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Sunitinib Malate side effects: what 39,092 FDA adverse event reports show

Sunitinib Malate · 1,140 reaction terms · 149,050 drug–reaction co-reports · data 2026-09-14
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Drug class

Kinase inhibitor

FDA label, Indications wording

Who reports

39,092 reports · 77% serious · 11,666 with death outcome · 35% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Sunitinib malate is a kinase inhibitor indicated for: treatment of adult patients with gastrointestinal stromal tumor (GIST) after disease progression on or intolerance to imatinib mesylate. ( 1.1 ) treatment of adult patients with advanced renal cell carcinoma (RCC). ( 1.2 ) adjuvant treatment of adult patients at high risk of recurrent RCC following nephrectomy.

FDA label, Indications and Usage

What it is

Sunitinib is a kinase inhibitor present in sunitinib malate capsules as the malate salt. Sunitinib malate is described chemically as N-(2-(Diethylamino)ethyl)-5-((Z)-(5-fluoro-1,2-dihydro-2-oxo-3H-indol-3-ylidene)methyl)-2,4-dimethyl-1H-pyrrole-3-carboxamide (2S)-hydroxybutanedioate acid.

FDA label, Description section

Boxed warning

HEPATOTOXICITY Hepatotoxicity may be severe, and in some cases, fatal. Monitor hepatic function and interrupt, dose reduce, or discontinue sunitinib malate capsules as recommended [see Warnings and Precautions ( 5.1 )] . WARNING: HEPATOTOXICITY See full prescribing information for complete boxed warning.

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 8Labeled (related wording) 6Likely indication confounding 5Reporting / coding artifact 2Not in label — unassessed 19
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). 1,100 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
Metastatic renal cell carcinoma764378.3
344.9–414.9ROR 385.8 · calibrated p 9e-13 ✓
219.7 EB05 206.9 · IC025 +7.5
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=639not reported in cached trials
Renal cell carcinoma stage iv26157.9
101.9–244.7ROR 158.0 · calibrated p 1e-8 ✓
112.0 EB05 80.3 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=22not reported in cached trials
Renal cell carcinoma975132.3
123.4–141.8ROR 135.7 · calibrated p 1e-8 ✓
105.8 EB05 100.3 · IC025 +6.5
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=785not reported in cached trials
Gastrointestinal stromal tumour436104.3
94.2–115.6ROR 105.5 · calibrated p 8e-8 ✓
87.0 EB05 80.3 · IC025 +6.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=381not reported in cached trials
Yellow skin68091.0
83.9–98.6ROR 92.6 · calibrated p 2e-7 ✓
77.6 EB05 72.8 · IC025 +6.1
3/3 methods agree
Labeled adverse reaction
exact term
serious n=528NCT00716625: 57/1,673 (3.4%) on Sunitinib Malate
Eyelash discolouration3083.9
57.1–123.3ROR 83.9 · calibrated p 1e-6 ✓
69.4 EB05 51.0 · IC025 +4.5
3/3 methods agree
Not in label — unassessed♀ 60% (drug 35%)not reported in cached trials
Malignant urinary tract neoplasm1682.1
48.5–139.0ROR 82.1 · calibrated p 2e-6 ✓
65.8 EB05 43.0 · IC025 +3.7
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Pancreatic neuroendocrine tumour7975.3
59.5–95.4ROR 75.5 · calibrated p 1e-6 ✓
65.1 EB05 53.9 · IC025 +5.2
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=64not reported in cached trials
Pancreatic neuroendocrine tumour metastatic2151.6
33.0–80.8ROR 51.6 · calibrated p 3e-5 ✓
45.3 EB05 31.3 · IC025 +3.8
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=16not reported in cached trials
Plantar erythema2150.0
32.0–78.2ROR 50.0 · calibrated p 3e-5 ✓
44.1 EB05 30.4 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Nephritic syndrome2547.2
31.3–71.0ROR 47.2 · calibrated p 4e-5 ✓
42.1 EB05 30.0 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=25 · ♀ 100% (drug 35%) · 100% cliniciannot reported in cached trials
Anal injury1447.1
27.3–81.4ROR 47.1 · calibrated p 7e-5 ✓
41.1 EB05 26.0 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Palmar-plantar erythrodysaesthesia syndrome1,45435.5
33.7–37.4ROR 36.9 · calibrated p 8e-5 ✓
33.3 EB05 31.9 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious PRR 25.3NCT00716625: 24/1,673 (1.4%) on Sunitinib Malate (serious AE)
Neoplasm progression2,01932.7
31.3–34.2ROR 34.4 · calibrated p 1e-4 ✓
30.8 EB05 29.7 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious PRR 23.1NCT00716625: 23/1,673 (1.4%) on Sunitinib Malate (serious AE)
Mouth injury7929.3
23.3–36.7ROR 29.3 · calibrated p 3e-4 ✓
27.6 EB05 22.9 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=77 · 100% consumernot reported in cached trials
Oral pain1,14728.8
27.2–30.6ROR 29.7 · calibrated p 3e-4 ✓
27.4 EB05 26.1 · IC025 +4.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 21.8NCT00326898: 1/628 (0.2%) on Sunitinib Malate; 1/625 (0.2%) control (serious AE)
Renal cell carcinoma stage unspecified2928.4
19.6–41.3ROR 28.4 · calibrated p 5e-4 ✓
26.6 EB05 19.4 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=29 · 100% cliniciannot reported in cached trials
Tumour compression1526.5
15.8–44.5ROR 26.5 · calibrated p 0.001 ✓
24.5 EB05 15.7 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=15not reported in cached trials
Hyperkeratosis23824.1
21.1–27.4ROR 24.2 · calibrated p 8e-4 ✓
23.0 EB05 20.7 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=148not reported in cached trials
Cardiopulmonary failure16423.4
20.0–27.4ROR 23.5 · calibrated p 1e-3 ✓
22.4 EB05 19.7 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=164not reported in cached trials
Hair colour changes46520.6
18.8–22.5ROR 20.8 · calibrated p 0.002 ✓
19.8 EB05 18.3 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=283not reported in cached trials
Second primary malignancy29419.6
17.5–22.1ROR 19.8 · calibrated p 0.002 ✓
18.9 EB05 17.2 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious PRR 14.2not reported in cached trials
Clear cell renal cell carcinoma2419.4
12.9–29.2ROR 19.5 · calibrated p 0.003 ✓
18.5 EB05 12.9 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=21 · 100% cliniciannot reported in cached trials
Disease progression3,91218.4
17.8–18.9ROR 20.3 · calibrated p 0.002 ✓
17.8 EB05 17.3 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious PRR 10.6NCT00716625: 187/1,673 (11.2%) on Sunitinib Malate (serious AE)
Hydrothorax2717.9
12.2–26.3ROR 17.9 · calibrated p 0.004 ✓
17.1 EB05 12.2 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=27 · ♀ 0% (drug 35%)not reported in cached trials
Hypogeusia6016.9
13.1–21.9ROR 16.9 · calibrated p 0.005 ✓
16.3 EB05 13.1 · IC025 +3.4
3/3 methods agree
Labeled adverse reaction
exact term
serious n=43not reported in cached trials
Tumour necrosis3216.8
11.8–23.9ROR 16.8 · calibrated p 0.006 ✓
16.1 EB05 11.8 · IC025 +3.1
3/3 methods agree
Labeled adverse reaction
exact term
serious n=32 · ♀ 0% (drug 35%) · 100% cliniciannot reported in cached trials
Tongue blistering5914.5
11.2–18.7ROR 14.5 · calibrated p 0.009 ✓
14.0 EB05 11.2 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=31not reported in cached trials
Glossodynia (burning tongue/mouth pain)58814.5
13.3–15.7ROR 14.7 · calibrated p 0.008 ✓
14.1 EB05 13.2 · IC025 +3.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 8.9NCT00716625: 1/1,673 (0.1%) on Sunitinib Malate (serious AE)
Thyroid function test abnormal10814.2
11.7–17.2ROR 14.3 · calibrated p 0.009 ✓
13.8 EB05 11.7 · IC025 +3.4
3/3 methods agree
Reporting / coding artifactserious n=72not reported in cached trials
Reversible posterior leukoencephalopathy syndrome2013.9
8.9–21.6ROR 13.9 · calibrated p 0.013 ✓
12.8 EB05 8.3 · IC025 +2.6
3/3 methods agree
Labeled adverse reaction
exact term
serious n=20not reported in cached trials
Ageusia (loss of taste)62313.7
12.6–14.8ROR 13.9 · calibrated p 0.010 ✓
13.3 EB05 12.5 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 12.8not reported in cached trials
Exposed bone in jaw5313.3
10.1–17.4ROR 13.3 · calibrated p 0.013 ✓
12.8 EB05 10.0 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=52not reported in cached trials
Stomatitis (mouth sores)1,46613.3
12.6–14.0ROR 13.7 · calibrated p 0.010 ✓
13.0 EB05 12.4 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 9.5NCT00326898: 2/625 (0.3%) control (serious AE)

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Sunitinib Malate 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 (7 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
Death7,4334.7
4.6–4.8ROR 5.5 · calibrated p 0.185
4.6 EB05 4.5 · IC025 +2.2
3/3 methods agree
Outcome field, not a reaction
boxed warning mentions mortality
serious PRR 3.5NCT00716625: 14/1,673 (0.8%) on Sunitinib Malate (serious AE)
Diarrhoea (diarrhea)4,4183.7
3.6–3.8ROR 4.0 · calibrated p 0.369
3.7 EB05 3.6 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.1NCT00326898: 2/626 (0.3%) on Sunitinib Malate; 57/625 (9.1%) control (serious AE)
Fatigue (tiredness)4,1902.9
2.8–3.0ROR 3.1 · calibrated p 0.585
2.9 EB05 2.8 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.6NCT00326898: 15/626 (2.4%) on Sunitinib Malate; 108/625 (17.3%) control (serious AE)
Disease progression3,91218.4
17.8–18.9ROR 20.3 · calibrated p 0.002 ✓
17.8 EB05 17.3 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious PRR 10.6NCT00716625: 187/1,673 (11.2%) on Sunitinib Malate (serious AE)
Nausea3,1212.1
2.1–2.2ROR 2.2 · calibrated p 0.939
2.1 EB05 2.1 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.0NCT00326898: 5/628 (0.8%) on Sunitinib Malate; 22/625 (3.5%) control (serious AE)
Asthenia (weakness)2,4623.5
3.4–3.7ROR 3.7 · calibrated p 0.438
3.5 EB05 3.4 · IC025 +1.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.0NCT00716625: 3/1,673 (0.2%) on Sunitinib Malate (serious AE)
Decreased appetite (loss of appetite)2,3175.4
5.2–5.6ROR 5.7 · calibrated p 0.172
5.4 EB05 5.2 · IC025 +2.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.5NCT00716625: 44/1,673 (2.6%) on Sunitinib Malate (serious AE)
Vomiting2,2102.5
2.4–2.6ROR 2.6 · calibrated p 0.760
2.5 EB05 2.4 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.3NCT00326898: 1/626 (0.2%) on Sunitinib Malate; 11/625 (1.8%) control (serious AE)
Neoplasm progression2,01932.7
31.3–34.2ROR 34.4 · calibrated p 1e-4 ✓
30.8 EB05 29.7 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious PRR 23.1NCT00716625: 23/1,673 (1.4%) on Sunitinib Malate (serious AE)
Hypertension (high blood pressure)1,8034.6
4.4–4.8ROR 4.8 · calibrated p 0.261
4.6 EB05 4.4 · IC025 +2.1
3/3 methods agree
Labeled — boxed warning
exact term
serious PRR 3.5NCT00326898: 15/626 (2.4%) on Sunitinib Malate; 104/625 (16.6%) control (serious AE)
Dysgeusia (altered taste)1,69612.4
11.9–13.0ROR 13.0 · calibrated p 0.013 ✓
12.2 EB05 11.7 · IC025 +3.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 15.0NCT00716625: 2/1,673 (0.1%) on Sunitinib Malate (serious AE)
Weight decreased (weight loss)1,5883.1
2.9–3.2ROR 3.2 · calibrated p 0.579
3.1 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.5NCT00326898: 2/626 (0.3%) control (serious AE)
Malaise (feeling unwell)1,5831.9
1.8–2.0ROR 2.0 · calibrated p 0.930
1.9 EB05 1.9 · IC025 +0.9Not in label — unassessedserious PRR 1.8NCT00716625: 37/1,673 (2.2%) on Sunitinib Malate (serious AE)
Stomatitis (mouth sores)1,46613.3
12.6–14.0ROR 13.7 · calibrated p 0.010 ✓
13.0 EB05 12.4 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 9.5NCT00326898: 2/625 (0.3%) control (serious AE)
Palmar-plantar erythrodysaesthesia syndrome1,45435.5
33.7–37.4ROR 36.9 · calibrated p 8e-5 ✓
33.3 EB05 31.9 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious PRR 25.3NCT00716625: 24/1,673 (1.4%) on Sunitinib Malate (serious AE)

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 Sunitinib Malate?

In FDA FAERS, the most frequently co-reported reaction terms for Sunitinib Malate are diarrhoea, fatigue, nausea, asthenia, decreased appetite, vomiting. 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 Sunitinib Malate have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: HEPATOTOXICITY Hepatotoxicity may be severe, and in some cases, fatal. Monitor hepatic function and interrupt, dose reduce, or discontinue sunitinib malate capsules as recommended [see Warnings and Precautions ( 5.1 )] . WARNING: HEPATOTOXICITY See full prescribing information for complete boxed warning.

Do FAERS signals prove that Sunitinib Malate 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.