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Stivarga Side Effects

Generic Name: regorafenib

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

In Summary

Common side effects of Stivarga include: infection, anemia, asthenia, diarrhea, fatigue, fever, hemorrhage, hyperbilirubinemia, hypertension, hypocalcemia, hypokalemia, hyponatremia, hypophosphatemia, increased amylase, increased inr, increased serum alanine aminotransferase, increased serum aspartate aminotransferase, increased serum lipase, lymphocytopenia, mucositis, neutropenia, pain, palmar-plantar erythrodysesthesia, proteinuria, skin rash, thrombocytopenia, voice disorder, weight loss, and decreased appetite. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to regorafenib: oral tablet

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

Major Side Effects

If any of the following side effects occur while taking regorafenib, check with your doctor immediately:

More common:
  • Bleeding gums
  • blurred vision
  • cough or hoarseness
  • coughing up blood
  • difficulty with breathing or swallowing
  • dizziness
  • fever or chills
  • headache
  • increased menstrual flow or vaginal bleeding
  • lower back or side pain
  • nervousness
  • nosebleeds
  • painful or difficult urination
  • pounding in the ears
  • prolonged bleeding from cuts
  • rash
  • red or black, tarry stools
  • redness, swelling, or pain of the skin
  • scaling of the skin on the hands and feet
  • slow or fast heartbeats
  • tingling of the hands and feet
  • ulcers on the skin
Less common:
  • Chest pain or discomfort
  • dark-colored urine
  • general feeling of tiredness or weakness
  • light-colored stools
  • nausea or vomiting
  • pain or discomfort in the arms, jaw, back, or neck
  • shakiness in the legs, arms, hands, or feet
  • stomach pain that continues
  • sweating
  • yellow eyes or skin
  • Confusion
  • heartburn
  • indigestion
  • severe stomach pain, cramping, or burning
  • vomiting of material that looks like coffee grounds

Minor Side Effects

Some regorafenib 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:
  • Bad, unusual, or unpleasant taste
  • hair loss or thinning of the hair
  • lack or loss of strength
  • muscle or joint stiffness
  • weight loss
Less common:
  • Constipation
  • depressed mood
  • dry skin and hair
  • feeling cold
  • muscle cramps
  • weight gain

For Healthcare Professionals

Applies to regorafenib: oral tablet


The most common side effect resulting in discontinuation was skin toxicity (HFSR/PPE or rash).
The most frequently observed adverse drug reactions (greater than or equal to 30%) were asthenia/fatigue, decreased appetite and food intake, HFSR/PPE, diarrhea, mucositis, weight loss, infection, hypertension and dysphonia.
The most serious adverse drug reactions were hepatotoxicity, hemorrhage, and gastrointestinal perforation.[Ref]


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


Very common (10% or more): HFSR/PPE (45%), rash (26%)
Common (1% to 10%): Alopecia (7.6%)[Ref]


Very common (10% or more): Increased lipase (46%), increased amylase (26%)
Common (1% to 10%): Hypothyroidism (4.2%)[Ref]


Very common (10% or more): Diarrhea (43%), mucositis (33%)
Common (1% to 10%): Taste disorder (7.6%), dry mouth (4.8%), gastroesophageal reflux (1.4%)
Uncommon (0.1% to 1%): Gastrointestinal fistula (0.8%)[Ref]


Very common (10% or more): Anemia (79%), lymphopenia (54%), thrombocytopenia (41%), increased INR (24%), hemorrhage (21%)
Common (1% to 10%): Neutropenia (3%)[Ref]


Very common (10% or more): Increased AST (65%), increased ALT (45%), hyperbilirubinemia (45%)[Ref]


Very common (10% or more): Infection (31%)[Ref]


Very common (10% or more): Hypocalcemia (59%), hypophosphatemia (57%), decreased appetite and food intake (47%), weight loss (32%), hyponatremia (30%), hypokalemia (26%)[Ref]


Common (1% to 10%): Musculoskeletal stiffness (6.0%)[Ref]

Nervous system

Very common (10% or more): Pain (29%), headache (10%)
Common (1% to 10%): Tremor (2%)[Ref]


Rare (less than 0.1%): Keratoacanthoma/squamous cell carcinoma of the skin (0.09%)[Ref]


Very common (10% or more): Asthenia/fatigue (64%), fever (28%)[Ref]


Very common (10% or more): Proteinuria (60%)[Ref]


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


1. Godfraind T "[Pharmacology of digitalis receptors]." Bull Acad R Med Belg 12 (1972): 403-48

It is possible that some side effects of Stivarga 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.