Skip to main content

Ivosidenib Side Effects

Medically reviewed by Last updated on Feb 22, 2022.

For the Consumer

Applies to ivosidenib: oral tablet


Oral route (Tablet)

Warning: Differentiation SyndromePatients treated with ivosidenib have experienced symptoms of differentiation syndrome, which can be fatal if not treated. Symptoms may include fever, dyspnea, hypoxia, pulmonary infiltrates, pleural or pericardial effusions, rapid weight gain or peripheral edema, hypotension, and hepatic, renal, or multi-organ dysfunction. If differentiation syndrome is suspected, initiate corticosteroid therapy and hemodynamic monitoring until symptom resolution.Early recognition and aggressive management of differentiation syndrome is required to lessen the likelihood of serious illness and death. Symptoms of differentiation syndrome should be described to patients when starting therapy and at follow-up visits. Differentiation syndrome has occurred as early as 10 days and up to 5 months after initiating therapy with another isocitrate dehydrogenase 2 inhibitor.

Side effects requiring immediate medical attention

Along with its needed effects, ivosidenib 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 ivosidenib:

More common

  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • burning, tingling, numbness or pain in the hands, arms, feet, or legs
  • chest pain or tightness
  • chills
  • confusion
  • cough
  • decreased urination
  • difficult or labored breathing
  • difficulty in moving
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • eye pain
  • fainting
  • fever
  • general feeling of illness
  • headache
  • irregular heartbeat, recurrent
  • joint pain, stiffness, or swelling
  • lower back, side, or stomach pain
  • muscle ache, cramps, pain, or stiffness
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • rapid weight gain
  • rash
  • sensation of pins and needles
  • sore throat
  • sores, ulcers, or white spots on the lips, tongue, or inside the mouth
  • stabbing pain
  • swelling of your arms, feet, or lower legs
  • unusual bleeding or bruising
  • unusual tiredness or weakness


  • Inability to move the arms and legs
  • sudden numbness and weakness in the arms and legs

Side effects not requiring immediate medical attention

Some side effects of ivosidenib 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

For Healthcare Professionals

Applies to ivosidenib: oral tablet


Common (1% to 10%): Hemoglobin decreased (60%), leukocytosis (e.g., leukocytosis, hyperleukocytosis, increased white blood cell count) (38%)[Ref]


Uncommon (0.1% to 1%): Guillain-Barre syndrome[Ref]


Very common (10% or more): Arthralgia (e.g., arthralgia, back pain, musculoskeletal stiffness, neck pain, pain in extremity) (36%), myalgia (e.g., myalgia, muscular weakness, musculoskeletal pain, musculoskeletal chest pain, musculoskeletal discomfort, myalgia intercostal) (18%)[Ref]


Very common (10% or more): Sodium decreased (39%), magnesium decreased (38%), uric acid increased (32%), potassium decreased (31%), phosphate decreased (25%), decreased appetite (18%)

Common (1% to 10%): Tumor lysis syndrome[Ref]


Very common (10% or more): Alkaline phosphatase increased (27%), aspartate aminotransferase increased (27%), bilirubin increased (16%), alanine aminotransferase increased (15%)[Ref]


Very common (10% or more): Dyspnea (33%), cough (e.g., cough, productive cough, upper airway cough syndrome) (22%), differentiation syndrome (can be associated with other commonly reported events such as peripheral edema, leukocytosis, pyrexia, dyspnea, pleural effusion, hypotension, hypoxia, pulmonary edema, pneumonia, pericardial effusion, rash, fluid overload, tumor lysis syndrome, creatinine increased) (19%), pleural effusion (13%)[Ref]


Very common (10% or more): Fatigue (39%), edema (e.g., peripheral edema, edema, fluid overload, fluid retention, face edema) (32%). pyrexia (23%)[Ref]

Nervous system

Very common (10% or more): Headache (16%), neuropathy (e.g., ataxia, burning sensation, gait disturbance, Guillain-Barre syndrome, neuropathy peripheral, paresthesia, peripheral sensory neuropathy, peripheral motor neuropathy, sensory disturbance) (12%)[Ref]


Very common (10% or more): Creatinine increased (23%)[Ref]


Very common (10% or more): Chest pain (e.g., angina pectoris, chest pain, chest discomfort, non-cardiac chest pain) (16%), hypotension (e.g., hypotension, orthostatic hypotension) (12%)

Common (1% to 10%): Electrocardiogram QT prolonged[Ref]


Very common (10% or more): Rash (e.g., dermatitis acneiform, dermatitis, rash, rash maculo-papular, urticaria, rash erythematous, rash macular, rash pruritic, rash generalized, rash papular, skin exfoliation, skin ulcer) (26%)[Ref]


Very common (10% or more): Diarrhea (38%), nausea (31%), mucositis (e.g., aphthous ulcer, esophageal pain, esophagitis, gingival pain, gingivitis, mouth ulceration, mucosal inflammation, oral pain, oropharyngeal pain, proctalgia, stomatitis) (28%), constipation (20%), vomiting (18%), abdominal pain (16%)[Ref]

Frequently asked questions


1. "Product Information. Tibsovo (ivosidenib)." Agios Pharmaceuticals, Inc. (2018):

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.