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Nintedanib Treatment: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Nintedanib is a prescription medication used to treat several lung conditions, including idiopathic pulmonary fibrosis (IPF) and certain types of interstitial lung disease (ILD). It is also used in combination with other treatments for some cancers. Nintedanib works by slowing the growth of scar tissue and cancer cells. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions you may have.
Names of Medication
US Brand Name: Ofev (Nintedanib)
The name in parentheses is the generic name. The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer.
Pharmacologic Category
Tyrosine Kinase Inhibitor
Antifibrotic Agent
Vascular Endothelial Growth Factor (VEGF) Inhibitor
Nintedanib Dosage
Nintedanib is prescribed for various conditions, and the dosage may vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can schedule a telemedicine appointment with one of our providers for personalized advice.
Nintedanib for Idiopathic Pulmonary Fibrosis (IPF)
Dosage: 150 mg taken orally twice daily.
Frequency: Every 12 hours, with food.
Length of Treatment: Long-term, as directed by your doctor.
Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)
Dosage: 150 mg taken orally twice daily.
Frequency: Every 12 hours, with food.
Length of Treatment: Long-term, as directed by your doctor.
Nintedanib for Chronic Fibrosing Interstitial Lung Diseases (ILDs) with a Progressive Phenotype
Dosage: 150 mg taken orally twice daily.
Frequency: Every 12 hours, with food.
Length of Treatment: Long-term, as directed by your doctor.
Nintedanib for Non-Small Cell Lung Cancer (NSCLC)
Dosage: 200 mg taken orally twice daily, in combination with docetaxel.
Frequency: Every 12 hours, with food.
Length of Treatment: As prescribed by your doctor, typically in cycles with other cancer treatments.
Nintedanib for Other Cancers (Ovarian, Pancreatic, Colorectal, Breast, Renal Cell Carcinoma, Hepatocellular Carcinoma)
Nintedanib is currently being studied for use in other cancers, but it is not yet FDA-approved for these conditions. Consult your healthcare provider for more information.
Dosage Forms and Strengths
Capsules: 100 mg, 150 mg
Administration Instructions for Nintedanib
Nintedanib should be taken with food to help reduce the risk of stomach upset. Swallow the capsule whole with a glass of water; do not crush or chew it. If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not take two doses at once. Always consult your healthcare provider for specific instructions.
Nintedanib Side Effects and Adverse Reactions
Like all medications, Nintedanib can cause side effects. Some are more common, while others are rare but serious. If you experience any side effects, contact your healthcare provider immediately. Our telemedicine providers are available to help manage any concerns you may have.
Common Nintedanib Side Effects (Occurring in more than 10% of patients)
Diarrhea: Loose stools are common. Staying hydrated is important.
Nausea: You may feel nauseous, especially when starting treatment.
Vomiting: Some patients may experience vomiting, which can be managed with anti-nausea medications.
Abdominal Pain: Stomach pain or discomfort may occur.
Decreased Appetite: You may notice a reduction in your appetite.
Less Common Nintedanib Side Effects (Occurring in 1-10% of patients)
Liver Enzyme Elevations: Your doctor may monitor your liver function through blood tests.
Weight Loss: Some patients may experience weight loss during treatment.
High Blood Pressure: Nintedanib may cause an increase in blood pressure.
Rare but Serious Nintedanib Side Effects (Occurring in less than 1% of patients)
Bleeding: Nintedanib may increase the risk of bleeding, especially in patients taking blood thinners.
Blood Clots: There is a risk of developing blood clots, which can be life-threatening.
Liver Damage: Severe liver injury is rare but possible. Your doctor will monitor your liver function closely.
Contraindications for Nintedanib Treatment
A contraindication is a condition or factor that makes the use of a particular medication unsafe or inappropriate. If you have any of the following conditions, it may not be safe for you to take Nintedanib. Always consult with your healthcare provider before starting or stopping any medication.
Allergy to Nintedanib or its ingredients: If you are allergic to Nintedanib or any of its inactive ingredients, taking it could cause a serious allergic reaction, which may include symptoms like rash, swelling, or difficulty breathing.
Severe liver disease: Nintedanib is processed by the liver. If your liver is not functioning properly, the medication may not be broken down correctly, leading to higher levels in your body and an increased risk of side effects.
Bleeding disorders: Nintedanib can increase the risk of bleeding. If you have a history of bleeding disorders or are taking blood thinners, this medication may not be safe for you.
Recent surgery: Nintedanib may impair wound healing, so it is generally not recommended for use immediately before or after surgery.
Drug to Drug Interactions
Certain medications can interact with Nintedanib, potentially increasing side effects or reducing its effectiveness. If you are taking any of the following, it’s important to inform your healthcare provider:
Ketoconazole (Nizoral): This antifungal medication can raise Nintedanib levels in your body, which may heighten the risk of side effects.
Rifampin (Rifadin): This antibiotic may decrease Nintedanib’s effectiveness by speeding up its breakdown in the body.
Blood thinners (e.g., Warfarin, Coumadin): Nintedanib can increase the risk of bleeding, which may be further elevated when combined with blood thinners.
St. John’s Wort: This herbal supplement can reduce Nintedanib’s effectiveness by accelerating its breakdown in the liver.
Nintedanib in Pregnancy
Is it Safe to Take Nintedanib When Pregnant?
No, Nintedanib is not considered safe during pregnancy. It can harm an unborn baby and may lead to birth defects. Women who are pregnant or planning to become pregnant should avoid taking Nintedanib. Those of childbearing age should use effective contraception while on this medication and for at least three months after stopping it. If you become pregnant while taking Nintedanib, contact your healthcare provider immediately.
Nintedanib While Breastfeeding
Is it Safe to Take Nintedanib While Breastfeeding?
It is not clear whether Nintedanib passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is generally recommended not to breastfeed while taking Nintedanib. If you are breastfeeding or planning to breastfeed, discuss the risks and benefits with your healthcare provider.
Estimated Cost of Nintedanib Medication
The cost of a 30-day supply of Nintedanib without insurance can range from $9,000 to $10,000 when using a GoodRx coupon. Prices may vary depending on the pharmacy and location. Check with your pharmacy for the most accurate pricing, and consider using discount programs or manufacturer assistance if needed.
Possible Alternatives to Nintedanib
If Nintedanib treatment is not suitable for you, other treatment options or lifestyle changes may help manage your condition. Always consult your healthcare provider before making any changes. Below are some alternatives for conditions treated with Nintedanib:
- Idiopathic Pulmonary Fibrosis (IPF): Medications like Pirfenidone (Esbriet) may help slow the progression of IPF. Lifestyle changes, such as quitting smoking and participating in pulmonary rehabilitation, can also improve quality of life.
- Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Immunosuppressive therapies like Mycophenolate Mofetil (CellCept) may be considered. Regular exercise and physical therapy can help maintain lung function.
- Chronic Fibrosing Interstitial Lung Disease: Corticosteroids or other immunosuppressive drugs may help manage symptoms. Pulmonary rehabilitation and oxygen therapy can also be beneficial.
- Non-Small Cell Lung Cancer (NSCLC): Depending on the stage of the cancer, treatments may include surgery, radiation, chemotherapy, or targeted therapies like Erlotinib (Tarceva). Quitting smoking can also improve treatment outcomes.
- Ovarian Cancer: Standard treatments include surgery and chemotherapy, such as Paclitaxel (Taxol) and Carboplatin. Targeted therapies like Bevacizumab (Avastin) may also be an option.
- Pancreatic Cancer: Treatment options include surgery, chemotherapy (e.g., Gemcitabine), and radiation therapy. Clinical trials may offer access to new therapies.
- Colorectal Cancer: Common treatments include surgery, chemotherapy (e.g., FOLFOX regimen), and targeted therapies like Cetuximab (Erbitux). A high-fiber diet and regular exercise may also help manage symptoms.
- Breast Cancer: Treatment options include surgery, radiation, chemotherapy (e.g., Doxorubicin), and hormone therapies like Tamoxifen. Maintaining a healthy weight and engaging in regular exercise can also improve outcomes.
- Renal Cell Carcinoma: Treatments may include surgery, targeted therapies like Sunitinib (Sutent), or immunotherapy. Staying physically active and maintaining a healthy diet can support overall health.
- Hepatocellular Carcinoma (Liver Cancer): Treatment options include surgery, liver transplantation, or targeted therapies like Sorafenib (Nexavar). Avoiding alcohol and maintaining a healthy weight can help reduce the risk of liver damage.
Recent Updates on Nintedanib Research
Recent studies continue to explore the benefits of Nintedanib in treating fibrotic lung diseases and certain cancers. A 2022 study found that Nintedanib may slow the progression of chronic fibrosing interstitial lung diseases beyond idiopathic pulmonary fibrosis, offering hope for patients with other forms of lung fibrosis. Additionally, ongoing clinical trials are investigating Nintedanib’s potential in combination with other therapies for treating non-small cell lung cancer and other cancers.
As research progresses, staying informed about new developments is crucial. If you have questions about whether Nintedanib is right for you, consider scheduling a telemedicine appointment with one of our healthcare providers to discuss your treatment options.
