What is Nintedanib: Uses, Dosage, Side Effects and More

Nintedanib is a prescription medication that helps slow down lung scarring in people with certain serious lung diseases. It's specifically designed to target the proteins that cause excessive scar tissue formation in your lungs, giving your body a chance to breathe more easily over time.

This medication represents an important breakthrough in treating conditions that were once considered untreatable. While it can't cure lung scarring, it can significantly slow its progression and help maintain your quality of life.

What is Nintedanib?

Nintedanib is a targeted therapy medication that belongs to a class of drugs called tyrosine kinase inhibitors. Think of it as a precise tool that blocks specific proteins responsible for creating excessive scar tissue in your lungs.

The medication comes in soft capsule form and is taken by mouth twice daily. It was developed specifically for people whose lungs are being damaged by abnormal scarring processes that make breathing increasingly difficult.

Unlike older treatments that only managed symptoms, nintedanib actually targets the underlying disease process. This makes it a disease-modifying treatment rather than just a symptom reliever.

What is Nintedanib Used For?

Nintedanib is primarily used to treat idiopathic pulmonary fibrosis (IPF), a serious lung condition where healthy lung tissue becomes replaced with scar tissue. It's also approved for certain other types of progressive lung scarring diseases.

IPF affects about 100,000 people in the United States and typically develops in people over 50. The word "idiopathic" means doctors don't know exactly what causes it, but the scarring makes your lungs stiff and breathing difficult.

Your doctor might also prescribe nintedanib for systemic sclerosis-associated interstitial lung disease (SSc-ILD). This occurs when an autoimmune condition called scleroderma affects your lungs, causing similar scarring problems.

In some cases, doctors may use nintedanib for other types of progressive pulmonary fibrosis when the scarring continues to worsen despite other treatments. However, this use requires careful evaluation by a lung specialist.

How Does Nintedanib Work?

Nintedanib works by blocking three specific growth factor receptors that drive the scarring process in your lungs. These receptors normally help with healing, but in pulmonary fibrosis, they become overactive and create too much scar tissue.

The medication is considered a moderately strong treatment that requires careful monitoring. It's not a mild medication, but it's generally well-tolerated when used under proper medical supervision.

By blocking these overactive signals, nintedanib helps slow down the rate at which healthy lung tissue gets replaced by scar tissue. This can help preserve your lung function and breathing capacity for longer periods.

The medication also has some anti-inflammatory effects, which may help reduce the ongoing damage to your lung tissue. However, its primary strength lies in stopping the scarring process rather than reversing existing damage.

How Should I Take Nintedanib?

Nintedanib should be taken exactly as prescribed by your doctor, typically 150 mg twice daily, approximately 12 hours apart. Taking it with food is essential because this significantly reduces stomach upset and helps your body absorb the medication properly.

Swallow the capsules whole with a full glass of water. Don't open, crush, or chew the capsules, as this can cause irritation to your mouth and throat and may affect how the medication works.

Taking nintedanib with a meal or substantial snack is crucial for your comfort. The food doesn't need to be large, but having something in your stomach helps prevent nausea and digestive upset that commonly occur with this medication.

Try to take your doses at the same times each day to maintain steady levels in your system. Many people find it helpful to take one dose with breakfast and another with dinner.

If you experience severe stomach upset, your doctor might temporarily reduce your dose or recommend specific foods that work well with the medication. Never adjust your dose without medical guidance.

How Long Should I Take Nintedanib For?

Nintedanib is typically a long-term treatment that you'll likely need to continue indefinitely, as long as it's helping slow your lung scarring and you're tolerating it well. Most people take it for years rather than months.

Your doctor will monitor your progress through regular lung function tests, chest scans, and blood work. These help determine whether the medication is working effectively and whether it's safe for you to continue.

The goal is to slow down the progression of lung scarring for as long as possible. Stopping the medication usually allows the scarring process to resume at its previous pace, which is why continuous treatment is generally recommended.

Some people may need to take breaks from the medication if they develop side effects that need time to resolve. Your doctor will work with you to find the right balance between effectiveness and tolerability.

What Are the Side Effects of Nintedanib?

Like all medications, nintedanib can cause side effects, though not everyone experiences them. The most common side effects are manageable and often improve as your body adjusts to the medication.

Let's start with the side effects you're most likely to encounter, which affect many people taking this medication:

• Diarrhea (affects about 60% of people) - usually mild to moderate and manageable with dietary adjustments
• Nausea and stomach upset - taking the medication with food helps significantly
• Decreased appetite and weight loss - your doctor will monitor this closely
• Abdominal pain or cramping - often improves with time and proper food intake
• Vomiting - less common than nausea but can occur, especially in the first few weeks

These digestive side effects are the most frequent complaints, but they often become more manageable as your body adapts to the medication.

Some people experience less common but still notable side effects that require monitoring:

• Elevated liver enzymes - detected through blood tests, usually without symptoms
• Fatigue or tiredness - can be related to the medication or your underlying lung condition
• Headaches - typically mild and responsive to over-the-counter pain relievers
• Dizziness - more common when starting the medication or increasing the dose
• Skin rash or itching - usually mild but should be reported to your doctor

Your doctor will check your liver function regularly since nintedanib can affect liver enzymes in some people.

Now, let's discuss the rare but more serious side effects that require immediate medical attention:

• Severe liver problems - symptoms include yellowing of skin or eyes, dark urine, or severe abdominal pain
• Heart problems - chest pain, irregular heartbeat, or unusual shortness of breath
• Blood clotting issues - unusual bleeding or bruising, especially if severe
• Severe lung problems - new or worsening cough, fever, or breathing difficulties
• Severe skin reactions - widespread rash, blistering, or peeling skin

These serious side effects are uncommon, but it's important to recognize them and seek medical care immediately if they occur.

Who Should Not Take Nintedanib?

Nintedanib isn't suitable for everyone, and your doctor will carefully evaluate whether it's safe for you based on your medical history and current health status.

You should not take nintedanib if you're allergic to it, soy, or peanuts, since the capsules contain soy lecithin. People with known hypersensitivity to any component of the medication should avoid it entirely.

Several medical conditions make nintedanib potentially dangerous or require special precautions:

• Severe liver disease or active liver problems - the medication can worsen liver function
• Recent heart attack or unstable heart disease - nintedanib can affect heart rhythm
• Active bleeding disorders - the medication can increase bleeding risk
• Severe kidney disease - your kidneys help process the medication
• Recent major surgery - increased bleeding risk during healing

Pregnancy and breastfeeding are absolute contraindications, as nintedanib can harm developing babies and may pass into breast milk.

Some people need extra monitoring but may still be able to take nintedanib with adjustments:

• Mild to moderate liver problems - requires dose adjustment and frequent monitoring
• History of heart problems - needs cardiac evaluation and ongoing monitoring
• Taking blood thinners - requires careful coordination with your doctor
• Older adults - may need lower doses due to increased sensitivity
• People with stomach ulcers - higher risk of digestive complications

Your doctor will weigh the benefits against the risks for your specific situation and may recommend alternative treatments if nintedanib isn't suitable for you.

Nintedanib Brand Names

Nintedanib is available under the brand name Ofev in most countries, including the United States. This is the most widely recognized brand name for the medication.

In some regions, you might encounter nintedanib under different brand names, but Ofev remains the primary brand used by most healthcare providers and pharmacies.

The medication is manufactured by Boehringer Ingelheim, a pharmaceutical company that specializes in respiratory medications. Generic versions of nintedanib are not yet widely available in most markets.

When discussing your medication with healthcare providers or pharmacists, you can refer to it by either its generic name (nintedanib) or brand name (Ofev). Both names refer to the same medication.

Nintedanib Alternatives

If nintedanib isn't suitable for you or doesn't work well, several alternative treatments are available for pulmonary fibrosis. Your doctor will help determine the best option based on your specific condition and medical history.

Pirfenidone (brand name Esbriet) is another FDA-approved medication for idiopathic pulmonary fibrosis. It works differently than nintedanib by reducing inflammation and slowing scar tissue formation through different pathways.

For some people, traditional treatments may still be appropriate:

• Corticosteroids - help reduce inflammation but have limited effectiveness for IPF
• Immunosuppressive drugs - may be used for certain types of pulmonary fibrosis
• Oxygen therapy - helps with breathing symptoms but doesn't slow disease progression
• Pulmonary rehabilitation - exercise and breathing programs to maintain function

In advanced cases, lung transplantation may be considered for eligible patients who don't respond to medications.

Some people benefit from combination approaches, such as using medication along with oxygen therapy and pulmonary rehabilitation. Your lung specialist will create a comprehensive treatment plan tailored to your needs.

Is Nintedanib Better Than Pirfenidone?

Both nintedanib and pirfenidone are effective treatments for idiopathic pulmonary fibrosis, but they work through different mechanisms and have different side effect profiles. Neither is definitively "better" than the other for all patients.

Research studies show that both medications can slow the decline in lung function by similar amounts. The choice between them often depends on which side effects you're more likely to tolerate and your individual medical circumstances.

Nintedanib tends to cause more digestive side effects like diarrhea and nausea, while pirfenidone more commonly causes skin sensitivity to sunlight and stomach upset. Some people tolerate one better than the other.

Your doctor will consider several factors when choosing between these medications, including your other health conditions, current medications, and lifestyle factors. The "better" choice is the one that works well for your specific situation.

In some cases, doctors might try one medication first and switch to the other if the initial choice isn't well-tolerated or doesn't seem to be working effectively.