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Agalsidase beta Side Effects

Medically reviewed by Last updated on July 1, 2020.

For the Consumer

Applies to agalsidase beta: intravenous powder for solution

Side effects requiring immediate medical attention

Along with its needed effects, agalsidase beta may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking agalsidase beta:

More common

  • Blurred vision
  • chest pain or discomfort
  • confusion
  • cough producing mucus
  • difficulty breathing
  • difficulty in moving
  • dizziness;
  • fatigue
  • faintness or lightheadedness when getting up from a lying or sitting position suddenly
  • feeling unusually cold shivering
  • headache
  • hives or welts
  • irregular heartbeat
  • itching
  • joint pain
  • muscle aching or cramping
  • muscle pains or stiffness
  • nervousness
  • pain
  • pounding in the ears
  • redness of skin
  • shortness of breath
  • skin rash
  • stomach pain
  • sweating
  • swelling of ankles, feet, and lower legs
  • swollen joints
  • tightness in chest
  • unusual tiredness or weakness
  • wheezing

Incidence unknown

  • Cloudy or bloody urine
  • decreased cardiac output
  • difficulty in speaking
  • double vision
  • feeling of constant movement of self or surroundings
  • high blood pressure
  • inability to move arms, legs, or facial muscles
  • inability to speak
  • no blood pressure or pulse
  • partial loss of hearing
  • pounding or rapid pulse
  • problems with muscle control or coordination
  • sensation of spinning
  • shakiness and unsteady walk
  • slow speech
  • stopping of heart
  • swelling of face
  • swelling of the lip or ear
  • throat tightness
  • trembling
  • unconsciousness

Side effects not requiring immediate medical attention

Some side effects of agalsidase beta may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Acid or sour stomach
  • belching
  • body aches or pain
  • body produces substance that can bind to drug making it less effective or cause side effects
  • burning, crawling, itching, numbness, prickling, "pins and needles" , or tingling feelings
  • congestion
  • discouragement
  • dryness or soreness of throat
  • fear
  • feeling sad or empty
  • fever, not related to infusion
  • heartburn
  • hoarseness
  • indigestion
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • nausea
  • pain or tenderness around eyes and cheekbones
  • paleness of skin
  • runny nose
  • sensation of change in temperature
  • skeletal pain
  • sneezing
  • stuffy nose; swelling of testes
  • tender, swollen glands in neck
  • trouble concentrating
  • trouble sleeping
  • trouble in swallowing
  • voice changes

For Healthcare Professionals

Applies to agalsidase beta: intravenous powder for injection


The most serious adverse reactions were anaphylactic/anaphylactoid and allergic reactions.

The most frequently reported adverse reactions were infusion reactions and consisted of chills, fever, feeling hot or cold, dyspnea, nausea, flushing, headache, vomiting, paresthesia, fatigue, pruritus, pain in extremity, hypertension, chest pain, throat tightness, abdominal pain, dizziness, tachycardia, nasal congestion, diarrhea, peripheral edema, back pain, pallor, bradycardia, hypotension, face edema, rash, and somnolence.[Ref]


Very common (10% or more): Hypertension (14%)

Common (1% to 10%): Tachycardia, ventricular wall thickening, hot flush, palpitations, blood pressure increased, heart rate increased, blood pressure increased, flushing, pallor, bradycardia

Uncommon (0.1% to 1%): Sinus bradycardia, peripheral coldness

Frequency not reported: Cardiac arrhythmia, cardiac arrest, cardiac output decreased, aortic valve incompetence, supraventricular arrhythmia, right bundle branch block, cardiac valve disease, atrial dilation, ventricular dilation, mitral valve disease, mitral valve incompetence, mitral valve sclerosis, pulmonary valve incompetence, supraventricular extrasystoles, ventricular extrasystoles, ventricular hypokinesia, cardiac imaging procedure abnormal, ejection fraction decreased, ECG PR shortened, ECG ST segment abnormal, ECG T wave abnormal, heart rate irregular, right ventricular systolic pressure increased, orthostatic hypotension, poor peripheral circulation, poor venous access, vasoconstriction, vasospasm

Postmarketing reports: Cardiorespiratory arrest, cardiac failure, myocardial infarction, palpitations[Ref]


In clinical trials, IgE antibody testing was performed in about 60 patients who experienced moderate to severe infusion reactions or in whom mast cell activation was suspected. Of the approximately 60 patients tested, 7 tested positive for anti-drug IgE antibodies or had a positive skin test.

Frequency not reported: Anaphylaxis/anaphylactoid reaction, seasonal allergy, skin test positive

Postmarketing reports: Anaphylactic shock


Very common (10% or more): Nausea, vomiting

Common (1% to 10%): Toothache, dry mouth, abdominal pain/discomfort, stomach discomfort, hypoesthesia oral, upper abdominal pain, diarrhea

Uncommon (0.1% to 1%): Dyspepsia, dysphagia

Frequency not reported: gastroenteritis, gingivitis, retching

Postmarketing reports: Lip swelling, tongue swelling[Ref]


Very common (10% or more): Rash (20%), pruritus (10%)

Common (1% to 10%): Urticaria, erythema, angioneurotic edema, maculopapular rash

Uncommon (0.1% to 1%): Livedo reticularis, rash erythematosus, pruritic rash, skin discoloration, skin discomfort

Frequency not reported: Leukocytoclastic vasculitis, pustular rash, excoriation, acne, eczema, hair growth abnormal

Postmarketing reports: Hyperhidrosis, localized angioedema, erythema[Ref]


The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay and positivity in an assay may be influenced by several factors including assay methodology, sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies described below with the incidence of antibodies in other studies or to other agalsidase products may be misleading. The following data reflect the percentage of patients whose test results were considered positive for antibodies to this drug using an ELISA and radioimmunoprecipitation assay for antibodies. During clinical trials, 95 of 121 adult patients and 11 of 16 pediatric patients developed anti-drug IgG antibodies; the majority of whom developed antibodies within the first 3 months. In pediatric patients, IgG seroconversion was associated with a prolonged half-life which was not seen in adults. This prolonged half-life may be due to the ability of antibodies to act as carriers for their antigens. Among the 14 females, 6 adult females developed IgG anti-drug antibodies.[Ref]

Very common (10% or more): Anti-drug IgG antibody development (74%)

Postmarketing reports: Sepsis[Ref]

Nervous system

Very common (10% or more): Headache (39%), paresthesia (31%), dizziness (21%)

Common (1% to 10%): Burning sensation, somnolence, hypoesthesia, lethargy, syncope

Uncommon (0.1% to 1%): Hyperesthesia, tremor

Frequency not reported: Stroke, ataxia, cerebrovascular accident, ischemic stroke, migraine, psychomotor hyperactivity, sinus headache, vasovagal syncope, restless leg syndrome, balance disorder, dyskinesia

Postmarketing reports: Cerebrovascular accident, hypesthesia, oral hypoesthesia[Ref]


Very common (10% or more): Pain in extremity (19%), back pain (16%), myalgia (14%)

Common (1% to 10%): Muscle spasms, arthralgia, muscle tightness, musculoskeletal stiffness, musculoskeletal pain

Frequency not reported: Chest wall pain, flank pain, groin pain, joint stiffness, musculoskeletal chest pain, pain in jaw, shoulder pain

Postmarketing reports: Arthralgia[Ref]


Very common (10% or more): Chills (43%), pyrexia (39%), procedural pain (25%), fatigue (24%), peripheral edema (21%), pain (16%), feeling cold (11%), adverse event (10%), post procedural complication (10%)

Common (1% to 10%): Tinnitus, hypoacusis, chest discomfort, fungal infection, viral infection, localized infection, fall, contusion, thermal burn, feeling hot, asthenia, chest pain, face edema, malaise, hyperthermia, body temperature increased, vertigo

Uncommon (0.1% to 1%): Auricular swelling, ear pain/discomfort, influenza-like illness

Frequency not reported: Oxygen saturation decreased, hypoacousia, axillary pain, discomfort, feeling jittery, gait disturbance, sluggishness, thirst, gingival infection, infection, tooth infection, fall, post procedural nausea, vascular access complication, blood alkaline phosphatase increased

Postmarketing reports: Asthenia[Ref]


Very common (10% or more): Upper respiratory tract infection (44%), cough (33%), nasal congestion (19%), lower respiratory tract infection (18%)

Common (1% to 10%): Sinusitis, pharyngitis, dyspnea, exacerbated dyspnea, respiratory tract congestion, wheezing, throat tightness, nasopharyngitis

Uncommon (0.1% to 1%): Rhinitis, bronchospasm, pharyngolaryngeal pain, rhinorrhea, tachypnea, upper respiratory tract congestion

Frequency not reported: Hypoxia, pulmonary edema, respiratory distress, allergic rhinitis, rhonchi, throat irritation

Postmarketing reports: Respiratory failure, pneumonia, pharyngeal edema, rhinorrhea, hypoxia[Ref]


Common (1% to 10%): Anxiety, depression

Frequency not reported: Agitation, confessional state, visual hallucination, flat affect, restlessness[Ref]


Frequency not reported: Hypocalcemia[Ref]


Common (1% to 10%): Lacrimation increased

Uncommon (0.1% to 1%): Eye pruritus, ocular hyperemia

Frequency not reported: Diplopia, eye edema, night blindness, blurred vision, visual acuity reduced, visual disturbance, intraocular pressure increased

Postmarketing reports: Eye swelling, increased lacrimation[Ref]


Common (1% to 10%): Blood creatinine increased

Frequency not reported: Nephrotic syndrome, creatinine clearance decreased, cystatin C increased, renal failure, renal impairment

Postmarketing reports: Renal failure[Ref]


Postmarketing infusion-associated reactions include anaphylaxis, localized angioedema (including auricular swelling, eye swelling, dysphagia, lip swelling, edema, pharyngeal edema, face swelling, and swollen tongue), and bronchospasm.[Ref]

Frequency not reported: Catheter site rash, catheter site related reaction, infusion site pain, infusion site thrombosis

Postmarketing reports: Infusion site reactions[Ref]


Frequency not reported: Alanine aminotransferase increased, aspartate aminotransferase increased, hepatic enzyme increased[Ref]


Frequency not reported: Anemia, eosinophilia, leukopenia, hematocrit decreased, hemoglobin decreased

Postmarketing reports: Lymphadenopathy[Ref]


Frequency not reported: Prostate examination abnormal, albuminuria, proteinuria, dysuria, hematuria, benign prostatic hyperplasia, dysmenorrhea, nipple pain, erectile dysfunction[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Fabrazyme (agalsidase beta)." Genzyme Corporation, Cambridge, MA.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.