NINTEDANIB ZENTIVA 100 mg SOFT CAPSULES

2. What you need to know before you take Nintedanib Zentiva

Do not takeNintedanib Zentiva

• if you are allergic to nintedanib or any of the other ingredients of this medicine (listed in section 6),
• if you are pregnant.

Warnings and precautions

Talk to your doctor or pharmacist before taking Nintedanib Zentiva if:

• you have or have had liver problems,
• you have or have had kidney problems, or if you have been found to have an increased amount of protein in your urine,
• you have or have had bleeding problems,
• you are taking medicines to thin your blood (such as warfarin, phenprocoumon, or heparin) to prevent blood clots,
• you are taking pirfenidone, as this may increase the risk of you suffering from diarrhea, nausea, vomiting, and liver problems,
• you have or have had heart problems (such as a heart attack),
• you have recently undergone surgery. Nintedanib may affect the way wounds heal. Therefore, treatment with this medicine will usually be stopped for a while if you undergo surgery. Your doctor will decide when to restart treatment with this medicine.
• you have high blood pressure,
• you have abnormally high blood pressure in the blood vessels of the lungs (pulmonary hypertension),
• you have or have had an aneurysm (enlargement and weakening of the wall of a blood vessel) or a tear in the wall of a blood vessel.

Based on this information, your doctor may perform some blood tests, for example, to check your liver function. Your doctor will discuss the results of these tests with you to decide if you can take Nintedanib Zentiva.

Tell your doctor immediately while taking this medicine if:

• you have diarrhea. It is important to treat diarrhea early (see section 4);
• you have vomiting or feel like vomiting (nausea);
• you have symptoms without an apparent cause such as yellowing of the skin or the whites of the eyes (jaundice), dark or brown urine (the color of tea), pain in the upper right side of the stomach area (abdomen), bleeding or bruising more easily than normal, or feeling tired. These could be symptoms of serious liver problems;
• you have severe stomach pain, fever, chills, dizziness, vomiting, or stiffness or swelling of the abdomen, as these could be symptoms of having a hole in the wall of the intestines ("gastrointestinal perforation"). Also, tell your doctor if you have had stomach ulcers or diverticular disease in the past or if you are being treated with anti-inflammatory medicines (NSAIDs) (used to relieve pain and swelling) or steroids (used against inflammation and allergies), as this may increase the risk;
• you have a combination of severe or colicky stomach pain, blood in the stool, or diarrhea, as these could be symptoms of intestinal inflammation due to insufficient blood supply;
• you have pain, swelling, redness, or warmth in a limb, as these could be symptoms of having a blood clot in one of your veins (a type of blood vessel);
• you have pressure or pain in the chest, usually on the left side of the body, pain in the neck, jaw, shoulder, or arm, rapid heartbeat, difficulty breathing, nausea, or vomiting, as these could be symptoms of a heart attack;
• you have a significant bleeding.
• you experience bruising, bleeding, fever, fatigue, and confusion, as these may be a sign of a blood vessel injury known as thrombotic microangiopathy (TMA);
• if you experience symptoms such as headache, changes in vision, confusion, seizures, or other neurological disorders such as weakness in an arm or leg, with or without high blood pressure, which could be symptoms of a brain disorder called posterior reversible encephalopathy syndrome (PRES).

Children and adolescents

Nintedanib Zentiva should not be taken by children and adolescents under 18 years of age.

Other medicines and Nintedanib Zentiva

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Nintedanib Zentiva may interact with other medicines. The following medicines may increase the levels of nintedanib in the blood and, therefore, increase the risk of side effects (see section 4):

• a medicine used to treat fungal infections (ketoconazole)
• a medicine used to treat bacterial infections (erythromycin)
• a medicine that affects your immune system (cyclosporine)

The following medicines are examples that may decrease the levels of nintedanib in the blood and, thus, reduce the effectiveness of Nintedanib Zentiva:

• an antibiotic used to treat tuberculosis (rifampicin)
• medicines used to treat seizures (carbamazepine, phenytoin)
• a herbal medicine used to treat depression (St. John's Wort)

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Pregnancy

Do not take this medicine during pregnancy, as it may harm the fetus and cause birth defects.

A pregnancy test should be performed to ensure you are not pregnant before starting treatment with this medicine. Talk to your doctor.

Contraception

• Women who may become pregnant must use a highly effective method of contraception to avoid pregnancy when starting to take Nintedanib Zentiva, while taking Nintedanib Zentiva, and for at least 3 months after stopping treatment.
• Talk to your doctor about the most suitable contraceptive methods for you.
• Vomiting and/or diarrhea or other gastrointestinal disorders may affect the absorption of hormonal oral contraceptives, such as birth control pills, and may reduce their effectiveness.

Therefore, if you experience any of these situations, talk to your doctor to assess an alternative contraceptive method that is more suitable for you.

• Tell your doctor or pharmacist immediately if you become pregnant or think you may be pregnant during treatment with this medicine.

Breastfeeding

Do not breastfeed while taking this medicine, as it may harm the baby.

Driving and using machines

This medicine has a minor influence on the ability to drive and use machines. Do not drive or use machines if you feel dizzy.

3. How to take Nintedanib Zentiva

Always take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, check with your doctor or pharmacist.

Take the capsules twice a day, approximately 12 hours apart, and at about the same time each day; for example, one capsule in the morning and one capsule in the evening. This will help keep a constant level of nintedanib in your blood. Swallow the capsules whole with water, without chewing them. It is recommended that you take the capsules with food, for example, during meals or immediately before or after meals. Do not open or break the capsule (see section 5).

Adults

The recommended dose is one 100 mg capsule twice a day (a total of 200 mg per day).

Do not take more than the recommended dose of two Nintedanib Zentiva 100 mg capsules per day.

If you do not tolerate the recommended dose of two Nintedanib Zentiva 100 mg capsules per day (see possible side effects in section 4), your doctor may recommend that you stop taking this medicine. Do not reduce the dose or stop treatment by yourself without consulting your doctor first.

If you take moreNintedanib Zentivathan you should

Contact your doctor or pharmacist immediately.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount taken.

If you forget to takeNintedanib Zentiva

Do not take two capsules together if you have missed your previous dose. You should take your next dose of 100 mg of Nintedanib Zentiva according to the schedule established and recommended by your doctor or pharmacist.

If you stop taking Nintedanib Zentiva

Do not stop taking Nintedanib Zentiva without talking to your doctor first. It is important to take this medicine every day while your doctor prescribes it.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

You should pay special attention if you experience the following side effects during treatment with Nintedanib Zentiva:

Diarrhea(very common, may affect more than 1 in 10 people):

Diarrhea can cause dehydration: a loss of fluids and important salts (electrolytes, such as sodium or potassium) from the body. At the first symptoms of diarrhea, drink plenty of fluids and consult your doctor immediately. Start appropriate antidiarrheal treatment as soon as possible, for example, by taking loperamide.

The following side effects have also been observed during treatment with nintedanib (the active substance of this medicine).

Talk to your doctor if you experience any type of side effect

Idiopathic pulmonary fibrosis (IPF)

Very common side effects(may affect more than 1 in 10 people)

• Feeling sick (nausea)
• Stomach pain (abdominal pain)
• Abnormal liver test results

Common side effects(may affect up to 1 in 10 people)

• Vomiting
• Lack of appetite
• Weight loss
• Bleeding
• Rash
• Headache

Uncommon side effects(may affect up to 1 in 100 people)

• Pancreatitis
• Inflammation of the large intestine
• Low platelet count (thrombocytopenia)
• High blood pressure (hypertension)
• Yellowing of the skin or the whites of the eyes (jaundice)
• Itching
• Heart attack
• Hair loss (alopecia)
• Increased amount of protein in the urine (proteinuria)

Frequency not known(cannot be estimated from the available data)

• Kidney failure
• Enlargement and weakening of the wall of a blood vessel or tear in the wall of a blood vessel (aneurysms and arterial dissections)
• Brain disorder with symptoms such as headache, changes in vision, confusion, seizures, or other neurological disorders such as weakness in an arm or leg, with or without high blood pressure (posterior reversible encephalopathy syndrome)

Other chronic fibrosing interstitial lung diseases (ILD) with a progressive phenotype

Very common side effects(may affect more than 1 in 10 people)

• Feeling sick (nausea)
• Vomiting
• Lack of appetite
• Stomach pain (abdominal pain)
• Abnormal liver test results

Common side effects(may affect up to 1 in 10 people)

• Weight loss
• High blood pressure (hypertension)
• Bleeding
• Severe liver problems
• Rash
• Headache

Uncommon side effects(may affect up to 1 in 100 people)

• Pancreatitis
• Inflammation of the large intestine
• Low platelet count (thrombocytopenia)
• Yellowing of the skin or the whites of the eyes (jaundice)
• Itching
• Heart attack
• Hair loss (alopecia)
• Increased amount of protein in the urine (proteinuria)

Frequency not known(cannot be estimated from the available data)

• Kidney failure
• Enlargement and weakening of the wall of a blood vessel or tear in the wall of a blood vessel (aneurysms and arterial dissections)
• Brain disorder with symptoms such as headache, changes in vision, confusion, seizures, or other neurological disorders such as weakness in an arm or leg, with or without high blood pressure (posterior reversible encephalopathy syndrome)

Interstitial lung disease associated with systemic sclerosis (SSc-ILD)

Very common side effects(may affect more than 1 in 10 people)

• Feeling sick (nausea)
• Vomiting
• Stomach pain (abdominal pain)
• Abnormal liver test results

Common side effects(may affect up to 1 in 10 people)

• Bleeding
• High blood pressure (hypertension)
• Lack of appetite
• Weight loss
• Headache

Uncommon side effects(may affect up to 1 in 100 people)

• Inflammation of the large intestine
• Severe liver problems
• Kidney failure
• Low platelet count (thrombocytopenia)
• Rash
• Itching

Frequency not known(cannot be estimated from the available data)

• Heart attack
• Pancreatitis
• Yellowing of the skin or the whites of the eyes (jaundice)
• Enlargement and weakening of the wall of a blood vessel or tear in the wall of a blood vessel (aneurysms and arterial dissections)
• Hair loss (alopecia)
• Increased amount of protein in the urine (proteinuria)
• Brain disorder with symptoms such as headache, changes in vision, confusion, seizures, or other neurological disorders such as weakness in an arm or leg, with or without high blood pressure (posterior reversible encephalopathy syndrome)

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly to the Spanish Medicines Agency's Pharmacovigilance System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Nintedanib Zentiva

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after CAD. The expiry date is the last day of the month indicated.

This medicine does not require any special storage conditions.

Do not use this medicine if you notice that the blister containing the capsules is open or that a capsule is broken.

If you come into contact with the contents of the capsule, wash your hands immediately with plenty of water (see section 3).

Medicines should not be disposed of via wastewater or household waste. Dispose of the packaging and any unused medicine in the SIGRE collection point at your pharmacy. If you are unsure, ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Package contents and additional information

Composition ofNintedanib Zentiva

• The active substance is nintedanib. Each capsule contains 100 mg of nintedanib (as esilate).
• The other ingredients are:
• • Capsule content: medium-chain triglycerides, hard fat, and triglycerol dioleate.
  • Capsule shell: gelatin, glycerol, titanium dioxide (E 171), red iron oxide (E 172), and yellow iron oxide (E 172), purified water.
  • Printing ink: shellac, carmine acid (E 120), propylene glycol (E 1520), and simethicone.

Appearance of the product and package contents

Nintedanib Zentiva 100 mg are soft, oblong, opaque, peach-colored capsules containing a viscous yellow suspension, printed with “NT 100” in red ink and approximately 16 mm in length.

The soft capsules of Nintedanib Zentiva 100 mg are available in cardboard boxes with perforated aluminum OPA/Al/PVC unit-dose blisters.

Package sizes:

30 soft capsules

60 soft capsules

Not all pack sizes may be marketed.

Marketing authorization holder

Zentiva, k.s.

U Kabelovny 130

Dolní Mecholupy

102 37 Prague 10

Czech Republic

Manufacturer

Pharmadox Healthcare Limited

KW20A Kordin Industrial Park

Paola PLA 3000

Malta

Or

Qualimetrix S.A.

579 Mesogeion Avenue,

Agia Paraskevi, Athens, 15343,

Greece

Or

Adalvo Limited

Malta Life Sciences Park, Building 1, Level 4,

Sir Temi Zammit Buildings

San Gwann Industrial Estate, SGN 3000,

Malta

You can request more information about this medicine by contacting the local representative of the marketing authorization holder:

Zentiva Spain S.L.U.

Avenida de Europa, 19, Edificio 3, Planta 1.

28224 Pozuelo de Alarcón, Madrid

Spain

This medicine is authorized in the Member States of the European Economic Area under the following names:

Date of the last revision of this leaflet: January 2025

Detailed information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/