Nintedanib Teva (Nintedanib)

Nintedanib acts on multiple receptor tyrosine kinases involved in fibrotic and oncogenic pathways, providing therapeutic benefit in several serious lung conditions.

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

• Nintedanib inhibits a spectrum of 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, it reduces angiogenesis, fibroblast proliferation, and extracellular matrix deposition, thereby limiting fibrotic remodeling and tumor vascularization.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Diarrhea
• Nausea
• Vomiting
• Abdominal pain
• Decreased appetite
• Elevated liver enzymes (ALT/AST)

Serious or Rare Side Effects

• Hepatic failure or severe liver injury
• Major bleeding events
• Cardiovascular complications (e.g., myocardial infarction)
• Gastrointestinal perforation
• Severe infections
• Pneumothorax

Patients should be monitored for safety and tolerability throughout therapy.

• Liver function: assess baseline enzymes and monitor periodically.
• Bleeding risk: avoid concomitant use of strong anticoagulants unless medically necessary.
• Gastrointestinal health: counsel patients on managing diarrhea and report severe abdominal pain.
• Cardiovascular status: evaluate history of ischemic heart disease before initiation.
• Pregnancy and lactation: use only if the potential benefit justifies the potential risk to the fetus or infant.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Nintedanib may interact with drugs that affect its metabolism or increase bleeding risk.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase nintedanib exposure.
• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce nintedanib exposure.
• Anticoagulants (e.g., warfarin, direct oral anticoagulants): heightened bleeding potential.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin): monitor for increased side effects.
• Moderate CYP3A4 inducers (e.g., phenytoin): assess therapeutic response.
• Diuretics: watch renal function and electrolyte balance.