Nintedanib (Ofev)


Nintedanib is used for treatment of lung fibrosis in interstitial lung disease. It works by blocking pathways in the body that result in fibrosis, which is the thickening or scarring of the tissue. Nintedanib does not reduce the strength of the body’s immune system. It was initially approved for treatment of a lung condition called idiopathic pulmonary fibrosis (IPF). It has since been approved for slowing the progression of lung fibrosis in patients with systemic sclerosis (scleroderma), as well as those with other rheumatologic diseases who have progressive lung fibrosis (e.g., progressive fibrosing interstitial lung disease). Nintedanib can be used alone or in combination with other medications (e.g., mycophenolate) used to treat lung fibrosis. The effectiveness of nintedanib for treatment of fibrosis in other organs, such as skin, is not established.

How To Take It

Nintedanib is an oral capsule typically taken twice daily. It comes in two strengths (150 mg and 100 mg). The target dose is 150 mg twice daily. The dose can be lowered in patients who develop side effects or signs of inability to tolerate the medication. It takes approximately six months of therapy with nintedanib before seeing an improvement in lung volumes.

Side Effects

Nintedanib should be avoided in patients with moderate to severe liver disease. Blood tests for liver enzymes should be obtained at the start of medication and at regular intervals during the first 3 months of treatment.

Diarrhea is a common side effect. This side effect can be managed in most patients by taking anti-diarrheal medications, decreasing the nintedanib dose, or temporarily stopping nintedanib. Other gastrointestinal side effects such as abdominal pain and nausea can also occur.

Nintedanib is not safe during pregnancy or breastfeeding. Patients who may become pregnant should use highly effective contraception during therapy and for ≥3 months after the last dose.

Tell Your Rheumatology Provider

You should contact your rheumatology provider if you develop diarrhea or other gastrointestinal symptoms on nintedanib. Before starting this medication, let your rheumatology provider know if you are pregnant or considering pregnancy. Women should discuss birth control with their primary care physicians or gynecologists before starting the medication. Breastfeeding should be avoided while taking this medication.

Updated February 2024 by Kiren Sahni, DO, FACR, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified healthcare provider for professional medical advice, diagnosis, and treatment of a medical or health condition.

We use cookies on our website to improve our service to you and for security purposes. By continuing to use our site without changing your browser cookie settings, you agree to our cookie policy and the use of cookies. See ACR Policies