Nintedanib Teva (Nintedanib)

Nintedanib Teva is used to treat fibrotic lung diseases by targeting pathways that drive fibroblast activity.

• 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 of respiratory symptoms.
• Other progressive fibrosing interstitial lung diseases: may reduce the rate of forced vital capacity decline in patients with a progressive phenotype.

• Nintedanib inhibits multiple receptor tyrosine kinases, including vascular endothelial growth factor receptors (VEGFR 1‑3), platelet‑derived growth factor receptors (PDGFR‑α/β) and fibroblast growth factor receptors (FGFR 1‑3). By blocking these pathways, it reduces fibroblast proliferation, differentiation and extracellular matrix deposition, thereby attenuating the fibrotic remodeling of lung tissue. The combined inhibition curtails angiogenic and profibrotic signaling, which are central to the pathogenesis of interstitial lung disease.

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

Common Side Effects

• Diarrhea: frequent loose stools, often manageable with antidiarrheal agents.
• Nausea: mild to moderate feeling of sickness.
• Vomiting: occasional episodes.
• Decreased appetite: reduced desire to eat.
• Abdominal pain: discomfort in the stomach area.
• Elevated liver enzymes: mild increases in ALT/AST.

Serious or Rare Side Effects

• Hepatotoxicity: significant liver injury requiring monitoring.
• Bleeding events: increased risk of gastrointestinal or other bleeding.
• Cardiovascular events: rare cases of myocardial infarction or stroke.
• Severe infections: opportunistic infections in immunocompromised patients.
• Interstitial lung disease exacerbation: worsening of underlying lung condition.

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

• Liver function monitoring: check ALT, AST and bilirubin before and during therapy.
• Gastrointestinal management: advise patients to stay hydrated and report severe diarrhea.
• Cardiovascular assessment: evaluate history of ischemic heart disease before initiation.
• Bleeding risk evaluation: avoid concomitant anticoagulants unless necessary.
• Pregnancy and lactation: drug is contraindicated; advise effective contraception.
• Store at ambient temperature: keep below 25 °C, protect from moisture and light in original packaging.

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

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors: may increase nintedanib exposure and toxicity.
• Anticoagulants (e.g., warfarin): heightened risk of bleeding.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors or inducers: may alter plasma levels, requiring observation.
• P-glycoprotein substrates: potential changes in drug transport.
• NSAIDs and antiplatelet agents: additive bleeding risk.
• Proton pump inhibitors: may affect absorption, monitor clinical response.