Why does Ofev cause diarrhea?
Experts are not sure exactly why Ofev causes diarrhea but research has suggested that it may be due to receptor inhibition (Ofev is a triple receptor [PDGFR, VEGFR, or FGFR] tyrosine kinase inhibitor) or via a direct inflammatory action on intestinal mucosa by Ofev or its breakdown products.
The BRAT diet (bananas, rice [white], applesauce, and toast) has been shown to help the symptoms of diarrhea. Foods that are likely to exacerbate diarrhea should be avoided, including:
- Alcohol or caffeine
- Brassicas, such as broccoli, cauliflower, brussels sprouts, cabbage, collards, or Bok choy
- Fried or greasy foods, such as French fries, burgers, and fried chicken
- High-fiber foods, such as beans, lentils, nuts, or whole grains
- Milk or milk products
- Spicy foods, such as chili
- Sugar-free candy made with alcohols such as xylitol.
Diarrhea is a common side effect of Ofev reported in up to 76% of trial participants. It is usually mild to moderate in intensity and most likely to occur in the first 3 months of treatment. People who develop diarrhea with Ofev should also keep adequately hydrated and consider dose reduction or treatment interruption if diarrhea continues. Trials report that diarrhea caused by Ofev resulted in a permanent dose reduction in up to 22% of patients with approximately 7% choosing to discontinue Ofev.
References
- Tips to Help Treat Diarrhea, Nausea, and Vomiting Side Effects. AID. Ofev Side Effects. https://www.ofevhcp.com/assets/pdf/diarrhea-nasuea-vomiting-management.pdf
- Ofev (nintedanib) Updated 11/2022. Boehringer Ingelheim Pharmaceuticals, Inc. https://www.drugs.com/pro/ofev.html
- Ofev (nintedanib) 150mg capsules Working with your Healthcare Team. https://www.ofev.com/healthcare-team
- Kato, M., Sasaki, S., Nakamura, T. et al. Gastrointestinal adverse effects of nintedanib and the associated risk factors in patients with idiopathic pulmonary fibrosis. Sci Rep 9, 12062 (2019). https://doi.org/10.1038/s41598-019-48593-4
Read next
What food should I avoid while taking Ofev?
If you experience side effects from Ofev such as diarrhea, nausea, and vomiting it may help to avoid the following foods and drinks:
- Alcohol or caffeine
- Brassicas, such as broccoli, cauliflower, brussels sprouts, cabbage, collards, or Bok choy
- Fried or greasy foods, such as French fries, burgers, and fried chicken
- High-fiber foods, such as beans, lentils, or whole grains
- Milk or milk products
- Spicy foods, such as chili
- Sugar-free candy made with alcohols such as xylitol.
How long does it take for Ofev to start working?
It takes 6 to 12 weeks for Ofev to start working, which has been measured in clinical trials of people with interstitial lung disease as less of a change in lung capacity (as measured by an FVC or Forced Vital Capacity) after at least 6 weeks in those prescribed Ofev. Continue reading
Can Ofev and Esbriet be given together?
There has been one phase 4 trial that has investigated the combination of Ofev (nintedanib) and Esbriet (pirfenidone) for idiopathic pulmonary fibrosis (IPF) that showed a slightly increased risk of side effects with combination treatment, but the trial was not large enough to make a solid conclusion about increased/decreased effectiveness. Both Ofev and Esbriet slow IPF’s worsening but do not stop its progression, and neither medication is recommended over the other. Because they work on different aspects of the fibrotic cascade, there has been some suggestion that there may be some benefit in combining them. Continue reading
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Drug information
- Ofev Information for Consumers
- Ofev prescribing info & package insert (for Health Professionals)
- Side Effects of Ofev (detailed)
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