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FDA Approves Nintedanib Capsules (nintedanib esylate) for Idiopathic Pulmonary Fibrosis and Progressive Fibrosing ILDs

FDA Approves Nintedanib Capsules (nintedanib esylate) for Idiopathic Pulmonary Fibrosis and Progress…
Photo by Cristine Enero / Unsplash
Key Takeaway
Consider nintedanib for adults with IPF or progressive fibrosing ILDs, with dose adjustment for mild hepatic impairment.

The FDA has approved nintedanib capsules, a kinase inhibitor, for two indications in adults: treatment of idiopathic pulmonary fibrosis (IPF) and treatment of chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype. This approval provides a treatment option for patients with these progressive, fibrotic lung conditions. The drug's efficacy in IPF was evaluated in three randomized, double-blind, placebo-controlled studies involving 1,231 patients, with the primary endpoint being the annual rate of decline in Forced Vital Capacity (FVC). The recommended dosage is 150 mg taken orally twice daily, approximately 12 hours apart, with food. Important pre-treatment requirements include liver function tests for all patients and a pregnancy test for females of reproductive potential. Dose adjustments are required for patients with mild hepatic impairment (Child Pugh A), and the drug is not recommended for patients with moderate or severe hepatic impairment.

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

Not reported in label.

Indication & Patient Population

Nintedanib Capsules is indicated for the treatment of adults with idiopathic pulmonary fibrosis (IPF). It is also indicated for the treatment of adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype.

Dosing & Administration

The recommended dosage is 150 mg taken orally twice daily, approximately 12 hours apart, taken with food. The capsules should be swallowed whole with liquid and not chewed, opened, or crushed. For patients with mild hepatic impairment (Child Pugh A), the recommended dosage is 100 mg orally twice daily. Treatment is not recommended for patients with moderate or severe hepatic impairment. Dose reduction to 100 mg twice daily, treatment interruption, or discontinuation should be considered for management of adverse reactions. Prior to treatment initiation, conduct liver function tests in all patients and a pregnancy test in females of reproductive potential. If a dose is missed, the next dose should be taken at the next scheduled time; do not make up for a missed dose. Do not exceed 300 mg daily.

Key Clinical Trial Data

The clinical efficacy of nintedanib capsules for IPF was studied in 1,231 patients in one phase 2 and two phase 3 studies. These were randomized, double-blind, placebo-controlled studies comparing nintedanib capsules 150 mg twice daily to placebo for 52 weeks. The primary endpoint was the annual rate of decline in Forced Vital Capacity (FVC). Time to first acute IPF exacerbation was a key secondary endpoint in the two phase 3 studies and a secondary endpoint in the phase 2 study. Trial data for the ILD indication is referenced but not detailed in the provided label text.

Warnings & Contraindications

Not reported in label.

Place in Therapy

Not reported in label.

Study Details

Study typeFda approval
PublishedApr 2026
View Original Abstract ↓
1 INDICATIONS AND USAGE Nintedanib Capsules is a kinase inhibitor indicated in adults for: Treatment of idiopathic pulmonary fibrosis (IPF) ( 1.1 ) Treatment of chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype ( 1.2 ) 1.1 Idiopathic Pulmonary Fibrosis Nintedanib Capsules is indicated for the treatment of adults with idiopathic pulmonary fibrosis (IPF). 1.2 Chronic Fibrosing Interstitial Lung Diseases with a Progressive Phenotype Nintedanib Capsules is indicated for the treatment of adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype [see Clinical Studies (14.2) ].
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