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nintedanib (Oral route)


Commonly used brand name(s)

In the U.S.

  • Ofev

Available Dosage Forms:

  • Capsule

Pharmacologic Class: Tyrosine Kinase Inhibitor

Uses For nintedanib

Nintedanib is used to treat idiopathic pulmonary fibrosis.

nintedanib is available only with your doctor's prescription.

Before Using nintedanib

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nintedanib, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to nintedanib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies have not been performed on the relationship of age to the effects of nintedanib in the pediatric population. Safety and efficacy have not been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of nintedanib in the elderly.


Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking nintedanib, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using nintedanib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abiraterone
  • Acenocoumarol
  • Amiodarone
  • Apixaban
  • Ardeparin
  • Argatroban
  • Bivalirudin
  • Carbamazepine
  • Certoparin
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desirudin
  • Diltiazem
  • Dronedarone
  • Drotrecogin Alfa
  • Enoxaparin
  • Erythromycin
  • Etravirine
  • Fondaparinux
  • Fosphenytoin
  • Heparin
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lepirudin
  • Lomitapide
  • Lopinavir
  • Nadroparin
  • Nilotinib
  • Parnaparin
  • Phenindione
  • Phenprocoumon
  • Phenytoin
  • Primidone
  • Protein C
  • Ranolazine
  • Reviparin
  • Rifampin
  • Ritonavir
  • Rivaroxaban
  • Simeprevir
  • St John's Wort
  • Telaprevir
  • Ticagrelor
  • Tinzaparin
  • Verapamil
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using nintedanib with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use nintedanib, or give you special instructions about the use of food, alcohol, or tobacco.

  • Tobacco

Other Medical Problems

The presence of other medical problems may affect the use of nintedanib. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems, history of or
  • Blood clots, history of or
  • Heart attack, recent or
  • Stroke, history of—Use with caution. May make these conditions worse.
  • Coronary artery disease or
  • Heart disease or
  • Stomach or abdominal surgery, recent—May increase risk for more serious side effects.
  • Liver disease, moderate or severe—Use is not recommended in patients with these conditions.

Proper Use of nintedanib

Take nintedanib exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

nintedanib should come with patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Swallow the capsule whole with liquids. Do not crush, break, or chew it. Take nintedanib with food.


The dose of nintedanib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of nintedanib. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For idiopathic pulmonary fibrosis:
      • Adults—150 milligrams (mg) two times a day, taken 12 hours apart.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of nintedanib, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using nintedanib

It is very important that your doctor check your progress at regular visits to make sure that nintedanib is working properly. Blood tests may be needed to check for unwanted effects.

Using nintedanib while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and at least 3 months after the last dose. If you think you have become pregnant while using nintedanib, tell your doctor right away.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

nintedanib may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

nintedanib may increase risk of bleeding, heart attack, or stroke. Check with your doctor right away if you have chest pain or discomfort, dizziness, headache, shortness of breath, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, sweating, or unusual bleeding or bruising.

nintedanib may cause a tear (perforation) in your stomach or bowels. Check with your doctor right away if you have a severe stomach pain that does not go away.

Stop smoking before treatment with Ofev® and avoid smoking while you are using nintedanib.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

nintedanib Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Diarrhea
  • nausea
  • severe abdominal or stomach pain
  • vomiting
Less common
  • Abdominal or stomach pain or swelling
  • black, tarry stools
  • blood in the eyes
  • blood in the urine
  • blurred vision
  • bruising or purple areas on the skin
  • chest pain or discomfort
  • coughing up blood
  • decreased alertness
  • dizziness
  • headache
  • irregular heartbeat
  • joint pain or swelling
  • nervousness
  • nosebleeds
  • pain or discomfort in the arms, jaw, back, or neck
  • pains in the chest, groin, or legs, especially calves of the legs
  • pounding in the ears
  • severe headaches of sudden onset
  • shortness of breath
  • slow or fast heartbeat
  • sudden loss of coordination
  • sudden onset of shortness of breath for no apparent reason
  • sudden onset of slurred speech
  • sudden vision changes
  • sweating

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decreased appetite
  • weight loss
Less common
  • Constipation
  • depressed mood
  • dry skin and hair
  • feeling cold
  • hair loss
  • hoarseness or husky voice
  • muscle cramps and stiffness
  • slowed heartbeat
  • unusual tiredness or weakness
  • weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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