nintedanib esilate at a glance
Medicine class
Antifibrotic tyrosine kinase inhibitor
Main respiratory role
Slows further loss of lung function; it does not remove existing scarring or cure the underlying condition.
How it is taken
Take with food and swallow the soft capsule intact with water.
Key monitoring
Liver blood tests are required before and during treatment.
What is nintedanib esilate used for?
UK-licensed uses in adults represented by the selected product are:
Idiopathic pulmonary fibrosis.
Other chronic fibrosing interstitial lung diseases with a progressive phenotype.
Systemic sclerosis-associated interstitial lung disease.
With docetaxel, locally advanced, metastatic or locally recurrent non-small-cell lung cancer of adenocarcinoma histology after first-line chemotherapy.
How does nintedanib esilate work?
Nintedanib blocks several signalling enzymes, including VEGF, FGF and PDGF receptors. This reduces signalling that promotes fibroblast activity, tissue remodelling and new blood-vessel formation, helping slow lung fibrosis and tumour-supporting angiogenesis in its cancer indication.
nintedanib esilate preparations and strengths
Capsule
Route: Oral
Strengths: 25 mg, 100 mg, 150 mg
How to take nintedanib esilate
Follow the specialist's prescription and the leaflet supplied with the product.
Take with food.
Swallow the capsule whole with water; do not chew, crush or open it.
If swallowing is difficult, place the intact capsule on a small amount of cold or room-temperature soft food and swallow immediately without chewing.
Do not handle capsule contents. Wash exposed skin promptly with plenty of water if a capsule leaks or breaks.
nintedanib esilate side effects
Common or expected effects
- Diarrhoea
- Nausea or vomiting
- Abdominal pain
- Reduced appetite and weight loss
- Headache
- Raised liver enzymes
- Bleeding or bruising
- Rash; hair loss and mouth inflammation may also occur, particularly in the cancer setting
Get urgent medical advice
- Severe diarrhoea causing dehydration or electrolyte disturbance
- Drug-induced liver injury
- Serious bleeding
- Gastrointestinal perforation, ischaemic colitis or pancreatitis
- Heart attack or another arterial clotting event
- Kidney impairment, marked protein loss in urine or thrombotic microangiopathy
- Posterior reversible encephalopathy syndrome
- Severe infection or febrile neutropenia when combined with docetaxel
nintedanib esilate in pregnancy
Nintedanib may harm an unborn baby. Pregnancy is contraindicated when used for fibrosing lung disease and should generally be avoided in its cancer indication. Pregnancy testing and highly effective contraception are required where relevant; contact the specialist promptly if pregnancy occurs.
nintedanib esilate while breastfeeding
It is unknown whether nintedanib enters human milk, and harm to a breastfed child cannot be excluded. Breastfeeding should be stopped during treatment; discuss feeding options with the specialist team.
nintedanib esilate interactions
Ask a pharmacist or prescriber to check all prescribed, non-prescribed and herbal products. Important examples include:
Potent P-glycoprotein inhibitors, such as ketoconazole, erythromycin or ciclosporin
May increase nintedanib exposure and adverse effects, requiring closer tolerability monitoring.
Potent P-glycoprotein inducers, such as rifampicin, carbamazepine, phenytoin or St John's wort
May reduce nintedanib exposure; an alternative with little or no inducing effect should be considered.
Anticoagulants and other medicines that increase bleeding
Bleeding risk may be higher; clinical bleeding and relevant anticoagulation tests require monitoring.
Common questions about nintedanib esilate
Answers are fully visible for fast scanning and source review.
Can nintedanib cure pulmonary fibrosis?
No. It can slow further loss of lung function but does not remove existing lung scarring or cure the underlying condition.
Will nintedanib improve breathlessness straight away?
Not usually. Its role is to slow disease progression rather than provide rapid symptom relief, so a person may not feel an immediate difference.
Can capsules be opened or crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.