Your treating physician has discussed the use of nintedanib (brand name Ofev®) with you. This is a medication used for the treatment of pulmonary fibrosis. In this leaflet, you will find information about the effects and use of this medication. You will also read what to do if you experience side effects. However, this leaflet is not a substitute for the official package insert. If you have any questions after reading this leaflet, you can ask your treating physician and/or nurse specialist.

Why are you prescribed nintedanib?

Nintedanib is a medication used for the treatment of patients with pulmonary fibrosis. In pulmonary fibrosis, scarring of the lung tissue occurs, which can cause symptoms such as coughing and shortness of breath.

How does nintedanib work?

Nintedanib slows down the formation of scar tissue in your lungs, with the aim of slowing the decline in lung function and the worsening of your symptoms. Damage that already exists cannot be repaired by the medication.

What is the dosage and how do you take nintedanib?

Nintedanib is available as capsules that should be taken twice daily with meals. These are available in dosages of 100 mg and 150 mg. The dose is determined by your doctor. The capsules should be swallowed whole with water, preferably with food.

Nintedanib is only available by prescription and treatment must be started and supervised by a physician experienced in the diagnosis and treatment of pulmonary fibrosis.

What are the side effects of nintedanib?

It is not possible to predict in advance which side effects will occur and to what extent. The most common side effects of nintedanib are: nausea, heartburn, abdominal pain, diarrhea, loss of appetite, headache, and sometimes fatigue.

When should you contact your treating physician?

Contact your doctor if you experience:

  • nausea or vomiting even after taking anti-nausea medication
  • pain on the right side of your abdomen
  • bleeding or bruising more easily than normal
  • persistent loss of appetite or weight loss.

If you notice the following (very rare) side effects, you should immediately inform your doctor and stop the medication:

  • yellowing of your skin and/or the whites of your eyes
  • dark or brown-colored urine
  • bloody stools
  • a severe allergic reaction such as swelling of the face, lips, and/or tongue, breathing difficulties, or wheezing.

What can you do yourself in case of side effects?

Diarrhea

  • Do not take laxatives unless specifically advised by your doctor or nurse specialist.
  • Make sure you have loperamide (anti-diarrhea medication) available. Start taking it as soon as you get watery diarrhea.
  • Drink at least 1.5 to 2 liters of fluid per day to compensate for fluid loss.
  • Avoid coffee, alcohol, and carbonated drinks.
  • Avoid gas-forming foods such as leeks, onions, cabbage, and legumes.
  • Avoid highly spiced and fatty foods.
  • Fibers bind excess moisture in the stool. Eat light whole grain products, vegetables, and fruit. Coarse fibers stimulate the bowel extra and are therefore less suitable.

Nausea

  • Eat small meals more frequently throughout the day.
  • Avoid fatty and highly spiced foods.

What monitoring is needed when using nintedanib?

Sometimes liver or kidney function or blood cell production is disturbed. For this reason, your treating physician will regularly have your blood tested. Usually, this will be every 4 weeks for 3 months after starting the medication. If results are stable, blood tests can be reduced to once every 3 - 4 months.

When should you not use nintedanib?

You should not use nintedanib if you:

  • are allergic to soy and/or peanuts
  • have previously had an allergic reaction to nintedanib
  • have known severe liver or kidney problems
  • are pregnant.

Can you use nintedanib with other medications?

You can use nintedanib with almost all medications. Always inform your treating specialist about which medications you use and for what purpose.

What else should you know?

Alcohol

Be careful with alcohol. In combination with nintedanib, the risk of liver dysfunction is higher. Therefore, do not consume more than one alcoholic drink per day.

Vaccinations

We recommend that you get a flu shot and a coronavirus vaccination every year. Get the pneumococcal vaccination once every 5 years.

Travel

Take a medication passport with you when traveling abroad. This contains an up-to-date overview of your medications. You can request this from your own pharmacy.

Can I smoke while using nintedanib?

The advice is to stop smoking.

Do you need a new prescription?

Nintedanib may only be prescribed by a physician experienced with this medication. You can request a repeat prescription from your treating specialist (pulmonologist) during your outpatient visit. If you need a new prescription earlier, you can request it

  • via 'Mijn Dossier' and then 'Medicines'. Click on 'Request repeat prescriptions'
  • call the Pulmonary Diseases outpatient clinic to request a repeat prescription by phone.
    • Please do this at least 2 weeks before you need your new prescription. Otherwise, we cannot guarantee that your prescription will be sent to your pharmacy on time.

Do you have any questions?

If you have any questions or doubts, please contact the Pulmonary Diseases outpatient clinic using the contact details known to you.