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Obinutuzumab Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Mar 11, 2023.


Commonly reported side effects of obinutuzumab include: infection, fever, hyperkalemia, hypocalcemia, hypokalemia, hypophosphatemia, and neutropenia. Continue reading for a comprehensive list of adverse effects.

Applies to obinutuzumab: intravenous solution.


Intravenous route (Solution)

Hepatitis B virus (HBV) reactivation can occur in patients receiving obinutuzumab or other CD20-directed cytolytic antibodies, which can progress to life-threatening or fatal fulminant hepatitis or hepatic failure. Screen patients at baseline for HBV infection. Monitor HBV-positive patients during and after treatment with obinutuzumab. If HBV reactivation occurs, discontinue obinutuzumab and concomitant medications. Life-threatening or fatal progressive multifocal leukoencephalopathy has also been reported.

Serious side effects of Obinutuzumab

Along with its needed effects, obinutuzumab 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 or nurse immediately if any of the following side effects occur while taking obinutuzumab:

More common

  • Back pain
  • black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chest tightness
  • chills
  • cough
  • fever
  • flushing
  • headache
  • hoarseness
  • lower back or side pain
  • nausea
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • sore throat
  • trouble breathing
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting

Less common

  • Joint pain, stiffness, or swelling
  • stomach pain
  • swelling of the feet or lower legs


  • Bruising
  • confusion
  • coughing or vomiting blood
  • persistent bleeding or oozing from puncture sites, mouth, or nose
  • rash

Incidence not known

  • Blurred vision
  • dark urine
  • dizziness
  • drowsiness
  • general tiredness and weakness
  • light-colored stools
  • seizures
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Other side effects of Obinutuzumab

Some side effects of obinutuzumab 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:

Incidence not known

  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

For Healthcare Professionals

Applies to obinutuzumab: intravenous solution.


Common (1% to 10%): Hypertension, cardiac failure

Frequency not reported: Worsening of preexisting cardiac conditions with fatalities, atrial fibrillation[Ref]


Very common (10% or more): Neutropenia (41%), thrombocytopenia (15%), anemia (12%)

Common (1% to 10%): Leukopenia, lymph node pain[Ref]


Very common (10% or more): AST (SGOT) increased (28%), ALT (SGPT) increased (25%)[Ref]


Very common (10% or more): Hypophosphatemia (36%), hypoalbuminemia (33%), hypoproteinemia (32%), hypocalcemia (32%), hypocalcemia (32%), hyperuricemia (28%), hyponatremia (26%), hyperkalemia (23%), hypernatremia (16%) alkaline phosphatase increased (16%), decreased appetite (14%)

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


Common (1% to 10%): Arthralgia, back pain, musculoskeletal chest pain, pain in extremity, bone pain[Ref]

Nervous system

Very common (10% or more): Headache (18%), asthenia

Frequency not reported: Progressive multifocal leukoencephalopathy (PML)[Ref]


Very common (10% or more): Pyrexia (18%)[Ref]


Very common (10% or more): Creatinine increased (30%)[Ref]


Very common (10% or more): Cough (26%), pneumonia (14%), sinusitis (12%), upper respiratory tract infection

Common (1% to 10%): Rhinitis, pharyngitis, nasopharyngitis, lung infection, nasal congestion, rhinorrhea, lung infection[Ref]


Very common (10% or more): Positive test for anti-obinutuzumab antibodies (13%)

Common (1% to 10%): Infection (9%)

Frequency not reported: Hepatitis B reactivation, immunogenicity[Ref]


Very common (10% or more): Alopecia (13%)

Common (1% to 10%): Pruritus, night sweats, eczema[Ref]


Very common (10% or more): Infusion related reactions (69%)[Ref]


Common (1% to 10%): Ocular hyperemia[Ref]


Common (1% to 10%): Urinary tract infection, urinary incontinence, dysuria[Ref]


Common (1% to 10%): Squamous cell carcinoma of the skin[Ref]


Very common (10% or more): Constipation (19%), diarrhea (10%)

Common (1% to 10%): Oral herpes, dyspepsia, colitis, hemorrhoids[Ref]


Frequency not reported: This drug can cause serious infusion reactions. See Warnings.[Ref]

Frequently asked questions


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

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

3. "Product Information. Gazyva (obinutuzumab)." Genentech (2013):

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.