Reported Reactions

Drugs › Nucleoside metabolic inhibitor

Generic name

Fludarabine phosphate: adverse event reports filed with FDA

8,426 reports list it as a suspect or interacting product, 2004–2026. Class: Nucleoside metabolic inhibitor. Also reported as Fludarabine Phosphate For Injection.

8,426
reports as suspect product
0% of all reports · about 375 a year
419
reports, 12 months to June 2026
477 in the 12 months before
98.5%
marked serious by the reporter
92.2% across the class
31.6%
record death among outcomes, as reported
2,659 reports · not verified by FDA

Between January 2004 and June 2026, 8,426 adverse event reports received by FDA list fludarabine phosphate, a generic name as a suspect or interacting product. Reports that mention it only as a concomitant medication (2,236) are left out of every figure here.

In the 12 months to June 2026, 419 reports listed it, down 12% from 477 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 375 reports a year and 0% of the 20,646,523 reports in the database, and 2.7% of the reports for the nucleoside metabolic inhibitor class. How many people take it is not in the data, so a count is not a rate of occurrence.

Reporters most often recorded off label use (15.5%), pyrexia (8.6%) and febrile neutropenia (8.1%). A report can list several reactions, so shares add to more than 100%; 1,328 different terms appear across these reports. Off label use is recorded in 15.5% of these reports, a larger share than in the median nucleoside metabolic inhibitor drug (6.1%).

98.5% of the reports are marked serious by the reporter (92.2% across the class); 31.6% record death among the outcomes and 31% record hospitalisation, as reported. 51% of the reports came from other health professionals, and the largest patient age group is 45 to 64 (25.1%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

051102Jul 2021: 37Aug 2021: 62Sep 2021: 44Oct 2021: 30Nov 2021: 39Dec 2021: 632022Jan 2022: 39Feb 2022: 22Mar 2022: 42Apr 2022: 39May 2022: 19Jun 2022: 47Jul 2022: 63Aug 2022: 29Sep 2022: 37Oct 2022: 25Nov 2022: 22Dec 2022: 302023Jan 2023: 32Feb 2023: 43Mar 2023: 27Apr 2023: 48May 2023: 24Jun 2023: 41Jul 2023: 57Aug 2023: 43Sep 2023: 28Oct 2023: 47Nov 2023: 102Dec 2023: 302024Jan 2024: 30Feb 2024: 38Mar 2024: 48Apr 2024: 52May 2024: 47Jun 2024: 64Jul 2024: 54Aug 2024: 49Sep 2024: 39Oct 2024: 41Nov 2024: 41Dec 2024: 472025Jan 2025: 31Feb 2025: 18Mar 2025: 23Apr 2025: 40May 2025: 24Jun 2025: 70Jul 2025: 92Aug 2025: 39Sep 2025: 35Oct 2025: 30Nov 2025: 25Dec 2025: 142026Jan 2026: 18Feb 2026: 56Mar 2026: 19Apr 2026: 26May 2026: 20Jun 2026: 45

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

04529032004: 12020042005: 2182006: 1752007: 24720072008: 3532009: 3952010: 24120102011: 4992012: 3212013: 12220132014: 2332015: 2592016: 25020162017: 3782018: 5172019: 57420192020: 9032021: 5102022: 41420222023: 5222024: 5502025: 44120252026: 184

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Fludarabine phosphate reports recording the termmedian drug in nucleoside metabolic inhibitor

  1. Off label useused for a purpose or in a way not on the label15.5%1,305
  2. Pyrexiafever8.6%721
  3. Febrile neutropeniafever with low white blood cells8.1%682
  4. Product use in unapproved indicationused for a purpose not on the label6%506
  5. Neutropenialow neutrophils, a type of white blood cell5.9%501
  6. Drug ineffectivethe medicine did not work as expected4.2%357
  7. Thrombocytopenialow platelets4.1%347
  8. Pancytopenialow counts of all blood cells4.1%345
  9. Sepsisa severe body-wide response to infection4%341
  10. Infectionan infection, type not specified3.4%286
  11. Pneumonialung infection3.4%283
  12. Cytomegalovirus infection reactivation3.2%272
  13. Respiratory failurethe lungs could not supply enough oxygen2.9%248
  14. Anaemialow red blood cells2.9%244
  15. Diarrhoealoose or frequent stools2.7%227
  16. Nauseafeeling sick2.5%210
  17. Septic shockshock arising from infection2.4%200
  18. Adenovirus infection2.3%198
  19. Deaththe patient died; cause not stated by this term2.3%195
  20. Platelet count decreasedlow platelet count2.3%193
  21. Venoocclusive liver disease2.3%193
  22. Acute graft versus host disease2.1%180
  23. Multiple organ dysfunction syndromeseveral organs failing2.1%180

Top 30 of 1,328 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 19 drugs in the nucleoside metabolic inhibitor class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death31.6%2,659
Life-threatening8.2%688
Hospitalisation (initial or prolonged)31%2,616
Disability1.8%153
Congenital anomaly0%2
Other serious65.6%5,527
Not serious1.5%127

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 313,386 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 23.3%276
2 to 118.5%713
12 to 174.7%398
18 to 4411.7%990
45 to 6425.1%2,118
65 to 7413.5%1,136
75 and over2.9%247
Age not given30.2%2,548

Patient sex

Female29.8%2,511
Male45.3%3,816
Not given24.9%2,099

Who reported

Physician32.3%2,719
Pharmacist2.1%180
Other health professional51%4,295
Lawyer0%2
Consumer or non-health professional7%590
Not given7.6%640

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 20.9% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Bone marrow conditioning regimen1,65219.6%
Chronic lymphocytic leukaemia1,39516.6%
Acute myeloid leukaemia6037.2%
Stem cell transplant3464.1%
Allogenic stem cell transplantation1802.1%
B-cell lymphoma1451.7%

The indication field is filled in by the reporter and is often blank; shares are of all 8,426 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Fludarabine phosphate reports
Cyclophosphamide4,29851%
Rituximab2,00723.8%
Busulfan1,40816.7%
Cyclosporine1,35816.1%
Cytarabine1,26715%
Methotrexate1,22914.6%
Mycophenolate mofetil1,14313.6%
Melphalan1,02012.1%
Tacrolimus94111.2%
Alemtuzumab88210.5%

Other products listed in reports where Fludarabine phosphate is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureFludarabine phosphateNucleoside metabolic inhibitorAll reports
Reports as suspect product8,426313,38620,646,523
Share of that pool—2.7%0%
Reports, latest 12 months419—1,332,454
Marked serious98.5%92.2%57.4%
Death recorded among outcomes, per 1,000 reports31621091
Hospitalisation recorded, per 1,000 reports310380213
Consumer-filed share7%11.4%45.8%
Top term, share of reportsOff label use 15.5%median 6.1%4.1%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the nucleoside metabolic inhibitor class

DrugName typeReportsLatest 12 monthsMarked serious
Fluorouracilgeneric60,4515,31596.1%
Capecitabinegeneric51,7833,28183.3%
Cytarabinegeneric50,7413,54597.9%
Gemcitabinegeneric33,1982,92097.9%
Xelodabrand32,27928073%
Fludarabinebrand20,2601,90098.7%
Azacitidinegeneric14,9691,83098%
Gemcitabine hydrochloridegeneric12,3991,16497.1%
Mercaptopurinegeneric10,54050795.8%
Vidazabrand9,08735896.9%
Decitabinegeneric3,02625896.8%
Clofarabinegeneric2,0207796.5%
Purixangeneric7672981.5%
Onuregbrand7556949.8%
Pentostatingeneric6971691.7%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Fludarabine phosphate reports

How many adverse event reports has FDA received for Fludarabine phosphate?

8,426 reports list Fludarabine phosphate as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 419 of them arrived in the latest 12 months. Another 2,236 list it only as a concomitant medication.

What reactions are recorded in Fludarabine phosphate reports?

off label use (15.5%), pyrexia (8.6%), febrile neutropenia (8.1%), product use in unapproved indication (6%) and neutropenia (5.9%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Fludarabine phosphate was responsible.

How serious are the reports?

98.5% are marked serious by the reporter. Among the outcomes recorded, 31.6% of reports include death and 31% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (51%), physician (32.3%) and not given (7.6%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Fludarabine phosphate rising?

419 reports in the 12 months to June 2026, down 12% from 477 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Fludarabine phosphate was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Fludarabine phosphate?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Fludarabine phosphate as a suspect or interacting product; reports listing it only as a concomitant medication (2,236) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.