Nintedanib interactions

Food & lifestyle

• food

  Moderate

  Absorption

  Food enhances the oral bioavailability of nintedanib. After food intake, nintedanib exposure increased by approximately 20% compared to administration under fasted conditions. Absorption was also delayed, as indicated by an increase in the median time to reach maximum plasma concentration (Tmax) from 2 hours in the fasted state to approximately 4 hours under fed conditions, irrespective of the type of food ingested.

  What to do: Nintedanib should be administered with food.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):

Conditions

Conditions in which Nintedanib needs care, as documented in this source.

• Hemorrhage

  Moderate

  Nintedanib may increase the risk of bleeding. Nintedanib should only be used in patients with known risk of bleeding if the anticipated benefit outweighs the potential risk. Close monitoring is recommended.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):

• Hepatic Insufficiency

  Moderate

  The use of nintedanib is associated with elevations of liver enzymes. Treatment with nintedanib is not recommended in patients with moderate or severe hepatic impairment. Patients with mild hepatic impairment can be treated with a reduced dose of nintedanib. It is recommended to conduct liver function tests prior to treatment with nintedanib and periodically thereafter as clinically indicated. Dosage modifications or interruption may be necessary for liver enzyme elevations as clinically indicated and according to medical practices.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):

• Kidney Diseases

  Moderate

  Based on a population pharmacokinetics analysis of nintedanib, exposure to nintedanib is not influenced by mild or moderate renal impairment. No dose adjustment is required in patients with mild to moderate renal impairment. Care and close monitoring is recommended when using this agent in patients with severe renal impairment and end-stage renal disease as the safety, efficacy, and, pharmacokinetics of nintedanib have not been studied these patients.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):

• Lung Diseases

  Moderate

  The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.

  7 sources

  1. "Product Information. Vandetanib (vandetanib)." Astra-Zeneca Pharmaceuticals (2011):
  2. "Product Information. Zelboraf (vemurafenib)." Genentech (2011):
  3. "Product Information. Xalkori (crizotinib)." Pfizer U.S. Pharmaceuticals Group (2011):
  4. "Product Information. Mekinist (trametinib)." GlaxoSmithKline (2013):
  5. "Product Information. Zykadia (ceritinib)." Novartis Pharmaceuticals (2014):
  6. "Product Information. Zydelig (idelalisib)." Gilead Sciences (2014):
  7. "Product Information. Alecensa (alectinib)." Genentech (2015):

• Peptic Ulcer Perforation

  Moderate

  Nintedanib may increase the risk of gastrointestinal perforation. Use caution when treating patients who have had recent abdominal surgery. It is recommended to discontinue therapy with nintedanib in patients who develop gastrointestinal perforation. Nintedanib should only be used in patients with known risk of gastrointestinal perforation if the anticipated benefit outweighs the potential risk. Care and close monitoring is recommended.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):

• Thromboembolism

  Moderate

  Arterial thromboembolic events, including myocardial infarction have been reported in patients taking nintedanib. It is recommended to exercise caution when treating patients at higher cardiovascular risk, including known coronary artery disease and to consider treatment interruption in patients who develop signs or symptoms of acute myocardial ischemia.

  1 source

  1. "Product Information. Ofev (nintedanib)." Boehringer Ingelheim (2014):