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Isavuconazonium Side Effects

In Summary

Commonly reported side effects of isavuconazonium include: dyspnea, increased serum alanine aminotransferase, increased serum alkaline phosphatase, increased serum aspartate aminotransferase, and increased serum bilirubin. Other side effects include: hypotension. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to isavuconazonium: oral capsule

Along with its needed effects, isavuconazonium 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 isavuconazonium:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody urine
  • blurred vision
  • chest pain
  • confusion
  • convulsions
  • decreased frequency or amount of urine
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast or irregular heartbeat
  • loss of appetite
  • lower back or side pain
  • muscle pain or cramps
  • muscle spasms (tetany) or twitching
  • numbness or tingling in the hands, feet, or lips
  • seizures
  • severe nausea or vomiting
  • sweating
  • tightness in the chest
  • tingling of the hands or feet
  • trembling
  • trouble breathing
  • unusual tiredness or weakness
Less common or rare
  • Cough or hoarseness
  • dark urine
  • fever with or without chills
  • hives, itching, or rash
  • irritation
  • joint pain, stiffness, or swelling
  • light-colored stools
  • red, swollen skin
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain
  • unusual bleeding or bruising
  • upper right abdominal or stomach pain
  • yellow eyes and skin
Incidence not known
  • Blistering, peeling, or loosening of the skin
  • chills
  • diarrhea
  • red skin lesions, often with a purple center
  • red, irritated eyes

Some side effects of isavuconazonium 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
  • anxiety
  • back pain
  • headache
  • heartburn or indigestion
  • seeing, hearing, or feeling things that are not there
  • stomach discomfort or upset
  • trouble sleeping
  • unusual excitement, nervousness, or restlessness
Less common or rare
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • decreased vision
  • eye pain
  • feeling of constant movement of self or surroundings
  • hair loss or thinning of the hair
  • hearing loss
  • sensation of spinning

For Healthcare Professionals

Applies to isavuconazonium: intravenous powder for injection, oral capsule


The most common side effects were nausea, vomiting, diarrhea, headache, elevated liver chemistry tests, hypokalemia, constipation, dyspnea, cough, peripheral edema, and back pain. Serious side effects were reported in 55% of patients. Therapy was permanently discontinued due to side effects in 14% of patients; confusional state, acute renal failure, increased blood bilirubin, convulsion, dyspnea, epilepsy, respiratory failure, and vomiting led to permanent discontinuation most often.[Ref]


Very common (10% or more): Nausea (up to 27.6%), vomiting (up to 25%), diarrhea (up to 23.7%), abdominal pain (16.7%), constipation (up to 14%)
Common (1% to 10%): Dyspepsia
Frequency not reported: Abdominal distension, gastritis, gingivitis, stomatitis


Very common (10% or more): Hypokalemia (up to 19.1%)
Common (1% to 10%): Decreased appetite, hypomagnesemia
Frequency not reported: Hypoalbuminemia, hypoglycemia, hyponatremia[Ref]


Elevated liver transaminases (ALT or AST) greater than 3 times the upper limit of normal (3 x ULN) and greater than 10 x ULN were reported in 4.4% and 1.2% of patients, respectively.[Ref]

Very common (10% or more): Elevated liver chemistry/laboratory tests (includes increased ALT, AST, blood alkaline phosphatase, blood bilirubin, GGT; up to 17.1%)
Common (1% to 10%): Elevated liver transaminases (ALT or AST)
Frequency not reported: Cholecystitis, cholelithiasis, hepatitis, hepatomegaly, hepatic failure, cholestasis[Ref]


Very common (10% or more): Dyspnea (up to 17.1%), cough (12%)
Common (1% to 10%): Acute respiratory failure
Frequency not reported: Bronchospasm, tachypnea[Ref]

Nervous system

Very common (10% or more): Headache (up to 17%)
Frequency not reported: Convulsion, epilepsy, dysgeusia, encephalopathy, hypoesthesia, migraine, peripheral neuropathy, paresthesia, somnolence, stupor, syncope, tremor, tinnitus, vertigo[Ref]


Very common (10% or more): Peripheral edema (up to 15.2%), fatigue (10.5%)
Common (1% to 10%): Chest pain
Frequency not reported: Infusion-related reactions (including hypotension, dyspnea, chills, dizziness, paresthesia, hypoesthesia), catheter thrombosis, malaise, chills, fall[Ref]


Very common (10% or more): Insomnia (10.5%)
Common (1% to 10%): Delirium (includes agitation, confusional state, delirium, disorientation, mental status changes), anxiety
Frequency not reported: Confusion, hallucination, depression[Ref]


Very common (10% or more): Renal failure (10.1%)
Frequency not reported: Acute renal failure[Ref]


Very common (10% or more): Back pain (up to 10.1%)
Frequency not reported: Myositis, bone pain, neck pain[Ref]


Common (1% to 10%): Hypotension
Frequency not reported: Atrial fibrillation, atrial flutter, bradycardia, reduced QT interval on ECG, palpitations, supraventricular extrasystoles, supraventricular tachycardia, ventricular extrasystoles, cardiac arrest, thrombophlebitis[Ref]


Common (1% to 10%): Rash, pruritus
Frequency not reported: Alopecia, dermatitis, exfoliative dermatitis, erythema, petechiae, urticaria[Ref]


Common (1% to 10%): Injection site reaction[Ref]


Frequency not reported: Agranulocytosis, leukopenia, pancytopenia[Ref]


Frequency not reported: Hypersensitivity[Ref]


Frequency not reported: Hematuria, proteinuria[Ref]


Frequency not reported: Optic neuropathy[Ref]


1. "Product Information. Cresemba (isavuconazonium)." Astellas Pharma US, Inc, Deerfield, IL.

Some side effects of isavuconazonium may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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