Nintedanib: Pulmonary Fibrosis (IPF) Drug

Nintedanib is a potent intracellular tyrosine kinase inhibitor that targets multiple growth factor receptors (PDGFR, FGFR, VEGFR) involved in the pathogenesis of fibrosis and tumor angiogenesis. It effectively slows down the decline in lung function in patients with chronic fibrosing lung diseases.

It is considered a standard-of-care therapy for Idiopathic Pulmonary Fibrosis (IPF). On Unifarm, you can find original medications (such as Ofev) and generics containing this active ingredient.

Wikipedia page

Indications

Idiopathic Pulmonary Fibrosis (IPF): To slow the rate of decline in forced vital capacity (FVC).
Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD).
Chronic Fibrosing Interstitial Lung Diseases (ILDs): With a progressive phenotype.
Non-Small Cell Lung Cancer (NSCLC): Adenocarcinoma histology (in combination with docetaxel) after prior chemotherapy.

Dosage and administration

Nintedanib capsules are taken orally twice daily, approximately 12 hours apart. It must be taken with food to minimize gastrointestinal adverse effects.

Recommended Regimen (for Fibrosis):

Standard Dose: 150 mg twice daily (total 300 mg/day).
Reduced Dose: 100 mg twice daily (managed by a physician for adverse reactions).
Swallow capsules whole with water; do not chew or crush.

Pregnancy (can cause fetal harm) and breastfeeding.
Severe hepatic impairment.
Hypersensitivity to Nintedanib, peanut, or soya (capsules often contain soya lecithin).
Children and adolescents under 18 years of age.

The most common side effect involves the gastrointestinal tract and requires management:

Gastrointestinal: Diarrhea (very common), nausea, vomiting, abdominal pain, decreased appetite, weight loss.
Hepatic: Elevation of liver enzymes (ALT, AST) — regular blood tests are required.
Cardiovascular: Hypertension, increased risk of bleeding (especially if on anticoagulants).