An antifibrotic for pulmonary fibrosis
Nintedanib
A specialist antifibrotic that slows lung scarring in IPF and some other progressive lung fibrosis.
What is Nintedanib?
Nintedanib is a specialist medicine used to slow the lung scarring seen in idiopathic pulmonary fibrosis (IPF) and in some other progressive lung-scarring conditions, including the lung disease that can occur with scleroderma. It does not cure these conditions but can slow how quickly lung function declines, and it is started and monitored by lung specialists. The most common effect is diarrhoea, which is usually manageable. The liver is checked with blood tests, it can increase the risk of bleeding, and it must not be used in pregnancy.
Education and reference only. This is a plain-language guide to Nintedanib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Nintedanib is an antifibrotic medicine used to slow progressive lung scarring. It is used in idiopathic pulmonary fibrosis (IPF), in other progressive fibrosing interstitial lung diseases, and in lung disease linked to scleroderma (systemic sclerosis). In all of these the lungs gradually become scarred and stiff, making breathing harder. It is a specialist treatment, started by an interstitial lung disease team, and is taken by mouth as a capsule, usually twice a day with food.
How it works
Nintedanib blocks several signals that the body uses to drive fibrosis, the build-up of scar tissue, and the growth of small blood vessels involved in that process. By interfering with these signals in the lung, it slows the rate at which scarring develops and lung function declines. It does not remove existing scarring, so the goal is to slow progression and preserve lung function for longer. The same effects on blood vessels and healing are part of why it can increase the risk of bleeding and slow wound healing.
Company & origin
Originated / developed by: Specialist medicine.
A specialist antifibrotic medicine used in the UK to slow lung scarring in idiopathic pulmonary fibrosis and some other progressive lung-scarring conditions.
Practical use
How to take Nintedanib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the capsules with food, usually twice a day about twelve hours apart, swallowed whole with water, as directed by your lung specialist.
- If you get diarrhoea, keep well hydrated and use the anti-diarrhoea advice you are given; tell your team if it is severe.
- Attend your regular liver blood tests, and report any yellowing of the skin or eyes, dark urine or unusual tiredness.
- Tell any healthcare professional you take nintedanib before surgery or dental work, as it can increase bleeding and slow healing.
- If you could become pregnant, use effective contraception, as it must not be taken in pregnancy.
Weighing it up
Advantages & disadvantages of Nintedanib
Advantages
- Can slow the decline in lung function in IPF and other progressive lung-scarring conditions.
- Useful in several conditions, including scleroderma-associated lung disease.
- Taken by mouth and managed by a specialist lung team with regular review.
Disadvantages
- Does not cure these conditions or reverse existing lung scarring.
- Very commonly causes diarrhoea, and can cause nausea and weight loss.
- Needs liver blood tests, can increase bleeding risk and slow wound healing, and must not be used in pregnancy.
Practical use
Good to know
Like the other antifibrotic, nintedanib slows these lung conditions rather than curing them; it cannot reverse scarring already present, but it can slow how fast lung function falls. The most common effect by far is diarrhoea, which is usually manageable with good fluid intake, anti-diarrhoea measures and sometimes a dose adjustment, but should be reported if severe so dehydration is avoided. The liver is checked with regular blood tests because it can affect liver function. Nintedanib can increase the risk of bleeding and can slow wound healing, so it is important to mention it before any surgery or dental work and to report unusual bleeding. It must not be used in pregnancy because it can harm a developing baby, so effective contraception is needed for those who could become pregnant. Nausea, vomiting and reduced appetite can also occur.
Who should not take it / use with caution
- It must not be used in pregnancy and is avoided while breastfeeding.
- It is used with caution, or avoided, in significant liver problems and in people at high risk of bleeding.
- Care is needed in people with recent heart problems, or who are about to have surgery, so a full assessment is made first.
Monitoring
- Regular liver blood tests, particularly in the early months.
- Watching for diarrhoea, weight loss and any signs of unusual bleeding.
- Lung function tests over time to see how the disease is progressing.
Side effects
- Diarrhoea is very common; nausea, vomiting, reduced appetite and weight loss can also occur.
- Changes in liver blood tests, tummy pain and tiredness are seen.
- Less often, an increased tendency to bleed or, rarely, more serious blood-vessel or bowel problems.
Key interactions
- Blood-thinning medicines and others that increase bleeding can add to the bleeding risk.
- Some medicines that affect the same liver pathway can raise or lower its levels, so they are checked.
- Tell your prescriber about all your medicines, including over-the-counter and herbal products.
Available as: Capsules taken by mouth with food, swallowed whole.
Answers
Nintedanib: frequently asked questions
Does nintedanib cure pulmonary fibrosis?
No. It does not cure these conditions or reverse existing scarring, but it can slow how quickly lung function declines, which is valuable in a serious illness.
Why does it cause diarrhoea?
Diarrhoea is the most common effect; keeping well hydrated and using the anti-diarrhoea advice you are given usually helps, and your team can adjust the dose if it is severe.
Can I take it if I might become pregnant?
Nintedanib must not be used in pregnancy as it can harm a developing baby, so effective contraception is needed for anyone who could become pregnant while taking it.
Do I need to mention it before surgery?
Yes. It can increase bleeding and slow wound healing, so tell any healthcare professional you take it before surgery or dental work.
Why do I need blood tests?
Nintedanib can affect the liver, so regular blood tests check liver function; report any yellowing of the skin or eyes, dark urine or unusual tiredness.
The wider class
About Antifibrotic (pulmonary fibrosis)
Nintedanib belongs to the antifibrotic (pulmonary fibrosis) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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