Common use

Nintedanib is a tyrosine kinase inhibitor used to treat idiopathic pulmonary fibrosis (IPF), chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, and systemic sclerosis-associated ILD. It works by blocking specific enzymes involved in the scarring (fibrosis) process in the lungs. This helps slow the progression of lung damage and preserves respiratory function over time. Nintedanib does not cure these diseases but can help manage symptoms and disease progression.

Dosage and direction

The standard dose of nintedanib for adults is 150 mg taken twice daily, approximately 12 hours apart, with food to reduce stomach upset. Dosage may be reduced to 100 mg twice daily in case of intolerable side effects. Capsules should be swallowed whole and not chewed or crushed. Patients should follow the prescribed schedule exactly and consult their doctor before making any changes.

Precautions

Nintedanib may increase the risk of bleeding, liver enzyme elevation, and gastrointestinal problems such as diarrhea. Regular liver function tests are recommended during treatment. Use caution in patients with cardiovascular disease, hepatic impairment, or those on anticoagulants. Pregnant women should avoid the drug due to potential harm to the fetus.

Contraindications

Nintedanib is contraindicated in patients with a known hypersensitivity to nintedanib or any of its components. It should not be used during pregnancy due to the risk of fetal harm. Use is also cautioned in patients with severe liver impairment (Child-Pugh C). It is not recommended for children or adolescents under 18 years of age.

Possible side effect

The most common side effect is diarrhea, which can usually be managed with supportive care or dose adjustments. Other frequent effects include nausea, vomiting, elevated liver enzymes, abdominal pain, and decreased appetite. Rare but serious side effects include arterial thromboembolic events, GI perforation, or bleeding complications. Report any signs of serious side effects, such as black stools, severe stomach pain, or jaundice, immediately.

Drug interaction

Nintedanib may interact with drugs that affect P-glycoprotein (P-gp) and CYP3A4 enzymes, such as ketoconazole, rifampin, or St. John’s Wort. Co-administration with anticoagulants like warfarin or heparin may increase bleeding risk. Grapefruit and grapefruit juice should be avoided. Always inform your healthcare provider of all medications and supplements you are using.

Missed dose

If a dose is missed, it should be skipped, and the next dose taken at the regular time. Do not take two doses at once to make up for the missed one. Missing doses can reduce the drug’s effectiveness, so maintaining a consistent schedule is important. If multiple doses are missed, consult your doctor for guidance.

Overdose

Overdose symptoms may include intensified gastrointestinal issues, liver dysfunction, or increased bleeding risk. There is no specific antidote, so treatment is mainly supportive and symptomatic. Seek emergency medical attention in the event of a suspected overdose. Always store and use the medication responsibly to avoid accidental misuse.

Storage

Store nintedanib capsules at room temperature (20°C to 25°C / 68°F to 77°F) in a dry place, away from heat and moisture. Keep the capsules in their original container until use. Do not use expired medication. Keep out of reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.