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Drug side effects

azelaic acid Side Effects

The reactions most often reported to the FDA for azelaic acid (also sold as Finacea, Azelex), with demographics, serious outcomes, and reporting trends.

Data updated 2026-05-15

826
FAERS reports

Data from the FDA Adverse Event Reporting System (FAERS), 2004 to 2025. A FAERS report records a temporal association, not proof of cause. See our methodology for how figures are compiled and de-duplicated.

The most commonly reported side effects of azelaic acid come from 826 reports to the FDA, broken down here by frequency, patient demographics, and serious outcomes.

This page analyzes 826 reports to the FDA Adverse Event Reporting System (FAERS) for azelaic acid (Finacea): the reactions reported most often, who reported them, serious outcomes such as hospitalization, and year-over-year trends. A FAERS report does not prove the drug caused the effect, and report volume tracks how widely a drug is used, not how likely an effect is for any one person. Educational information, not medical advice.

Total Reports

826

Reports Mentioning Death

55

6.7% of reports — not proof the medicine caused the death

Hospitalizations

150

18.2% of reports

Top Indication

Product Used For Unknown Indication

Most Reported Adverse Reactions

PAIN
109
VOMITING
91
ABDOMINAL PAIN UPPER
84
GASTROOESOPHAGEAL REFLUX DISEASE
83
MIGRAINE
81
PARAESTHESIA
78
HYPOAESTHESIA
77
MEMORY IMPAIRMENT
77
RASH
75
BLEPHAROSPASM
73
EPILEPSY
73
TASTE DISORDER
72
CONDITION AGGRAVATED
49
NAUSEA
48
DIARRHOEA
45
FATIGUE
39

Who Reports Side Effects

Gender Distribution

Female 589 (84%)
Male 110 (16%)
Unknown 4

Age Distribution

0-17 23 (5%)
18-44 246 (48%)
45-64 134 (26%)
65-74 63 (12%)
75+ 43 (8%)

Reporting Trend by Year

2004 2025

Reactions in Death Reports

Top reactions reported in 55 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
GASTROOESOPHAGEAL REFLUX DISEASE 28
HYPOAESTHESIA 27
VOMITING 27
PARAESTHESIA 26
RHEUMATIC FEVER 26
ABDOMINAL PAIN UPPER 25
BLEPHAROSPASM 25
EPILEPSY 25
MEMORY IMPAIRMENT 25
RASH 25
STOMATITIS 25
PAIN 24
RHEUMATOID ARTHRITIS 24
SYNOVITIS 24
TASTE DISORDER 24
MIGRAINE 23

Reactions in Hospitalization Reports

Top reactions in 150 reports where hospitalization was an outcome.

Reaction Reports
VOMITING 34
PAIN 32
RASH 32
GASTROOESOPHAGEAL REFLUX DISEASE 31
ABDOMINAL PAIN UPPER 30
HYPOAESTHESIA 29
MIGRAINE 29
MEMORY IMPAIRMENT 28
PARAESTHESIA 28
RHEUMATIC FEVER 28
BLEPHAROSPASM 27
EPILEPSY 27
RHEUMATOID ARTHRITIS 27
STOMATITIS 27
DYSPNOEA 26
SWELLING 26
SYNOVITIS 26

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What the FAERS Data Reveals About azelaic acid Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 826 voluntary reports linked to azelaic acid and its brand equivalents (Finacea, Azelex), spanning 2004 through 2025. Of those, 55 (6.7%) listed death as an outcome and 150 (18.2%) involved hospitalization. The most common indication reported alongside adverse events was Product Used For Unknown Indication.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 84% were female and 16% male; age distribution skews toward 18-44, with 246 reports in that bracket. The single most reported reaction is pain with 109 submissions, followed by vomiting and abdominal pain upper.

How to read these numbers

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice, speak with a licensed clinician about any side-effect concerns.

Drugs With a Similar FAERS Report Volume

Other medications with a total FDA adverse-event report count closest to azelaic acid's 826.