Nintedanib Teva (Nintedanib)

• Nintedanib is used in fibrotic lung disorders and selected oncologic indications, where it modulates disease‑driving pathways.
• Idiopathic pulmonary fibrosis: slows decline in lung function and reduces disease progression.
• Systemic sclerosis‑associated interstitial lung disease: improves pulmonary function and delays worsening.
• Non‑small cell lung cancer: used in combination therapy to inhibit tumor growth.

• 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 signaling pathways, the drug reduces fibroblast proliferation, angiogenesis, and extracellular matrix deposition, thereby limiting fibrotic tissue formation and tumor angiogenesis.

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

Common Side Effects

• Diarrhea: frequent loose stools.
• Nausea: mild to moderate sensation.
• Vomiting: occasional episodes.
• Elevated liver enzymes: increased ALT/AST levels.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver injury requiring monitoring.
• Bleeding events: heightened risk of gastrointestinal or intracranial hemorrhage.
• Cardiovascular events: arterial thromboembolism or myocardial infarction.

• When prescribing Nintedanib, clinicians should consider several safety measures.
• Liver function monitoring: perform baseline and periodic ALT/AST tests.
• Bleeding risk assessment: avoid concomitant anticoagulants unless necessary.
• Gastrointestinal health: monitor for severe diarrhea or colitis.
• Pregnancy and lactation: use only if benefits outweigh risks; consult physician.
• Drug interactions: review concomitant medications for CYP3A4 substrates.
• Store at below 25°C: keep in original packaging, protect from moisture and light.

Nintedanib can interact with other medicines, requiring careful management.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase nintedanib exposure.
• Anticoagulants (e.g., warfarin, direct oral anticoagulants): heightened bleeding risk.
• P‑glycoprotein inhibitors (e.g., verapamil): may raise plasma levels.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce efficacy.
• Antiplatelet agents (e.g., aspirin, clopidogrel): monitor for bleeding.
• Diuretics: watch for dehydration that can worsen gastrointestinal side effects.