0.657
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.1 · 76% consumerNCT00081770: 3/1,016 (0.3%) on Peginterferon Alfa-2A (serious AE)
Asthenia (weakness)3,1493.3
3.2–3.4ROR 3.4 · calibrated p 0.502
3.3 EB05 3.2 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.9 · 73% consumerNCT00922779: 2/6,661 (0.0%) on Peginterferon Alfa-2A (serious AE)
Insomnia (trouble sleeping)3,0794.5
4.4–4.7ROR 4.8 · calibrated p 0.262
4.5 EB05 4.4 · IC025 +2.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.8 · 80% consumerNCT00081770: 401/1,019 (39.4%) on Peginterferon Alfa-2A
Dyspnoea (shortness of breath)3,0512.1
2.0–2.2ROR 2.2 · calibrated p 0.963
2.1 EB05 2.0 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 1.7 · 74% consumerNCT00081770: 2/1,019 (0.2%) on Peginterferon Alfa-2A (serious AE)
Decreased appetite (loss of appetite)2,9185.0
4.8–5.1ROR 5.2 · calibrated p 0.215
4.9 EB05 4.8 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.4 · 78% consumerNCT00081770: 184/1,019 (18.1%) on Peginterferon Alfa-2A
Influenza like illness (flu-like illness)2,73813.3
12.9–13.8ROR 14.0 · calibrated p 0.009 ✓
12.9 EB05 12.5 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 8.6 · 83% consumerNCT00922779: 833/6,661 (12.5%) on Peginterferon Alfa-2A

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.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Erythropoiesis-stimulating agents (darbepoetin alfa) ↔ Mortality / cardiovascular risk.

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 Peginterferon Alfa-2A?

In FDA FAERS, the most frequently co-reported reaction terms for Peginterferon Alfa-2A are fatigue, nausea, anaemia, rash, headache, white blood cell count decreased. 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 Peginterferon Alfa-2A have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: RISK OF SERIOUS DISORDERS WARNING: RISK OF SERIOUS DISORDERS See full prescribing information for complete boxed warning. Risk of Serious Disorders May cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders.

Do FAERS signals prove that Peginterferon Alfa-2A 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.