Selpercatinib Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 12, 2025.

Applies to selpercatinib: oral capsule.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. Use an effective form of birth control during treatment and for at least 1 week after the last dose. Males with female partners who are able to become pregnant should use an effective form of birth control during treatment and for at least 1 week after the last dose. If you think you have become pregnant, tell your doctor right away.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause serious lung or breathing problems (eg, interstitial lung disease, pneumonitis). Check with your doctor right away if you have chest pain, chills, cough, fever, general feeling of discomfort or illness, thickening of bronchial secretions, or trouble breathing.

Check with your doctor right away if blurred vision, dizziness, nervousness, headache, pounding in the ears, or slow or fast heartbeat occurs during or after treatment with this medicine. These can be symptoms of hypertension (high blood pressure).

This medicine can cause changes in your heart rhythm, including a condition called QT prolongation. Call your doctor right away if you have dizziness, fainting, or slow, fast, pounding, or uneven heartbeats.

This medicine can cause serious bleeding problems that may be life-threatening. Check with your doctor right away if you have coughing up blood, increased menstrual flow or vaginal bleeding, nosebleeds, red or black, tarry stools, red or dark brown urine, vomiting of blood or material that looks like coffee grounds, or any unusual bleeding or bruising.

Selpercatinib may cause serious allergic reactions. Check with your doctor right away if you have a fever, rash, itching, joint or muscle pain, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you take the medicine.

This medicine may affect the way your body heals from cuts and wounds. Make sure any doctor who treats you knows that you are using this medicine. You may need to stop using this medicine several days before and after having surgery.

This medicine may cause a serious type of reaction called tumor lysis syndrome. Your doctor may give you medicine to help prevent this. Call your doctor right away if you have a decrease or change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, a rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness.

This medicine may cause hypothyroidism (underactive thyroid). Check with your doctor right away if you have constipation, depressed mood, dry skin and hair, feeling cold, hair loss, hoarseness or husky voice, muscle cramps and stiffness, slowed heartbeat, weight gain, or unusual tiredness or weakness.

Talk with your doctor before using this medicine if you plan to have children. Some men and women using this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Serious side effects of selpercatinib

Along with its needed effects, selpercatinib 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 selpercatinib:

Other side effects of selpercatinib

Some side effects of selpercatinib 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:

For healthcare professionals

Applies to selpercatinib: oral capsule, oral tablet.

General adverse events

The most common adverse effects occurring in at least 50% of patients included diarrhea, decreased albumin, decreased platelets, decreased neutrophils, decreased lymphocytes, decreased calcium, decreased albumin, increased glucose, increased alkaline phosphatase, and musculoskeletal pain.

Refer to the manufacturer product information for a list of included terms that may be reported with adverse effects, and for descriptions of select reactions.^[Ref]

Cardiovascular

• Very common (10% or more): Hypertension (up to 48%), prolonged QT interval (up to 21%)
• Common (1% to 10%): Myocardial infarction
• Uncommon (0.1% to 1%): Cardiac failure, cardiac arrest

Dermatologic

• Very common (10% or more): Rash (up to 33%), dry skin (up to 16.2%), alopecia (up to 10.4%)

Endocrine

• Very common (10% or more): Hypothyroidism (up to 19%)
• Uncommon (0.1% to 1%): Diabetic ketoacidosis

Gastrointestinal

• Very common (10% or more): Diarrhea (up to 50.1%), dry mouth (up to 43.7%), constipation (up to 35.2%), nausea (up to 34.5%), abdominal pain (up to 34%), vomiting (up to 30%), stomatitis (up to 15%), gastroesophageal reflux disease (up to 14.9%), ascites (up to 14.8%), abdominal distension (up to 14.2%)
• Common (1% to 10%): Abdominal infection, chylous ascites, pneumatosis intestinalis

Genitourinary

• Very common (10% or more): Erectile dysfunction (up to 16%)

Hematologic

• Very common (10% or more): Decreased albumin (up to 56%), decreased platelets (up to 53%), decreased neutrophils (up to 53%), decreased lymphocytes (up to 53%), decreased hemoglobin (up to 28%), hemorrhage (up to 26%)

Hepatic

• Very common (10% or more): Increased ALT (up to 81%), increased AST (up to 77%), increased bilirubin (up to 52%), increased total cholesterol (up to 35%)

Hypersensitivity

• Common (1% to 10%): Hypersensitivity (presenting with fever, rash, and/or arthralgias or myalgias with concurrent decreased platelets or increased aminotransferase)

Metabolic

• Very common (10% or more): Decreased calcium (up to 59%), decreased albumin (up to 56%), increased glucose (up to 53%), increased alkaline phosphatase (up to 52%), decreased sodium (up to 42%), decreased glucose (up to 34%), increased potassium (up to 34%), decreased magnesium (up to 33%), decreased appetite (up to 17%), decreased potassium (up to 17%), increased phosphate (up to 10.6%)
• Common (1% to 10%): Malnutrition, tumor lysis syndrome

Musculoskeletal

• Very common (10% or more): Musculoskeletal pain (up to 56%), arthralgia (up to 22.9%), back pain (up to 22.3%), pain in extremity (up to 13.6%), myalgia (up to 13.3%)
• Common (1% to 10%): Epiphysiolysis of the femoral head

Nervous system

• Very common (10% or more): Headache (up to 33%), dizziness (up to 11%)

Other

• Very common (10% or more): Edema (49%), fatigue/asthenia/malaise (46%), pyrexia (up to 26%), increased weight (up to 19%), decreased weight (up to 11.2%)
• Common (1% to 10%): Sepsis, rhinovirus infection
• Uncommon (0.1% to 1%): Multiple organ dysfunction syndrome, sudden death, somatic symptom disorder

Renal

• Very common (10% or more): Increased creatinine (up to 47%), proteinuria (up to 15%), urinary tract infection (up to 12%)

Consider alternative markers of renal function if persistent elevations in serum creatinine are observed.

Respiratory

• Very common (10% or more): COVID-19 infection (up to 30%), cough (up to 24%), dyspnea (up to 22.7%), oropharyngeal pain (up to 22%), dysphonia (up to 11.5%), pneumonia (up to 11%)
• Common (1% to 10%): Interstitial lung disease/pneumonitis, chylothorax, respiratory failure, pleural effusion

See also:

Further information

Selpercatinib side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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