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Synribo Side Effects

Generic Name: omacetaxine

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

For the Consumer

Applies to omacetaxine: subcutaneous powder for solution

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

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

More common:
  • Black, tarry stools
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • bloody nose
  • chills
  • cough
  • fever
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • rapid weight gain
  • shortness of breath
  • sore throat
  • tingling of the hands or feet
  • troubled breathing with exertion
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
Incidence not known:
  • Arm, back, or jaw pain
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • confusion
  • convulsions
  • decreased urination
  • deep, dark purple bruises
  • difficulty with speaking
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • dry mouth
  • fainting
  • fast, shallow breathing
  • fast, slow, pounding, or irregular heartbeat or pulse
  • flushed, dry skin
  • fruit-like breath odor
  • headache
  • hives, rash, or itching, pain, redness, or swelling of the skin
  • hoarseness
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • increased hunger
  • increased thirst
  • increased urination
  • irritation
  • joint pain, stiffness, or swelling
  • loss of consciousness
  • muscle cramps
  • nausea
  • nervousness
  • pale, clammy skin
  • pounding in the ears
  • rapid breathing
  • slow speech
  • stomachache
  • sunken eyes
  • sweating
  • swelling of the eyelids, face, lips, hands, or feet
  • thirst
  • troubled breathing or swallowing
  • unexplained weight loss
  • vomiting of blood or material that looks like coffee grounds
  • wrinkled skin

Minor Side Effects

Some omacetaxine 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:
  • Abdominal or stomach pain
  • back pain
  • 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
  • diarrhea
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • hair loss or thinning of the hair
  • lack or loss of strength
  • loss of appetite
  • muscle pain or stiffness
  • pain in the arms or legs
  • trouble sleeping
  • upper abdominal or stomach pain
  • weight loss
Incidence not known:
  • Acid or sour stomach
  • anxiety
  • belching
  • bleeding gums
  • bloody eye
  • bone pain
  • burning, dry, or itching eyes
  • continuous ringing or buzzing or other unexplained noise in the ears
  • darkening of the skin
  • decreased appetite
  • depression
  • double vision
  • dry skin
  • ear pain
  • eye discharge or excessive tearing
  • eye pain
  • general feeling of discomfort or illness
  • hearing loss
  • heartburn
  • increased sweating
  • indigestion
  • itching skin
  • muscle spasm, stiffness, or weakness
  • redness and swelling of the gums
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
  • stomach discomfort or upset
  • stuffy nose

For Healthcare Professionals

Applies to omacetaxine: subcutaneous powder for injection


The most common side effects (frequency greater than and equal to 20%) include thrombocytopenia, anemia, neutropenia, diarrhea, nausea, fatigue, asthenia, injection site reaction, pyrexia, infection, and lymphopenia.

Serious side effects occurring in at least 5% of patients included febrile neutropenia (18%), thrombocytopenia (9%), anemia (7%), diarrhea (6%), and convulsions (6%).

The most common side effects leading to withdrawal were leukocytosis (6%) and thrombocytopenia (4%).[Ref]


Common (1% to 10%): Tachycardia, palpitations, acute coronary syndrome, angina pectoris, arrhythmia, bradycardia, ventricular extrasystoles, hematoma, hypertension, hot flush, hypotension, chest pain, general edema[Ref]


Very common (10% or more): Alopecia (15%), rash (10%)
Common (1% to 10%): Erythema, pruritus, dry skin, petechiae, hyperhidrosis, night sweats, ecchymosis, purpura, skin lesion, skin ulcer, rash erythematous, rash papular, skin exfoliation, skin hyperpigmentation[Ref]


Very common (10% or more): Diarrhea (up to 42%), nausea (up to 32%), constipation (15%), abdominal pain (up to 14%), vomiting (up to 15%)
Common (1% to 10%): Stomatitis, mouth ulceration, abdominal distension, dyspepsia, gastroesophageal reflux disease, gingival bleeding, aphthous stomatitis, dry mouth, hemorrhoids, gastritis, gastrointestinal hemorrhage, melena, mouth hemorrhage, oral pain, anal fissure, dysphagia, gingival pain, gingivitis[Ref]


Common (1% to 10%): Dysuria[Ref]


Very common (10% or more): Thrombocytopenia (up to 74%), anemia (up to 61%), neutropenia (up to 50%), lymphopenia (17%), bone marrow failure (10%), febrile neutropenia (up to 20%)
Common (1% to 10%): Transfusion reaction
Frequency not reported: Pancytopenia, bone marrow necrosis[Ref]


Frequency not reported: Elevated transaminases[Ref]


Common (1% to 10%): Hypersensitivity[Ref]


Very common (10% or more: Anorexia (13%)
Common (1% to 10%): Decreased appetite, diabetes mellitus, gout, dehydration
Frequency not reported: Hyperosmolar nonketotic hyperglycemia
Laboratory abnormalities (Grade 3 or 4): platelets decreased (up to 88%), neutrophils decreased (up to 81%), hemoglobin decreased (up to 80%), leukocytes decreased (up to 72%), uric acid increased (up to 57%), creatinine increased (up to 16%), glucose increased (up to 15%), bilirubin increased (up to 9%), glucose decreased (up to 8%), alanine aminotransferase (ALT) increased (up to 6%)[Ref]


Very common (10% or more): Arthralgia (19%), pain in extremity (up to 13%), back pain (11%)
Common (1% to 10%): Bone pain, myalgia, muscular weakness, muscle spasms, musculoskeletal chest pain, musculoskeletal pain, musculoskeletal stiffness, musculoskeletal discomfort[Ref]

Nervous system

Very common (10% or more): Headache (up to 19%)
Common (1% to 10%): Dizziness, cerebral hemorrhage, paresthesia, convulsion, hypoesthesia, lethargy, sciatica, burning sensation, dysgeusia, tremor
Frequency not reported: Cerebral hemorrhage[Ref]


Common (1% to 10%): Cataract, blurred vision, conjunctival hemorrhage, dry eye, increased lacrimation, conjunctivitis, diplopia, eye pain, eyelid edema[Ref]


Very common (10% or more): Infections (bacterial, viral, fungal and nonspecified) and infestations (up to 56%), infusion and injection site related reactions (up to 34%), fatigue (up to 31%), pyrexia (up to 29%), asthenia (up to 24%), peripheral edema (13%), chills (13%)
Common (1% to 10%): Ear pain, ear hemorrhage, tinnitus, mucosal inflammation, pain, hyperthermia, influenza-like illness, catheter site pain, malaise, contusion
Frequency not reported: Multi-organ failure[Ref]


Very common (10% or more): Insomnia (10%)
Common (1% to 10%): Anxiety, depression, agitation, confusional state, mental status change[Ref]


Very common (10% or more): Cough (up to 16%), epistaxis (up to 15%), dyspnea (11%)
Common (1% to 10%): Pharyngolaryngeal pain, nasal congestion, dysphonia, productive cough, rales, rhinorrhea, hemoptysis, sinus congestion[Ref]


1. "Product Information. Synribo (omacetaxine)." Teva Pharmaceuticals USA, North Wales, PA.

It is possible that some side effects of Synribo 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.