Generic name
Thioguanine: adverse event reports filed with FDA
1,835 reports list it as a suspect or interacting product, 2004–2026. Class: Antimetabolite.
- 1,835
- reports as suspect product
- 0% of all reports · about 82 a year
- 67
- reports, 12 months to June 2026
- 91 in the 12 months before
- 97.9%
- marked serious by the reporter
- 89.5% across the class
- 18.3%
- record death among outcomes, as reported
- 335 reports · not verified by FDA
1,835 adverse event reports received by FDA list thioguanine, a generic name as a suspect or interacting product, from January 2004 to June 2026. A further 313 reports list it only as a concomitant medication, and those are not counted in the figures on this page.
In the 12 months to June 2026, 67 reports listed it, down 26% from 91 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 82 reports a year and 0% of the 20,646,523 reports in the database, and 20.9% of the reports for the antimetabolite class. How many people take it is not in the data, so a count is not a rate of occurrence.
The MedDRA terms listed most often are febrile neutropenia (27.8%), haematotoxicity (7.8%) and neutropenia (7.4%). A report can list several reactions, so shares add to more than 100%; 508 different terms appear across these reports. Febrile neutropenia is recorded in 27.8% of these reports, a larger share than in the median antimetabolite drug (4.1%).
97.9% of the reports are marked serious by the reporter (89.5% across the class); 18.3% record death among the outcomes and 51% record hospitalisation, as reported. 41.6% of the reports came from physicians, and the largest patient age group is 2 to 11 (27.2%). 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
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
2026 covers reports received through June 2026 only.
Reactions recorded in the reports
share of Thioguanine reports recording the termmedian drug in antimetabolite
- Febrile neutropeniafever with low white blood cells27.8%510
- Haematotoxicity7.8%143
- Neutropenialow neutrophils, a type of white blood cell7.4%135
- Pyrexiafever6.9%127
- Sepsisa severe body-wide response to infection5%92
- Thrombocytopenialow platelets4.9%90
- Off label useused for a purpose or in a way not on the label4.7%86
- Pancytopenialow counts of all blood cells4.4%81
- Vomitingbeing sick4.1%76
- Febrile bone marrow aplasia3.7%67
- Venoocclusive liver disease3.1%56
- Mucosal inflammation2.9%53
- Platelet count decreasedlow platelet count2.8%52
- Pneumonialung infection2.7%50
- Deaththe patient died; cause not stated by this term2.3%43
- Hepatotoxicityliver injury2.3%43
- Toxicity to various agentspoisoning or toxic effect of one or more substances2.3%43
- Abdominal painstomach or belly pain2.3%42
- Venoocclusive disease2.2%41
- Anaemialow red blood cells2.1%39
- Headachehead pain2%37
- Hypotensionlow blood pressure2%37
- Drug ineffectivethe medicine did not work as expected2%36
- Product use in unapproved indicationused for a purpose not on the label2%36
- Ascitesfluid in the abdomen1.9%35
- Osteonecrosis1.9%35
- Diarrhoealoose or frequent stools1.8%33
- Nauseafeeling sick1.8%33
- Colitisinflamed bowel1.7%32
- Seizurea fit or convulsion1.7%31
Top 30 of 508 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 3 drugs in the antimetabolite 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
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 8,764 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
Patient sex
Who reported
Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 37.8% of reports give the United States as the country of the event or reporter.
Reason for use recorded
| Indication as recorded (MedDRA) | Reports | Share |
|---|---|---|
| Acute lymphocytic leukaemia | 662 | 36.1% |
| Acute myeloid leukaemia | 134 | 7.3% |
| Precursor t-lymphoblastic lymphoma/leukaemia | 112 | 6.1% |
| B precursor type acute leukaemia | 79 | 4.3% |
| Chemotherapy | 39 | 2.1% |
| B-cell type acute leukaemia | 37 | 2% |
The indication field is filled in by the reporter and is often blank; shares are of all 1,835 reports.
Drugs most often listed in the same reports
| Drug (any role in the report) | Reports | Share of Thioguanine reports |
|---|---|---|
| Cytarabine | 1,515 | 82.6% |
| Cyclophosphamide | 1,328 | 72.4% |
| Methotrexate | 1,234 | 67.2% |
| Dexamethasone | 835 | 45.5% |
| Vincristine | 780 | 42.5% |
| Mercaptopurine | 679 | 37% |
| Vincristine sulfate | 618 | 33.7% |
| Doxorubicin | 548 | 29.9% |
| Daunorubicin | 522 | 28.4% |
| Prednisone | 439 | 23.9% |
Other products listed in reports where Thioguanine 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
| Measure | Thioguanine | Antimetabolite | All reports |
|---|---|---|---|
| Reports as suspect product | 1,835 | 8,764 | 20,646,523 |
| Share of that pool | — | 20.9% | 0% |
| Reports, latest 12 months | 67 | — | 1,332,454 |
| Marked serious | 97.9% | 89.5% | 57.4% |
| Death recorded among outcomes, per 1,000 reports | 183 | 139 | 91 |
| Hospitalisation recorded, per 1,000 reports | 510 | 394 | 213 |
| Consumer-filed share | 5.7% | 20.3% | 45.8% |
| Top term, share of reports | Febrile neutropenia 27.8% | median 4.1% | 0.3% |
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 antimetabolite class
| Drug | Name type | Reports | Latest 12 months | Marked serious |
|---|---|---|---|---|
| Hydroxyurea | generic | 4,260 | 326 | 86.8% |
| Hydrea | brand | 2,669 | 38 | 88% |
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 Thioguanine reports
How many adverse event reports has FDA received for Thioguanine?
1,835 reports list Thioguanine as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 67 of them arrived in the latest 12 months. Another 313 list it only as a concomitant medication.
What reactions are recorded in Thioguanine reports?
febrile neutropenia (27.8%), haematotoxicity (7.8%), neutropenia (7.4%), pyrexia (6.9%) and sepsis (5%). 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 Thioguanine was responsible.
How serious are the reports?
97.9% are marked serious by the reporter. Among the outcomes recorded, 18.3% of reports include death and 51% 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?
physician (41.6%), other health professional (37%) and not given (10.6%). Most reports reach FDA through the manufacturer, which must forward reports it receives.
Are reports for Thioguanine rising?
67 reports in the 12 months to June 2026, down 26% from 91 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 Thioguanine 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 Thioguanine?
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 Thioguanine as a suspect or interacting product; reports listing it only as a concomitant medication (313) 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.