← All drugs
Drug · FAERS side-effect profile with label screen

Voxelotor side effects: what 22,300 FDA adverse event reports show

Voxelotor · Oxbryta · 708 reaction terms · 53,272 drug–reaction co-reports · data 2026-09-14
Share: X Facebook Reddit Email

Drug class

Hemoglobin S Polymerization Inhibitor

FDA label (Established Pharmacologic Class)

Brand names

Oxbryta

openFDA label

Who reports

22,300 reports · 43% serious · 416 with death outcome · 60% female

openFDA FAERS counts, all years, deduplication not applied

Used for

OXBRYTA is indicated for the treatment of sickle cell disease (SCD) in adults and pediatric patients 4 years of age and older. This indication is approved under accelerated approval based on increase in hemoglobin (Hb) . Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).

FDA label, Indications and Usage

What it is

OXBRYTA contains voxelotor, a hemoglobin S polymerization 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 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 2Likely indication confounding 4Reporting / coding artifact 10Lab value / disease marker 3Not 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 flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 668 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
Sickle cell anaemia with crisis11,2182,377.3
2,301.5–2,455.5ROR 4,782.7 · χ² 7,479,904 / p <1e-300
666.8 EB05 656.6 · IC025 +9.3
3/3 methods agree
Not in label — unassessedserious PRR 770.2 · 88% consumerNCT04930445: 131/260 (50.4%) on Voxelotor (serious AE)
Acute chest syndrome391766.2
670.6–875.5ROR 779.9 · χ² 163,175 / p <1e-300
411.4 EB05 378.3 · IC025 +7.9
3/3 methods agree
Not in label — unassessedserious n=391NCT03036813: 2/92 (2.2%) on Voxelotor; 1/91 (1.1%) control (serious AE)
Sickle cell disease174576.0
476.9–695.7ROR 580.5 · χ² 61,246 / p <1e-300
342.2 EB05 301.6 · IC025 +7.2
3/3 methods agree
Likely indication confounding
term in indications
serious n=145 · 94% consumernot reported in cached trials
Hypersplenism77174.1
136.5–222.0ROR 174.7 · χ² 11,010 / p <1e-300
141.6 EB05 117.0 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=70NCT03036813: 1/88 (1.1%) on Voxelotor (serious AE)
Emergency care12541.2
34.5–49.3ROR 41.5 · χ² 4,662 / p <1e-300
39.3 EB05 33.9 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=44 · 86% consumernot reported in cached trials
Sickle cell anaemia2639.1
26.4–57.8ROR 39.1 · χ² 889 / p 1e-195
36.6 EB05 26.3 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=23 · 81% consumerNCT04930445: 131/260 (50.4%) on Voxelotor (serious AE)
Disease complication12726.7
22.4–31.8ROR 26.8 · χ² 3,028 / p <1e-300
25.9 EB05 22.3 · IC025 +4.3
3/3 methods agree
Reporting / coding artifactserious n=99 · 94% consumernot reported in cached trials
Priapism9125.3
20.6–31.2ROR 25.4 · χ² 2,045 / p <1e-300
24.6 EB05 20.6 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=44 · ♀ 0% (drug 60%)NCT04930445: 1/260 (0.4%) on Voxelotor
Reticulocyte count increased2023.7
15.2–37.0ROR 23.8 · χ² 403 / p 7e-90
22.7 EB05 15.5 · IC025 +3.2
3/3 methods agree
Lab value / disease markerserious n=14not reported in cached trials
Coronavirus infection15221.9
18.7–25.7ROR 22.0 · χ² 2,943 / p <1e-300
21.4 EB05 18.7 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=98 · 95% consumernot reported in cached trials
Expulsion of medication1121.2
11.7–38.5ROR 21.2 · χ² 188 / p 5e-43
19.7 EB05 11.1 · IC025 +2.5
3/3 methods agree
Not in label — unassessedserious n=1not reported in cached trials
Therapy cessation1,04019.5
18.4–20.7ROR 20.4 · χ² 17,924 / p <1e-300
19.1 EB05 18.2 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious PRR 19.3 · 85% consumernot reported in cached trials
Product use complaint29818.4
16.4–20.6ROR 18.7 · χ² 4,799 / p <1e-300
18.1 EB05 16.4 · IC025 +3.9
3/3 methods agree
Reporting / coding artifactserious n=69 · 94% consumernot reported in cached trials
Haemoglobin increased8618.3
14.8–22.6ROR 18.4 · χ² 1,362 / p 2e-298
17.9 EB05 14.9 · IC025 +3.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=31 · 84% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Product dose omission issue5,17217.4
17.0–17.8ROR 22.3 · χ² 79,448 / p <1e-300
17.1 EB05 16.7 · IC025 +4.0
3/3 methods agree
Reporting / coding artifactserious PRR 42.8 · 98% consumernot reported in cached trials
Blood bilirubin decreased1117.0
9.3–30.8ROR 17.0 · χ² 147 / p 4e-34
15.4 EB05 8.2 · IC025 +2.3
3/3 methods agree
Lab value / disease markerserious n=2NCT04930445: 1/260 (0.4%) on Voxelotor
Insurance issue20112.9
11.2–14.8ROR 13.0 · χ² 2,163 / p <1e-300
12.7 EB05 11.3 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious PRR 11.9 · 96% consumernot reported in cached trials
Therapy interrupted90012.4
11.6–13.2ROR 12.9 · χ² 9,343 / p <1e-300
12.3 EB05 11.6 · IC025 +3.5
3/3 methods agree
Reporting / coding artifactserious PRR 18.9 · 81% consumernot reported in cached trials
Haemoglobin abnormal8212.2
9.8–15.2ROR 12.2 · χ² 821 / p 8e-181
11.9 EB05 9.8 · IC025 +3.1
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=36 · 82% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Bone marrow transplant2412.1
8.1–18.1ROR 12.1 · χ² 230 / p 3e-52
11.3 EB05 7.6 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=24 · 75% consumernot reported in cached trials
Product size issue478.4
6.3–11.2ROR 8.4 · χ² 295 / p 2e-66
7.9 EB05 6.1 · IC025 +2.5
3/3 methods agree
Reporting / coding artifactserious n=17 · 98% consumernot reported in cached trials
Faeces soft587.6
5.9–9.8ROR 7.6 · χ² 323 / p 2e-72
7.2 EB05 5.7 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=23 · 91% consumernot reported in cached trials
Central venous catheterisation237.2
4.8–10.9ROR 7.2 · χ² 116 / p 3e-27
6.4 EB05 4.4 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=16 · 96% consumernot reported in cached trials
Haemoglobin decreased7536.9
6.5–7.4ROR 7.1 · χ² 3,801 / p <1e-300
6.9 EB05 6.5 · IC025 +2.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 6.0 · 88% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Blood iron increased136.5
3.8–11.3ROR 6.5 · χ² 55 / p 6e-14
5.4 EB05 3.3 · IC025 +1.5
3/3 methods agree
Lab value / disease markerserious n=7NCT04930445: 2/260 (0.8%) on Voxelotor (serious AE)
Therapy non-responder2956.3
5.6–7.0ROR 6.3 · χ² 1,292 / p 3e-283
6.2 EB05 5.6 · IC025 +2.4
3/3 methods agree
Reporting / coding artifactserious PRR 5.1 · 91% consumernot reported in cached trials
Medical procedure105.8
3.1–10.7ROR 5.8 · χ² 35 / p 2e-9
4.6 EB05 2.7 · IC025 +1.1
3/3 methods agree
Reporting / coding artifactserious n=7not reported in cached trials
Abdominal discomfort9695.5
5.1–5.8ROR 5.7 · χ² 3,549 / p <1e-300
5.4 EB05 5.2 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious PRR 4.1 · 94% consumernot reported in cached trials
Transfusion595.3
4.1–6.8ROR 5.3 · χ² 200 / p 8e-46
5.1 EB05 4.1 · IC025 +1.9
3/3 methods agree
Not in label — unassessedserious PRR 5.9 · 81% consumerNCT04930445: 1/260 (0.4%) on Voxelotor (serious AE)
Diarrhoea (diarrhea)3,1874.7
4.5–4.8ROR 5.3 · χ² 9,455 / p <1e-300
4.7 EB05 4.5 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.4 · 92% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Nail discolouration194.6
2.9–7.2ROR 4.6 · χ² 49 / p 1e-12
4.1 EB05 2.8 · IC025 +1.3
3/3 methods agree
Not in label — unassessedserious n=9not reported in cached trials
Skin ulcer1144.2
3.5–5.0ROR 4.2 · χ² 270 / p 5e-61
4.1 EB05 3.5 · IC025 +1.7
3/3 methods agree
Not in label — unassessedserious PRR 3.7NCT04930445: 1/260 (0.4%) on Voxelotor (serious AE)
Ocular icterus194.1
2.6–6.5ROR 4.1 · χ² 42 / p 5e-11
3.8 EB05 2.6 · IC025 +1.2
3/3 methods agree
Not in label — unassessedserious n=6NCT03036813: 6/88 (6.8%) on Voxelotor; 8/91 (8.8%) control
Thrombocytosis164.1
2.5–6.8ROR 4.1 · χ² 35 / p 2e-9
3.7 EB05 2.5 · IC025 +1.1
3/3 methods agree
Not in label — unassessedserious n=11NCT03036813: 1/91 (1.1%) control (serious AE)
Product administration interrupted334.1
2.9–5.7ROR 4.1 · χ² 73 / p 7e-18
3.8 EB05 2.9 · IC025 +1.4
3/3 methods agree
Reporting / coding artifactserious n=17 · 91% consumernot reported in cached trials
Osteonecrosis (bone death)1243.5
3.0–4.2ROR 3.5 · χ² 221 / p 2e-50
3.5 EB05 3.0 · IC025 +1.5
3/3 methods agree
Not in label — unassessedserious PRR 4.7NCT04930445: 8/260 (3.1%) on Voxelotor (serious AE)
Product dose omission in error983.4
2.8–4.2ROR 3.5 · χ² 167 / p 2e-38
3.4 EB05 2.9 · IC025 +1.4
3/3 methods agree
Reporting / coding artifactserious PRR 10.9 · 79% consumernot reported in cached trials
Hip surgery193.4
2.1–5.3ROR 3.4 · χ² 29 / p 3e-8
3.2 EB05 2.1 · IC025 +0.9
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Voxelotor 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 (17 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
Sickle cell anaemia with crisis11,2182,377.3
2,301.5–2,455.5ROR 4,782.7 · χ² 7,479,904 / p <1e-300
666.8 EB05 656.6 · IC025 +9.3
3/3 methods agree
Not in label — unassessedserious PRR 770.2 · 88% consumerNCT04930445: 131/260 (50.4%) on Voxelotor (serious AE)
Product dose omission issue5,17217.4
17.0–17.8ROR 22.3 · χ² 79,448 / p <1e-300
17.1 EB05 16.7 · IC025 +4.0
3/3 methods agree
Reporting / coding artifactserious PRR 42.8 · 98% consumernot reported in cached trials
Diarrhoea (diarrhea)3,1874.7
4.5–4.8ROR 5.3 · χ² 9,455 / p <1e-300
4.7 EB05 4.5 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.4 · 92% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Off label use (used outside approved label)2,4172.6
2.5–2.7ROR 2.8 · χ² 2,524 / p <1e-300
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Reporting / coding artifactserious PRR 2.4 · 92% consumernot reported in cached trials
Nausea2,0162.4
2.3–2.5ROR 2.5 · χ² 1,716 / p <1e-300
2.4 EB05 2.3 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 1.6 · 92% consumerNCT03036813: 1/88 (1.1%) on Voxelotor (serious AE)
Headache1,6912.5
2.4–2.7ROR 2.7 · χ² 1,627 / p <1e-300
2.5 EB05 2.4 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 1.6 · 92% consumerNCT03036813: 1/88 (1.1%) on Voxelotor (serious AE)
Pain1,0851.7
1.6–1.8ROR 1.7 · χ² 292 / p 1e-65
1.7 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 1.9 · 75% consumerNCT03036813: 2/92 (2.2%) on Voxelotor; 1/91 (1.1%) control (serious AE)
Therapy cessation1,04019.5
18.4–20.7ROR 20.4 · χ² 17,924 / p <1e-300
19.1 EB05 18.2 · IC025 +4.1
3/3 methods agree
Reporting / coding artifactserious PRR 19.3 · 85% consumernot reported in cached trials
Fatigue (tiredness)1,0071.2
1.1–1.3ROR 1.2 · χ² 41 / p 8e-11
1.2 EB05 1.2 · IC025 +0.2Not in label — unassessedserious PRR 0.9 · 93% consumerNCT03036813: 12/88 (13.6%) on Voxelotor; 12/91 (13.2%) control
Abdominal discomfort9695.5
5.1–5.8ROR 5.7 · χ² 3,549 / p <1e-300
5.4 EB05 5.2 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious PRR 4.1 · 94% consumernot reported in cached trials
Therapy interrupted90012.4
11.6–13.2ROR 12.9 · χ² 9,343 / p <1e-300
12.3 EB05 11.6 · IC025 +3.5
3/3 methods agree
Reporting / coding artifactserious PRR 18.9 · 81% consumernot reported in cached trials
Vomiting8331.7
1.6–1.8ROR 1.7 · χ² 229 / p 5e-52
1.7 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 1.0 · 91% consumerNCT03036813: 11/88 (12.5%) on Voxelotor; 15/91 (16.5%) control
Haemoglobin decreased7536.9
6.5–7.4ROR 7.1 · χ² 3,801 / p <1e-300
6.9 EB05 6.5 · IC025 +2.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 6.0 · 88% consumerNCT03036813: 1/92 (1.1%) on Voxelotor (serious AE)
Abdominal pain6272.5
2.4–2.7ROR 2.6 · χ² 589 / p 2e-130
2.5 EB05 2.4 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 1.2 · 88% consumerNCT03036813: 13/88 (14.8%) on Voxelotor; 10/91 (11.0%) control

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 Voxelotor?

In FDA FAERS, the most frequently co-reported reaction terms for Voxelotor are sickle cell anaemia with crisis, diarrhoea, nausea, headache, abdominal pain upper, pain. 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 Voxelotor have an FDA boxed warning?

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

Do FAERS signals prove that Voxelotor 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.