Nintedanib (Nintedanib)

Nintedanib is a prescription medicine used in the treatment of certain progressive lung diseases. It works by targeting pathways that drive abnormal blood vessel growth and scarring (fibrosis) within the lungs. This page explains how nintedanib works, how it is taken, what to expect, and important safety information for people in the United Kingdom.

Note: Always follow the advice of a healthcare professional and read the package information for full details specific to your product and situation.

Key product information

How nintedanib works (mechanism of action)

Nintedanib is a targeted medicine that blocks multiple signalling pathways involved in:

• Fibrosis (the formation of scar tissue in lung tissue)
• Abnormal blood vessel growth that supports disease progression
• Inflammation-related and growth-factor signalling linked to progressive lung scarring

It inhibits several tyrosine kinases, including receptors linked to fibroblast activation and extracellular matrix production. By reducing these disease-driving signals, nintedanib may help slow the decline in lung function in appropriate patients with progressive fibrosing interstitial lung disease.

Pharmacokinetics: how the body absorbs, uses, and removes it

Pharmacokinetics describes what the body does to a medicine. Key points for nintedanib include:

• Absorption: Nintedanib is taken by mouth and reaches peak blood levels after a few hours (timing can vary).
• Distribution: It circulates throughout the body and binds to proteins in the blood.
• Metabolism: The medicine is mainly processed in the liver via enzymatic pathways (notably CYP-related mechanisms).
• Elimination: It is cleared primarily through the bile and faeces, with some contribution from the kidneys.
• Steady state: With twice-daily dosing, blood levels stabilise after repeated doses.

Why this matters: Because the medicine is metabolised and can affect the liver, regular blood tests are recommended. Interactions with other medicines that influence liver enzymes may also be important.

What nintedanib is used for in the UK

In the UK, nintedanib is used for fibrosing interstitial lung diseases that follow a progressive course. Indications may include (depending on clinical assessment):

• Idiopathic pulmonary fibrosis (IPF)
• Systemic sclerosis–associated interstitial lung disease (SSc-ILD)
• Other chronic fibrosing interstitial lung diseases where the disease is progressive, in line with specialist diagnosis and current guidance

Eligibility for treatment depends on the precise diagnosis, disease severity, lung function tests, imaging, and overall health. A specialist respiratory team will usually assess whether nintedanib is appropriate.

Typical dosing and timing

Nintedanib is generally taken as a regular twice-daily schedule. The exact dose and any adjustments depend on tolerability, liver function, and other medicines you take.

Typical timing

• Twice daily, approximately 12 hours apart (for example, early morning and evening).
• Try to take doses at consistent times each day.

How to take the capsules

• Swallow whole with water.
• Do not crush, chew, or open the capsules unless your specific product instructions say otherwise.
• If a dose is missed, follow the general approach below.

If you miss a dose

• Take the missed dose only if it is close to the time of your next dose.
• If it is almost time for the next dose, skip the missed dose and continue with your usual schedule.
• Do not take two doses at the same time to make up for a missed dose.

Practical tip: Use a pill organiser and set reminders. Many patients find it easiest to link dosing to routine activities (e.g., with breakfast and with the evening meal).

Taking nintedanib with food

Food interactions and absorption are relevant for nintedanib. In many patients, taking the medicine with food may help reduce stomach-related side effects.

• Follow the instructions provided by your prescriber and the patient information leaflet.
• If you experience nausea or loss of appetite, discuss whether taking the next dose with meals may help.

Food timing note: Try to be consistent—either always take with food or always take in the same way as advised—so your body gets predictable exposure to the medicine.

Alcohol and medicine interactions

Alcohol

While moderate alcohol may not be strictly prohibited for everyone, it can increase the risk of stomach irritation and may affect the liver. Because nintedanib can raise liver enzymes, it’s best to:

• Ask your healthcare professional what is safest for you
• Consider limiting alcohol, especially if you already have liver issues or abnormal liver blood tests

Interactions with other medicines

Nintedanib can interact with medicines that affect liver metabolism and drug transport. Tell your healthcare professional about all medicines and supplements you use, including:

• Antifungals (some medicines used for fungal infections)
• Antibiotics (certain types)
• Anticonvulsants (some medicines for seizures)
• HIV medicines
• St John’s wort (herbal product) — often avoided due to interaction potential
• Other medicines that affect liver enzymes or blood clotting

Blood clotting and bleeding risk: As with many medicines that affect signalling pathways, it may be necessary to be cautious if you take medicines that increase bleeding risk. If you notice unusual bruising or bleeding, seek advice promptly.

Always check: If you start a new medicine, including “over-the-counter” products, confirm it is safe to combine with nintedanib.

Safety profile: common and serious side effects

Like all medicines, nintedanib can cause side effects. Many are manageable with dose adjustments, supportive care, or temporary interruption as guided by a clinician.

Common side effects

• Diarrhoea (one of the most common; can sometimes be severe)
• Nausea and vomiting
• Reduced appetite and weight loss
• Abdominal pain or indigestion
• Fatigue

Less common but important

• Liver enzyme elevations (abnormal blood tests)
• Changes in blood pressure or heart rate in some people
• Bleeding (unusual bruising, nosebleeds, blood in urine or stools—report promptly)

Serious symptoms—seek urgent medical advice

Contact urgent medical services or a healthcare professional promptly if you experience:

• Signs of severe dehydration (e.g., dizziness, fainting, very reduced urine)
• Severe or persistent diarrhoea or vomiting that you cannot manage
• Yellowing of skin/eyes, dark urine, or severe right-sided abdominal pain (possible liver problems)
• Breathing worsening, coughing up blood, or sudden chest pain
• Severe allergic-type reactions such as swelling of face/lips or trouble breathing

Practical use tips to improve comfort and adherence

Managing nintedanib is often about staying ahead of side effects—especially gastrointestinal effects.

Diarrhoea prevention and management

• At the first signs of diarrhoea, start supportive measures (and consider anti-diarrhoeal medicine if advised by your clinician).
• Increase fluid intake to avoid dehydration.
• Choose bland foods temporarily (e.g., toast, rice, bananas) if tolerated.
• Seek advice urgently if diarrhoea is severe, persistent, or accompanied by dizziness or fever.

Nausea and appetite changes

• Taking the medicine consistently with food may help (if this aligns with your instructions).
• Small, frequent meals can be easier than large meals.
• Discuss anti-nausea options with your healthcare professional if symptoms interfere with daily life.

Keep up with monitoring

• Attend scheduled blood tests—especially liver function tests.
• Report new symptoms early, rather than waiting until your next appointment.

Hydration and general wellbeing

• Because gastrointestinal side effects may occur, maintain adequate hydration.
• Stay active within your abilities and follow pulmonary rehabilitation or exercise guidance if offered.

Pharmacovigilance mindset: when your dose may be adjusted

Some people need temporary dose interruption, reduction, or supportive medicines to manage side effects such as diarrhoea or elevated liver enzymes. Do not change your dose schedule without healthcare guidance.

Clinicians may consider:

• Short-term interruption if side effects are significant
• Restarting at a lower dose
• Regular blood test monitoring to guide continuation

Alternative options (discuss with your specialist)

Depending on your exact diagnosis and disease severity, alternative or additional treatments may include:

• Other antifibrotic medicines used for idiopathic pulmonary fibrosis (for example, medicines in the same treatment class may be considered in appropriate patients)
• Immunomodulating treatments for certain inflammatory or connective tissue–related interstitial lung diseases
• Supportive care such as pulmonary rehabilitation, oxygen therapy, vaccines, and symptom-directed treatments

Choice depends on diagnosis, lung function, co-existing conditions, tolerability, and guidance from specialist respiratory teams.

UK market and legal context (availability, regulation, and guidance)

In the United Kingdom, nintedanib is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and used in line with nationally recognised guidance and specialist care pathways. Availability typically occurs through standard NHS prescribing processes and/or private routes where permitted.

Access and ongoing reimbursement may depend on:

• Whether the medicine is recommended for your condition under relevant healthcare commissioning arrangements
• Specialist assessment and eligibility criteria
• Clinical monitoring and tolerability

Recent guidance: Treatment recommendations for fibrosing interstitial lung diseases evolve as new evidence emerges. In practice, clinicians apply the latest specialist and guideline-informed approaches, including assessment of progression and careful monitoring for safety (especially gastrointestinal effects and liver function).

Delivery and availability in the UK

Online pharmacies serving the UK typically source medicines through licensed supply chains. Availability can vary by strength and formulation.

• Check product details for the specific strength, pack size, and formulation.
• Delivery times may vary depending on stock levels and location within the UK.
• If a medicine is temporarily unavailable, the pharmacy may offer an estimated restock date or alternative arrangements where appropriate.

For best results, place your order early, especially if you take nintedanib on a strict twice-daily schedule and want to avoid missed doses due to delivery delays.

FAQ: commonly asked questions

1) What is nintedanib used for?

Nintedanib is used to treat certain progressive fibrosing interstitial lung diseases. Your specialist will confirm whether it is appropriate for your diagnosis and disease stage.

2) How quickly will nintedanib work?

Nintedanib is designed to slow progression rather than provide immediate symptom relief. Some people may notice stabilisation over time, while others may not feel a dramatic short-term change.

3) How should I take my doses?

Most patients take nintedanib twice daily, about 12 hours apart. Swallow capsules whole with water and follow personalised instructions from your healthcare professional.

4) Can I take nintedanib with food?

Food can influence tolerability. Many patients do better taking nintedanib with meals. Follow your product leaflet and clinician advice for your specific regimen.

5) What can I do if I get diarrhoea?

Start supportive measures quickly: drink fluids, eat bland foods if helpful, and contact your healthcare team if diarrhoea is moderate to severe or persistent. Severe diarrhoea can lead to dehydration and requires prompt advice.

6) Does nintedanib affect the liver?

Yes. Nintedanib can cause elevations in liver enzymes. This is why regular blood tests are recommended and why alcohol should be limited or discussed with your clinician.

7) Are there important medicine interactions?

Yes. Tell your healthcare professional about all medicines and supplements. Interactions may occur with certain antibiotics, antifungals, anticonvulsants, HIV medicines, and herbal products such as St John’s wort.

8) Can I drink alcohol while taking nintedanib?

It’s best to discuss alcohol use with your healthcare professional. Because nintedanib may affect the liver and can worsen stomach symptoms, keeping alcohol limited is often advisable.

9) What if I miss a dose?

If it is close to your next dose, skip the missed dose and take your next one at the usual time. Do not double up to make up for a missed dose.

10) What should I do if I experience serious side effects?

Seek urgent medical advice for severe diarrhoea or vomiting, symptoms suggesting liver problems (e.g., yellowing skin/eyes or dark urine), bleeding, or signs of a serious allergic reaction.

Always consult a healthcare professional for personal medical advice. If you have symptoms that concern you, contact your clinical team promptly.