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Trabectedin Side Effects

In Summary

Commonly reported side effects of trabectedin include: increased creatine phosphokinase, increased liver enzymes, increased serum alanine aminotransferase, increased serum alkaline phosphatase, increased serum aspartate aminotransferase, increased serum bilirubin, and neutropenia. Other side effects include: febrile neutropenia, cardiomyopathy, and fever. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to trabectedin: intravenous powder for solution

As well as its needed effects, trabectedin may cause unwanted side effects that require medical attention.

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

More common:
  • Chest discomfort or pain
  • difficulty breathing
  • dizziness
  • faintness
  • fast irregular or pounding heartbeat
  • swelling of the feet or lower legs
  • unusual tiredness or weakness
Less common:
  • Dark-colored urine
  • fever
  • muscle cramps or spasms
  • muscle pain or stiffness
  • Abdominal or stomach pain or tenderness
  • clay colored stools
  • decreased appetite
  • headache
  • itching or skin rash
  • loss of appetite
  • nausea and vomiting
  • swelling of the feet or lower legs
  • yellow eyes or skin
Incidence not known:
  • Black, tarry stools
  • chills
  • cough
  • difficulty with swallowing
  • hives
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • sore throat
  • tightness in the chest
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising

Minor Side Effects

Some trabectedin 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:
  • Diarrhea
  • difficulty having a bowel movement (stool)
  • decreased appetite
  • headache
  • trouble sleeping
Incidence not known:
  • Pain at the injection site

For Healthcare Professionals

Applies to trabectedin: intravenous powder for injection


Very common (10% or more): Increased ALT (up to 96.1%), increased AST (up to 89.5%), increased alkaline phosphatase (up to 70%), hyperbilirubinemia (up to 25.2%), increased gamma-glutamyltransferase (% unavailable)
Common (1% to 10%): Drug-induced liver injury
Uncommon (0.1% to 1%): Hepatotoxicity
Frequency not reported: Hepatic failure, increased conjugated bilirubin[Ref]


Very common (10% or more): Anemia (up to 96%), neutropenia (up to 91.6%), leukopenia (up to 94.9%), thrombocytopenia (up to 63.7%)
Common (1% to 10%): Febrile neutropenia, neutropenic sepsis, pancytopenia, bone marrow failure, granulocytopenia
Uncommon (0.1% to 1%): Neutropenic infection[Ref]


Very common (10% or more): Nausea (up to 75%), vomiting (up to 51.7%), constipation (up to 37%), diarrhea (up to 35%), stomatitis (up to 19.2%),
Common (1% to 10%): Abdominal pain, dyspepsia, upper abdominal pain[Ref]


Very common (10% or more): Fatigue/asthenia/malaise (up to 69%), peripheral edema (up to 28%), mucosal inflammation (up to 11.4%), pyrexia (up to 10.2%)
Common (1% to 10%): Infection, edema, injection site reaction
Uncommon (0.1% to 1%): Septic shock
Frequency not reported: Multi-organ failure, catheter site reactions
Postmarketing reports: Extravasation/tissue necrosis[Ref]


Very common (10% or more): Hypoalbuminemia (up to 63%), decreased appetite (up to 37%), anorexia (up to 28.8%)
Common (1% to 10%): Dehydration, hypokalemia, decreased weight[Ref]


Very common (10% or more): Increased creatinine (up to 46%)
Common (1% to 10%): Renal failure[Ref]


Very common (10% or more): Elevated creatine phosphokinase (up to 33%), arthralgia (up to 15%), myalgia (up to 12%)
Common (1% to 10%): Back pain
Uncommon (0.1% to 1%): Rhabdomyolysis
Frequency not reported: Musculoskeletal pain[Ref]


Very common (10% or more): Dyspnea (up to 25%)
Common (1% to 10%): Cough, pulmonary embolism
Uncommon (0.1% to 1%): Pulmonary edema[Ref]

Nervous system

Very common (10% or more): Headache (up to 25%)
Common (1% to 10%): Peripheral neuropathy, dysgeusia, dizziness, paresthesia
Uncommon (0.1% to 1%): Syncope
Frequency not reported: Hypoesthesia[Ref]


Very common (10% or more): Palmar-plantar erythrodysesthesia (up to 24%), alopecia (up to 12%)
Common (1% to 10%): Rash, skin hyperpigmentation[Ref]


Very common (10% or more): Insomnia (up to 15%)[Ref]


Common (1% to 10%): Cardiomyopathy, decreased ejection fraction, hypotension, flushing
Uncommon (0.1% to 1%): Left ventricular dysfunction[Ref]


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


1. "Product Information. Yondelis (trabectedin)." Janssen Pharmaceuticals, Titusville, NJ.

It is possible that some side effects of trabectedin 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.