Nintedanib Onkogen (Nintedanib)

Nintedanib acts on fibrotic and angiogenic pathways, making it useful in several pulmonary and oncologic conditions.

• Idiopathic pulmonary fibrosis: slows decline in lung function and reduces disease progression.
• Non‑small cell lung cancer: used in combination therapy to inhibit tumor angiogenesis and growth.
• Systemic sclerosis‑associated interstitial lung disease: helps preserve lung capacity and delay functional deterioration.

• Nintedanib inhibits multiple receptor tyrosine kinases, including vascular endothelial growth factor receptors (VEGFR 1‑3), fibroblast growth factor receptors (FGFR 1‑3) and platelet‑derived growth factor receptors (PDGFR‑α/β). By blocking these pathways, the drug reduces endothelial cell proliferation, fibroblast activation and extracellular matrix deposition, leading to anti‑angiogenic and antifibrotic effects in target tissues.

Nintedanib may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea: feeling of stomach upset.
• Diarrhea: frequent loose stools.
• Vomiting: episodes of emesis.
• Decreased appetite: reduced desire to eat.
• Abdominal pain: discomfort in the stomach area.
• Weight loss: unintended reduction in body weight.

Serious or Rare Side Effects

• Elevated liver enzymes: signs of hepatic injury.
• Bleeding events: increased risk of gastrointestinal or other hemorrhage.
• Cardiovascular complications: such as hypertension or arterial thrombotic events.
• Severe infections: opportunistic or serious bacterial infections.
• Gastrointestinal perforation: rare but potentially life‑threatening.

When prescribing Nintedanib, clinicians should observe several precautionary measures to ensure patient safety.

• Liver function monitoring: assess transaminases before and during therapy.
• Cardiovascular assessment: evaluate blood pressure and cardiac risk factors.
• Bleeding risk evaluation: avoid use in patients with active bleeding or high anticoagulant exposure.
• Gastrointestinal health: monitor for severe diarrhea or abdominal pain.
• Pregnancy and lactation: contraindicated unless benefits outweigh risks (consult specialist).
• Store at below 25°C: keep in the original pack, protect from moisture.

Nintedanib can interact with other medicines, influencing its efficacy or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase nintedanib exposure.
• Anticoagulants (e.g., warfarin): heightened risk of bleeding.
• Antiplatelet agents (e.g., aspirin, clopidogrel): additive bleeding potential.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin, clarithromycin): may modestly raise drug levels.
• P‑gp inhibitors (e.g., verapamil, amiodarone): could increase exposure.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce therapeutic effect.