Nintedanib while it cannot cure lung fibrosis or scarring associated with interstitial lung disease, it can slow down the progression or decline in lung function.
Stopping nintedanib
Discuss with your doctor if you would like to stop taking nintedanib.
If you stop or delay your treatment, your disease may get worse. Keep taking your treatment, unless advised by your rheumatologist to stop or unless serious side effects occur (see Side Effects).
How will your condition be monitored?
You may have a combination of blood tests, chest X-ray’s and CT scans to monitor your condition.
A stabilisation or slowing of decline on lung function testing indicates your medication is working.
How is nintedanib given?
Nintedanib is taken by mouth in capsule form. It comes in 100mg or 150mg capsules.
The capsules should be swallowed whole and not be crushed.
When should nintedanib be taken?
Nintedanib is taken twice daily with a full glass of water at the same time each day. It should be taken with or immediately after food.
If a dose is missed, the next dose should be taken at the next scheduled time; do not make up for a missed dose or exceed the maximum dosage of 300 mg/day.
What is the dosage?
The usual starting dose for adults is 150 mg twice daily (approximately 12 hours apart).
In patients who do not tolerate this dose, the dose may be reduced to 100 mg twice a day.
Can other medicines be taken with nintedanib?
Some medicines can stop nintedanib working properly (for example, ketoconazole, clarithromycin, erythromycin, cyclosporine, rifampicin, carbamazepine, phenytoin and St John’s wort) and others can increase the side effects of nintedanib (for example, blood thinning medicines like warfarin, apixaban, rivaroxaban and dabigatran can increase your risk of bleeding).
Your doctor will check what other medicines you are taking before prescribing you nintedanib.
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products. It is important that you let your GP know that you are taking nintedanib when they are reviewing your current medications or if they prescribe you any new medications.
Do not smoke before and during treatment with this medicine.
Are there any side effects?
You might experience side effects with your treatment. Tell your doctor if you notice side effects that you think are caused by this medication. Many side effects disappear when nintedanib treatment is stopped.
Most common possible side effects
The most common side effects reported are are nausea, vomiting, diarrhoea, abdominal pain, decreased appetite, weight loss, rash, increased blood pressure, bleeding.
Liver function may be affected and regular monitoring blood tests will be ordered.
Less common or rare possible side effects
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Bloody or cloudy urine, difficult or painful urination, swelling of the face, feet, or lower legs, weight gain
- Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, unusual sweating, faintness
- Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
- Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking
- Severe diarrhoea, nausea, vomiting, stomach pain
- Unusual bleeding, bruising, or weakness
What precautions are necessary?
Infections
- Before you take nintedanib, tell your doctor about all of your medical conditions, including if you have:
- Liver problems
- Heart problems
- A history of blood clots
- A bleeding problem or a family history of a bleeding problem
- Stomach or digestion problems or have had recent surgery in your abdomen or stomach
Surgery
- Nintedanib can cause problems with bleeding, if surgery is planned, it is important to let your rheumatologist know.
Use with alcohol
- Nintedanib can be used safely with a moderate intake of alcohol. However, drinking more than 4 standard drinks on one occasion, even if infrequently, is strongly discouraged.
Use in pregnancy and when breastfeeding
- Nintedanib must not be used in pregnant or breastfeeding women.
- If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before starting treatment. Use an effective form of birth control during treatment and for at least 3 months after the last dose.
- Do not breastfeed during treatment with this medicine.
How to store nintedanib
Store below 25°C. Store in the original package in order to protect from moisture.
Protect from exposure to high humidity and avoid excessive heat.
Keep all medications out of reach of children.
For more information please see the Nintedanib- printable information sheet
This Information Sheet has been prepared using materials obtained from various sources which have been reviewed by the Australian Rheumatology Association (ARA). It contains general information only and does not contain a complete or definitive statement of all possible uses, actions, precautions, side effects or interactions of the medicines referenced. This information is not intended as medical advice for individual conditions nor for making an individual assessment of the risks and benefits of taking a particular medicine. Decisions regarding the assessment and treatment of patients are the sole responsibility of the treating medical professional, exercising their own clinical judgment and taking into account all of the circumstances and the medical history of the individual patient. ARA has used all reasonable endeavours to ensure the information on which this Information Sheet is based is accurate and up to date. However, the ARA accepts no responsibility or liability for the accuracy, currency, reliability and/or completeness of the information contained in this Information Sheet. To the maximum extent permitted by law, the ARA expressly disclaims any liability for any injury, loss, harm or damage arising from or in connection with use of and reliance on the information contained in this Information Sheet. This information sheet is copyright and may be reproduced in its entirety but may not be altered without prior written permission from the ARA.Page reviewed and updated March 2024
