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Onivyde Side Effects

Generic Name: irinotecan liposomal

Note: This page contains side effects data for the generic drug irinotecan liposomal. It is possible that some of the dosage forms included below may not apply to the brand name Onivyde.

In Summary

Common side effects of Onivyde include: fever. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to irinotecan liposomal: intravenous solution

As well as its needed effects, irinotecan liposomal (the active ingredient contained in Onivyde) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking irinotecan liposomal, check with your doctor or nurse immediately:

More common:
  • Confusion
  • decreased urination
  • diarrhea (severe)
  • dizziness
  • dry mouth
  • fainting
  • fever
  • lightheadedness
  • rapid breathing
  • sunken eyes
  • thirst
  • unusual tiredness or weakness
  • wrinkled skin
Less common:
  • Black, tarry stools
  • chest pain or discomfort
  • chills
  • confusion
  • cough
  • fast heartbeat
  • lightheadedness, dizziness, or fainting
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • rapid, shallow breathing
  • shortness of breath
  • slow or irregular heartbeat
  • sore throat
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
Incidence not known:
  • Difficulty with breathing or swallowing
  • hives, itching, or skin rash
  • nausea
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • reddening of the skin, especially around the ears
  • tightness in the chest

Minor Side Effects

Some irinotecan liposomal side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Decreased appetite
  • hair loss or thinning of the hair
  • lack or loss of strength
  • vomiting
  • weight loss
Less common:
  • Abdominal or stomach pain
  • feeling of warmth
  • increased sweating
  • runny nose
  • sneezing
  • stuffy nose
  • tearing of the eyes
  • watering of the mouth
  • weakness

For Healthcare Professionals

Applies to irinotecan liposomal: intravenous dispersion


Very common (10% or more): Diarrhea (59%), vomiting (52%), nausea (51%), stomatitis (32%)
Common (1% to 10%): Gastroenteritis[Ref]


Very common (10% or more): Alopecia (14%)[Ref]


The most common (2% or more) serious adverse reactions were diarrhea, vomiting, neutropenic fever or neutropenic sepsis, nausea, pyrexia, sepsis, dehydration, septic shock, pneumonia, acute renal failure, and thrombocytopenia.[Ref]


Very common (10% or more): Anemia (97%), lymphopenia (81%), neutropenia (52%), thrombocytopenia (41%)
Common (1% to 10%): Neutropenic fever/neutropenic sepsis[Ref]


Very common (10% or more): Increased ALT (51%), hypoalbuminemia (43%)[Ref]


Common (1% to 10%): Infusion reaction (rash, urticaria, periorbital edema, pruritus)[Ref]


Very common (10% or more): Decreased appetite (44%), hypomagnesemia (35%), hypocalcemia (32%), hypokalemia (32%), hypophosphatemia (29%), hyponatremia (27%), weight loss (17%)
Common (1% to 10%): Dehydration[Ref]

Nervous system

Common (1% to 10%): Cholinergic reactions[Ref]


Very common (10% or more): Fatigue/asthenia (56%), pyrexia (23%)
Common (1% to 10%): IV catheter-related infection, sepsis[Ref]


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


1. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals, Cambridge, MA.

It is possible that some side effects of Onivyde may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.