Ofev (Nintedanib)

Ofev is a tyrosine kinase inhibitor that targets pathways involved in fibrotic disease progression.

• Idiopathic pulmonary fibrosis (IPF): slows the decline of lung function and reduces disease progression.
• Chronic fibrosing interstitial lung disease (CFILD) with a progressive phenotype: helps preserve lung capacity.
• Systemic sclerosis‑associated interstitial lung disease (SSc‑ILD): contributes to stabilising lung function.
• Progressive pulmonary fibrosis secondary to other connective‑tissue diseases: aids in slowing the rate of functional decline.

• Nintedanib inhibits multiple receptor tyrosine kinases, including vascular endothelial growth factor (VEGF) receptors, fibroblast growth factor (FGF) receptors and platelet‑derived growth factor (PDGF) receptors. By blocking these signalling pathways, it reduces fibroblast activation, extracellular matrix deposition and the fibrotic remodeling process that underlies progressive lung scarring.

Adverse reactions reported with nintedanib vary in frequency and severity.

Common Side Effects

• Diarrhea: frequent, watery stools.
• Nausea: mild to moderate upset.
• Abdominal pain: cramping or discomfort.
• Decreased appetite: reduced food intake.
• Elevated liver enzymes (ALT/AST): mild laboratory changes.
• Headache: occasional.

Serious or Rare Side Effects

• Severe liver injury (hepatitis or fulminant failure).
• Gastrointestinal perforation (e.g., bowel perforation).
• Severe bleeding events, including pulmonary hemorrhage.
• Cardiovascular events such as myocardial infarction.
• Severe hypersensitivity reactions (anaphylaxis, angioedema).

When prescribing Ofev, clinicians should consider several safety aspects.

• Liver function monitoring: baseline and periodic laboratory tests are required.
• Bleeding risk assessment: evaluate for concomitant anticoagulants or bleeding disorders.
• Gastrointestinal health: monitor for signs of perforation or severe diarrhea.
• Cardiovascular evaluation: assess history of ischemic heart disease.
• Pregnancy and lactation: avoid use unless clearly justified.
• Store at ambient temperature: keep in the original packaging, protect from moisture and light.

Nintedanib may interact with several medicines that affect its absorption or metabolic clearance.

Major Interactions (Avoid)

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Moderate  -