Indications
Nintedanib is used to treat idiopathic pulmonary fibrosis (IPF), a long-term scarring disease of the lungs. It is also used for other progressive fibrosing lung diseases and for lung disease linked to systemic sclerosis. In some countries it is used together with chemotherapy for a type of lung cancer.
How It Works
Nintedanib is a tyrosine kinase inhibitor. It blocks several growth signals (receptors for growth factors called PDGF, FGF and VEGF) that drive the cells responsible for scar tissue. This slows the decline in lung function, although it does not reverse scarring already present.
Dosage and Administration
Take exactly as prescribed by your specialist. Capsules are usually taken twice a day, about 12 hours apart, with food. Swallow them whole with water; do not chew, open or crush them. Your doctor may lower the dose or pause treatment if side effects occur. If you miss a dose, skip it and take the next one at the usual time.
Interactions
- Ketoconazole, Erythromycin and similar medicines can increase its level and side effects.
- Rifampicin, Carbamazepine, Phenytoin and St John’s Wort can reduce its effect.
- Blood thinners such as Warfarin increase the risk of bleeding.
- Tell your doctor about all medicines and herbal products you take.
Contraindications
- Allergy to Nintedanib, peanut or soya (the capsules contain soya lecithin).
- Pregnancy.
- Moderate to severe liver impairment (generally not recommended).
Side Effects
Diarrhoea is very common and is usually managed with fluids and anti-diarrhoea medicine. Other effects include nausea, vomiting, stomach pain, loss of appetite, weight loss and raised liver enzymes. Bleeding (such as nosebleeds) and high blood pressure can occur.
Get urgent medical help if you have severe or ongoing diarrhoea with dehydration, yellow skin or eyes or dark urine, serious bleeding, chest pain or signs of a heart attack, severe stomach pain (possible bowel tear), or a severe allergic reaction.
Pregnancy and Lactation
Nintedanib can harm an unborn baby and must not be used in pregnancy. Women who could become pregnant should have a pregnancy test before starting and use effective contraception during treatment and for at least 3 months after the last dose. Do not breastfeed during treatment.
Precautions and Warnings
- Liver blood tests are checked before starting, regularly in the first months, and then as needed.
- Tell your doctor about bleeding problems, heart disease, recent surgery or stomach or bowel problems.
- Wound healing may be slower; tell your surgeon you take it.
- Drink enough fluids if you have diarrhoea.
Overdose
Overdose may cause more severe side effects, especially liver problems and diarrhoea. Contact a doctor or hospital immediately; treatment is supportive.
Therapeutic Class
Antifibrotic agent, tyrosine kinase inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep capsules in the original blister.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.