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Antifibrotic (Tyrosine Kinase Inhibitor)

Nintedanib

Brand names: Ofev

Nintedanib is an oral tyrosine kinase inhibitor used to treat idiopathic pulmonary fibrosis and other chronic fibrosing interstitial lung diseases with a progressive phenotype, including systemic sclerosis-associated interstitial lung disease.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits receptor tyrosine kinases including those for vascular endothelial growth factor, fibroblast growth factor and platelet-derived growth factor, slowing the fibroproliferative processes that drive lung fibrosis.

Prescribing in practice

  • Hepatotoxicity can occur, so liver function must be checked before treatment and monitored during therapy, with dose modification or interruption for significant derangement.
  • Diarrhoea is very common and should be managed promptly with hydration and antidiarrhoeal measures to maintain treatment.
  • It is contraindicated in pregnancy and carries a bleeding and gastrointestinal perforation risk; use caution with anticoagulants and recent surgery.

Monitoring

Check liver function before starting and periodically thereafter, and monitor for diarrhoea, weight loss and bleeding.

Counselling the patient

  • Take the capsules with food and report persistent diarrhoea, vomiting or abdominal pain.
  • Effective contraception is essential as this medicine can harm an unborn baby.
  • Report yellowing of the skin or eyes, dark urine or unusual bruising or bleeding.

Evidence & guidelines

Pivotal trials (INPULSIS and the SENSCIS study) demonstrated that nintedanib slows decline in forced vital capacity, supporting NICE-recommended use in fibrosing lung disease.

Reference: INPULSIS Trial (Richeldi et al, NEJM 2014); NICE TA379; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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