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Zokinvy Side Effects

Generic name: lonafarnib

Medically reviewed by Last updated on Nov 1, 2023.

Note: This document contains side effect information about lonafarnib. Some dosage forms listed on this page may not apply to the brand name Zokinvy.

Applies to lonafarnib: oral capsule.

Serious side effects of Zokinvy

Along with its needed effects, lonafarnib (the active ingredient contained in Zokinvy) 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 lonafarnib:

More common

Less common

Other side effects of Zokinvy

Some side effects of lonafarnib 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:

More common

Less common

For Healthcare Professionals

Applies to lonafarnib: oral capsule.


The more commonly reported adverse reactions have included gastrointestinal reactions, fatigue, infection, and laboratory abnormalities.[Ref]


Very common (10% or more): Vomiting (90%), diarrhea (81%), nausea (56%), abdominal pain (48%), constipation (22%)

Common (1% to 10%): Flatulence

Gastrointestinal (GI) adverse reactions were the most frequently reported adverse reactions in clinical trials. Vomiting was reported as mild, moderate, or severe in 30 (53%), 26 (46%) in 1 (2%) of patients, respectively. Nausea was reported as mild or moderate in 34 (97%) and 1 (3%) patient, respectively. Four patients discontinued therapy mostly due to nausea or vomiting. For patients experiencing diarrhea, the majority reported it as mild or moderate.


Very common (10% or more): Myelosuppression

Myelosuppression includes absolute neutrophil count decreased, low total white blood cells, lymphopenia, decreased hemoglobin, and hematocrit low.


Infection includes abdominal infection, candidiasis, chicken pox, Clostridium difficile colitis, colitis, croup, dengue fever, flu syndrome, flu-like symptoms, fungal infection, gastroenteritis, gastrointestinal infection, Helicobacter pylori infection, infection, infection viral, influenza, nail infection, otitis media, parotitis, perirectal abscess, pneumonia, small intestine infection, submandibular lymphadenitis, tonsillitis, viral infection.

Very common (10% or more): Infection (78%)


Very common (10% or more): Musculoskeletal pain (48%)

Musculoskeletal pain includes arthritis, back pain, bone pain, foot pain, intercostal pain, joint pain, knee pain, leg pain, musculoskeletal pain, pain in ankle/extremity/fingers/hip/leg/limb/lower limbs/left arm, shoulder pain, unilateral leg pain. Excludes musculoskeletal pain for abdomen.


Ocular changes include visual acuity change, corneal clouding, conjunctivitis, watering eyes, keratitis.

Very common (10% or more): Ocular changes (24%)


Electrolyte abnormalities include hypermagnesemia, hypokalemia, hyperkalemia, hyponatremia, hypercalcemia, hyperphosphatemia, hypocalcemia, and hypernatremia.

Very common (10% or more): Decreased appetite (53%), electrolyte abnormalities (43%), decreased weight (37%), decreased blood bicarbonate (33%)

Common (1% to 10%): Dehydration


Common (1% to 10%): Depressed mood


Very common (10% or more): Elevated alanine aminotransferase (27%), elevated aspartate aminotransferase (35%)


Very common (10% or more): upper respiratory tract infection (51%), rhinitis (19%), cough (33%), epistaxis (21%)

Upper respiratory infection includes bronchial infection, bronchitis, sinus infection, and upper respiratory infection.


Very common (10% or more): Fatigue (51%), pyrexia (14%)

Nervous system

Cerebral ischemia includes cerebral ischemia, central nervous system hemorrhage, and ischemia cerebrovascular.

Very common (10% or more): Headache (37%), cerebral ischemia (11%)


Increased blood pressure (BP) has been reported. At baseline 22 (35%) patients had a systolic or diastolic or both above the 95th percentile. During clinical studies, 18 (29%) patients had hypertension based on systolic or diastolic BP being above the 95th percentile on 3 or more occasions. Five (8%) patients who were normotensive at baseline had either systolic blood pressure or diastolic blood pressure above the 95th percentile at the end of treatment.

Very common (10% or more): Hypertension (29%)


Very common (10% or more): Rash (11%)

Common (1% to 10%): Pruritus, mucositis


1. (2020) "Product Information. Zokinvy (lonafarnib)." Eiger BioPharmaceuticals

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.