Nintedanib (Nintedanib) – Patient-Friendly Information
This page provides general, patient-friendly information about nintedanib, a medicine used for certain lung diseases and some cancers. It explains how nintedanib works, how it’s taken, what to expect, and important safety considerations. Always follow the guidance of your treating clinician and the medicine label for your specific plan.
1) Basic product information
| Information | Details |
|---|---|
| Generic name | Nintedanib |
| Common use | To slow progression of certain forms of progressive pulmonary fibrosis and to treat specific cancers |
| Medicinal class | Tyrosine kinase inhibitor (TKI) targeting multiple growth factor receptors |
| How it’s taken | Oral capsules (often twice daily depending on indication) |
| Where it’s used (Australia) | Under specialist supervision in line with Australian Therapeutic Goods Administration (TGA) approvals and clinical guidelines |
Brand names and capsule strengths may vary by manufacturer and approval status. Your pharmacist can confirm the exact product you are receiving.
2) What nintedanib is and how it works (mechanism of action)
Nintedanib is a multi-targeted tyrosine kinase inhibitor. In simple terms, it helps block chemical “signals” inside cells that drive:
- Fibrosis (scarring) in the lungs by interfering with signalling pathways that contribute to thickening and stiffening of lung tissue.
- Abnormal blood vessel growth and other processes involved in cancer progression by inhibiting receptors involved in growth and tumour-related signalling.
By slowing these pathways, nintedanib is intended to reduce disease progression rather than provide an instant cure. In lung disease, benefits are typically measured over weeks to months through lung function and symptom tracking.
3) Pharmacokinetics (absorption, distribution, metabolism, elimination)
Pharmacokinetics describes what the body does to a medicine. Key points for nintedanib include:
- Absorption: After oral dosing, nintedanib is absorbed through the gastrointestinal tract.
- Peak levels: Blood levels rise after taking a dose and reach a peak concentration after a short period.
- Food effects: Taking nintedanib with food may change how much medicine your body absorbs (see “Food interactions”).
- Metabolism: It is metabolised mainly in the liver via enzymes such as but not limited to CYP-related pathways.
- Elimination: Nintedanib and its metabolites are primarily eliminated via the liver/bile route.
Because the liver plays an important role, liver function tests are typically monitored during treatment. Let your clinician know if you have existing liver disease or abnormal liver tests.
4) Typical uses (indications)
Indications may depend on local approvals and individual clinical circumstances. In Australia, nintedanib is commonly used for:
- Pulmonary fibrosis that is progressive (including certain forms of interstitial lung disease with a progressive fibrosing phenotype).
- Certain cancers where nintedanib is used as part of treatment plans (the exact cancer types and regimens depend on approved indications).
Your treating team will confirm whether your diagnosis matches an approved or guideline-supported use in Australia.
5) How and when to take nintedanib (timing and routine)
Many patients take nintedanib twice daily (morning and evening), but the exact schedule can depend on indication and capsule strength. Follow the dosing schedule provided for your product and condition.
General timing tips
- Take at consistent times each day to maintain steady medicine levels.
- Try to leave a gap between doses (for example, about 12 hours apart if prescribed twice daily).
- Swallow whole with water. Do not crush or open unless your clinician/pharmacist instructs otherwise.
- Do not double up if you miss a dose—follow your clinician’s instructions or the product directions.
If you experience side effects (such as diarrhoea), your clinician may recommend supportive treatment, temporary dose interruption, or dose adjustment depending on severity.
6) Food interactions (including what to eat and avoid)
Food can influence how your body absorbs nintedanib. Because absorption may be altered, it’s important to take nintedanib consistently with respect to meals. Many prescribing instructions advise taking nintedanib .
Practical eating guidance
- Take with a meal (e.g., breakfast and dinner) if this is how your clinician or the product information recommends.
- Avoid large changes in meal timing or meal size suddenly. If you regularly skip meals, discuss this with your pharmacist.
- Stay hydrated, especially if you develop diarrhoea.
Because different jurisdictions and product labels can have slightly different instructions, always follow the directions provided with your specific nintedanib capsules.
7) Alcohol and medicine interactions
Alcohol
Alcohol may worsen side effects such as stomach irritation and can also affect liver function. If you drink alcohol, consider discussing an appropriate limit with your clinician, particularly if you have abnormal liver tests.
Medicine interactions
Nintedanib can interact with other medicines because it is processed in the body by metabolic pathways. Some medicines may change its levels, leading to reduced effect or increased side effects.
Tell your pharmacist or clinician about all medicines you take**, including:
- Prescription medicines
- Over-the-counter medicines
- Herbal products and supplements (including “natural” remedies)
- Recent courses of antibiotics or antifungals
In particular, medicines that strongly affect liver enzymes or drug transport proteins can alter nintedanib exposure. Your healthcare team can check interaction risks using your medication list.
If you notice new or worsening side effects soon after starting another medicine, contact your clinician promptly.
8) Dosing: what is commonly used
Dosing varies by indication, capsule strength, and individual tolerance. Your dose should be set by your treating clinician. Below are general patterns seen in practice; always confirm your exact regimen with your product instructions.
Common dosing pattern
- Twice daily administration is typical for many indications.
- Dose reductions or temporary interruptions may be considered if side effects occur.
If side effects occur
Dose management is a common part of safe use. Depending on the side effect and severity, your clinician may recommend:
- Supportive treatments (for example, anti-diarrhoeal care plans)
- Temporary holding of doses
- Permanent dose reduction to improve tolerability
Do not change your dose schedule on your own. If you miss several doses or have frequent side effects, contact your clinician for advice.
9) Safety profile: side effects and when to seek help
Like all medicines, nintedanib can cause side effects. Many are manageable, but some require urgent attention. Below is an overview of commonly discussed safety considerations.
Common side effects
- Diarrhoea (one of the most frequent): may occur early or at any time during treatment
- Nausea and reduced appetite
- Vomiting or abdominal discomfort
- Fatigue or weakness
- Changes in liver blood tests (elevated ALT/AST, etc.)
- Headache
Less common but important risks
- Bleeding risk in some situations (for example, if you take other medicines that affect clotting)
- High blood pressure in some patients
- Thromboembolic events (blood clot-related events) in some patients
- Serious liver injury (rare, but important)
- Wound healing complications (clinicians may adjust dosing around procedures)
- Interstitial lung disease-related symptoms may overlap with your underlying condition, so report changes promptly
Seek urgent medical attention if you experience
- Signs of serious bleeding (e.g., coughing up blood, black/tarry stools, severe unusual bruising)
- Severe or persistent diarrhoea causing dehydration (e.g., dizziness, fainting, very low urine output)
- Yellowing of the skin/eyes (jaundice) or severe abdominal pain
- Chest pain, sudden shortness of breath, or neurological symptoms (e.g., weakness on one side)
- Allergic-type reactions (swelling of face/lips, difficulty breathing, widespread rash)
Keep follow-up appointments and blood test schedules as advised, especially liver function monitoring.
10) Practical use tips (day-to-day guidance)
Managing diarrhoea
Diarrhoea is common with nintedanib. The goal is to manage it early to prevent dehydration and treatment interruptions. A clear plan is best—ask your clinician/pharmacist what to take at the first signs of diarrhoea.
- Start supportive care early if diarrhoea begins
- Drink fluids regularly (water, oral rehydration solutions if recommended)
- Avoid very greasy, spicy, or high-fibre foods if they worsen symptoms
- Track frequency and severity (for example, number of stools per day)
Taking your capsules
- Use a pill box if that helps you maintain timing (only if it matches your routine and doesn’t cause confusion)
- Store capsules as directed on the label (typically at controlled room temperature, away from moisture)
- Keep them out of reach of children
Blood tests and monitoring
Your clinician may monitor:
- Liver function tests (to detect potential liver effects)
- Blood pressure
- General blood counts or other labs as needed
If you develop symptoms that could indicate liver problems (fatigue, nausea, right upper abdominal discomfort, dark urine, jaundice), contact your clinician promptly.
Smoking and lung health
If you smoke, quitting can improve lung health and overall outcomes. Discuss cessation supports with your healthcare team. Vaccinations and pulmonary rehabilitation may also be part of comprehensive care for lung conditions.
11) Alternative options (discuss with your clinician)
Treatment alternatives depend on your diagnosis, disease severity, and prior therapies. If nintedanib isn’t suitable or doesn’t provide desired benefit or tolerability, clinicians may consider other options such as:
- Other antifibrotic medicines for appropriate pulmonary fibrosis indications
- Condition-specific therapies (e.g., immunomodulatory or supportive treatments) when clinically appropriate based on the underlying cause of lung disease
- Symptom-focused care such as oxygen support, pulmonary rehabilitation, and medications for breathlessness or cough
- For cancer-related indications: other targeted therapies, chemotherapy, immunotherapy, or combinations as per oncology guidance
Your clinician can explain the rationale for nintedanib versus alternatives and what monitoring would be required for any option.
12) Nintedanib in the Australian market: regulatory and legal context
In Australia, medicines must be supplied in accordance with Therapeutic Goods Administration (TGA) requirements. Availability, brand names, and approved indications can vary. For patient safety, pharmacies and healthcare professionals follow regulatory standards for supply, labelling, and counselling.
This page is intended to provide general information and does not replace advice from your healthcare provider. If you’re unsure about whether nintedanib is suitable for you, ask your clinician or pharmacist to review your medical history.
Recent guidance (general themes)
Over recent years, clinical guidance for progressive pulmonary fibrosis and related conditions has increasingly emphasised:
- Earlier identification of patients with a progressive fibrosing phenotype
- Use of antifibrotic therapies in appropriate patients
- Monitoring for adverse effects, particularly gastrointestinal tolerance and liver function
- Managing comorbidities (cardiovascular risk, infections, and respiratory complications)
Your treating team will follow the most current, locally accepted guidelines for your diagnosis.
13) Delivery and availability (online pharmacy considerations)
Availability of medicines can depend on supplier stock levels and current prescribing requirements. Where available, an online pharmacy may offer home delivery with secure packaging to protect the product during transit.
What to expect when ordering
- Verification and checks: your details may be verified to ensure safe supply.
- Packaging: medicines are typically shipped in protective packaging with clear labelling.
- Delivery timeframes: delivery schedules vary by region and stock availability.
- Temperature/moisture considerations: some products require specific storage; follow the label instructions.
If you need delivery updates, you can contact the pharmacy’s support service. Keep your tracking information if provided.
14) Frequently Asked Questions (FAQ)
How long does nintedanib take to work?
For progressive lung conditions, benefits are typically assessed over time using lung function tests and symptom changes. You may not feel an immediate difference. Attend scheduled reviews so your clinician can measure response and tolerability.
What should I do if I miss a dose?
If you miss a dose, follow the instructions from your medicine label or clinician. In general, you should not take an extra dose to “catch up” unless specifically directed.
Can I take nintedanib with food?
Many prescribing instructions advise taking nintedanib with food to support consistent absorption and tolerability. Always follow the exact instructions provided with your specific capsules.
What’s the most common side effect?
Diarrhoea is one of the most common side effects. Early management with the right supportive measures can reduce severity and help you continue treatment safely.
Do I need liver blood tests?
Often, yes. Because nintedanib can affect the liver, your clinician may monitor liver function tests periodically and more frequently if you have symptoms suggestive of liver problems.
Is it safe to drink alcohol while taking nintedanib?
Alcohol may increase risk of stomach upset and can affect the liver. If you drink alcohol, discuss a safe amount with your clinician. If you develop symptoms such as jaundice or severe abdominal pain, seek medical advice promptly.
Can nintedanib interact with other medicines?
Yes. Nintedanib can interact with certain prescription medicines, over-the-counter medicines, and herbal supplements. Provide your full medication list to your pharmacist or clinician so interactions can be assessed.
What if I need surgery or a dental procedure?
Let your surgeon/dentist and prescribing clinician know you’re taking nintedanib. Some treatments may require dose timing adjustments around procedures due to effects related to healing or bleeding risk.
Can I take antacids or stomach remedies?
Some stomach medicines may be appropriate, but interactions and timing may matter. Ask your pharmacist which options are suitable for your situation.
How should I store nintedanib capsules?
Store as directed on the packaging (typically at controlled room temperature, away from moisture, and out of reach of children). Do not use capsules after the expiry date printed on the box.
Where can I get reliable information in Australia?
Your clinician and pharmacist are the best sources for personal advice. You can also refer to official consumer medicines information provided by Australian health authorities and the product’s package information leaflet.
15) Important reminders
- Follow your clinician’s plan for dosing, monitoring, and side-effect management.
- Report symptoms early, especially diarrhoea, signs of dehydration, bleeding, or liver-related symptoms.
- Keep blood test appointments as advised.
- Review all medicines and supplements for interaction risks.
