Nintedanib
Uses of Nintedanib
Nintedanib is a tyrosine kinase inhibitor used to slow the progression of serious and progressive lung diseases involving fibrosis (scarring of lung tissue).
Nintedanib is commonly used for:
- Idiopathic pulmonary fibrosis (IPF): Slows the rate of decline in lung function in this progressive condition characterised by irreversible scarring of the lung tissue, for which the cause is unknown.
- Systemic sclerosis-associated interstitial lung disease (SSc-ILD): Used in patients with scleroderma-related lung disease to slow the progressive worsening of lung function.
- Chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype: Treats other forms of progressive ILDs that show continued worsening despite treatment, including hypersensitivity pneumonitis and connective tissue disease-associated ILDs.
Nintedanib does not reverse existing lung damage, but it helps slow the rate at which the condition worsens. Treatment is long-term and always under specialist supervision.
Side effects of Nintedanib
Diarrhoea
Nausea
Abdominal pain
Vomiting
Decreased appetite
How Nintedanib works
Nintedanib works by blocking specific enzymes called tyrosine kinases that are involved in signalling pathways driving inflammation, scar tissue (fibrosis) formation, and abnormal blood vessel growth in the lungs.
In interstitial lung diseases such as IPF, overactivation of growth factor signalling pathways stimulates lung cells called fibroblasts to produce excessive amounts of collagen and other scar-forming materials. This progressive scarring replaces normal, functional lung tissue and impairs breathing.
Nintedanib simultaneously targets and inhibits three key growth factor receptor tyrosine kinases:
- VEGFR (Vascular Endothelial Growth Factor Receptor): Reduces abnormal new blood vessel growth (angiogenesis) that feeds fibrotic tissue.
- FGFR (Fibroblast Growth Factor Receptor): Reduces the activation of fibroblasts that produce scar tissue.
- PDGFR (Platelet-Derived Growth Factor Receptor): Further inhibits fibroblast proliferation and migration to sites of lung injury.
By blocking all three pathways simultaneously, Nintedanib disrupts the key drivers of progressive lung fibrosis, slowing the rate of functional decline in lung disease.
Certified content
Written By
BDS, MDS
Reviewed By
BAMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
- Nintedanib is available in the form of capsules for oral administration.
Age And Dose Restrictions
- This medicine is meant for adults.
- It is not recommended for use in children as the safety and effectiveness in this age group have not been established.
Contraindications
- Nintedanib is contraindicated in patients with known hypersensitivity to the active ingredient or any of the excipients used in the formulation.
Other Medications To Avoid With This Medicine
- Nintedanib may interact with P-glycoprotein (P-gp) inhibitors (such as amiodarone and verapamil) and CYP3A4 inhibitors (such as ketoconazole and ritonavir).
Overdose And Missed Dose
- An overdose of Nintedanib may cause severe diarrhoea, nausea, vomiting, and abdominal pain. If you suspect an overdose, contact your doctor or seek emergency medical attention immediately. As Nintedanib may also affect liver function, signs such as yellowing of the skin or eyes, dark urine, or unusual fatigue following an overdose should be reported urgently.
- If you miss a dose of Nintedanib, take it as soon as you remember. If it is nearly time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time to compensate for the missed one.
Management Of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
- Drinking plenty of fluids can help manage side effects like diarrhoea and nausea.
- Eating small, frequent meals can help manage decreased appetite.
Use In Driving And Operating Machinery
- Nintedanib may cause side effects such as dizziness or blurred vision which may affect your ability to drive or operate machinery.
Use In Pregnancy And Lactation
- Nintedanib can cause harm to the fetus and is not recommended during pregnancy.
- It's also not recommended during breastfeeding as it's unknown whether this medicine passes into breast milk.
Caution In Other Conditions
- Nintedanib should be used with caution in patients with liver problems as it may worsen the condition.
- Its use should also be monitored closely in patients with bleeding disorders or heart problems.
Special Dietary And Lifestyle Recommendation
- Those suffering from interstitial lung disease should maintain a healthy weight as being overweight can put more stress on the lungs.
- Engage in regular physical activity to keep the lungs healthy and functioning well.
- Avoid exposure to pollutants and irritants that can cause further damage to the lungs.
- Follow a balanced diet, rich in fruits, vegetables, and lean proteins to support overall health and well-being.
- Regular follow-ups with the doctor are necessary to monitor the progression of the disease and adjust medication if needed.
Frequently asked questions
Is Nintedanib a steroid?
No, Nintedanib is not a steroid. It is an anti-fibrotic drug classified as a tyrosine kinase inhibitor.
Does Nintedanib have any effect on sleep?
The research data does not specify any impact of Nintedanib on sleep. However, individual patient experiences may vary. If any sleep disturbances are noticed while taking Nintedanib, it should be discussed with the doctor.
Will Nintedanib affect fertility?
Nintedanib may potentially harm the foetus if given to pregnant women. Women of reproductive age are advised to use highly effective contraception during treatment and for at least 3 months after the last dose of Nintedanib.
Is it safe to take Nintedanib daily?
Nintedanib should be taken as advised by your doctor. The usual recommended dosage is twice daily.
How much time does Nintedanib take to work?
The exact time for Nintedanib to show its effect can vary between individuals and depends on the specific condition being managed.
What is the best time to take Nintedanib?
Nintedanib should be taken orally twice daily, approximately 12 hours apart, with food, or as instructed by your doctor.
Can Nintedanib cause weight loss?
Yes, weight loss is one of the common side effects associated with Nintedanib.
List of medicines for Nintedanib
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