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Alectinib Side Effects

In Summary

Commonly reported side effects of alectinib include: cough, dyspnea, increased creatine phosphokinase, increased serum aspartate aminotransferase, musculoskeletal pain, and myalgia. Other side effects include: bradycardia, and increased serum bilirubin. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to alectinib: oral capsule

In addition to its needed effects, some unwanted effects may be caused by alectinib. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking alectinib:

More common:
  • Chest pain or discomfort
  • cough
  • difficulty with moving
  • joint pain
  • lightheadedness, dizziness, or fainting
  • muscle aching or cramping
  • muscle pains or stiffness
  • shortness of breath
  • slow or irregular heartbeat
  • swollen joints
  • unusual tiredness
Less common:
  • Abdominal pain or tenderness
  • clay colored stools
  • dark urine
  • decreased appetite
  • fever
  • headache
  • itching or skin rash
  • loss of appetite
  • nausea and vomiting
  • swelling of the feet or lower legs
  • yellow eyes or skin
  • Difficult breathing
  • fever

Minor Side Effects

Some of the side effects that can occur with alectinib may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Back pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blurred vision
  • difficulty having a bowel movement (stool)
  • double vision
  • lack or loss of strength
  • rapid weight gain
  • rash with flat lesions or small raised lesions on the skin
  • seeing double
  • seeing floating dark spots or material before the eyes
  • swelling around the eyes
  • tingling of the hands or feet
  • unusual weight gain or loss
  • vision changes

For Healthcare Professionals

Applies to alectinib: oral capsule


Very common (10% or more): Anemia (56%), lymphopenia (22%)[Ref]


Very common (10% or more): Increased AST (51%), increased alkaline phosphatase (47%), hyperbilirubinemia (39%), increased ALT (34%)[Ref]


Very common (10% or more): Increased CPK (43%), myalgia/musculoskeletal pain (29%), back pain (12%)[Ref]


Very common (10% or more): Fatigue/asthenia (41%), edema (30%)[Ref]

The following types of edema were reported: peripheral, generalized, eyelid, and periorbital.[Ref]


Very common (10% or more): Hyperglycemia (36%), hypocalcemia (32%), hypokalemia (29%), hypophosphatemia (21%), hyponatremia (20%), increased weight (11%)[Ref]


Very common (10% or more): Constipation (34%), nausea (18%), diarrhea (16%), vomiting (12%)[Ref]


Very common (10% or more): Increased creatinine (28%)[Ref]


Very common (10% or more): Rash (18%)
Common (1% to 10%): Photosensitivity[Ref]

Reported cases of rash included acneiform dermatitis, erythema, and different types of rash (macular, papular, maculopapular, generalized, and pruritic).[Ref]

Nervous system

Very common (10% or more): Headache (17%)[Ref]


Very common (10% or more): Cough (19%), dyspnea (16%)
Uncommon (0.1% to 1%): Interstitial lung disease[Ref]


Reported cases of vision disorder included blurred vision, vitreous floaters, visual impairment, reduced visual acuity, asthenopia, and diplopia.[Ref]

Very common (10% or more): Vision disorder (10%)[Ref]


Common (1% to 10%): Bradycardia[Ref]


In 253 patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) who received this drug (600 mg orally twice a day) for a median duration of 9.3 months, serious (19%) and fatal (2.8%) adverse reactions occurred.[Ref]


1. "Product Information. Alecensa (alectinib)." Genentech, South San Francisco, CA.

Not all side effects for alectinib may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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