NINTEDANIB TEVA 100 mg SOFT CAPSULES

Introduction

Package Leaflet: Information for the Patient

Nintedanib Teva 100 mg Soft Capsules EFG

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.

• This medicine has been prescribed for you only, and you should not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist, even if you think they might be unrelated to the medicine. See section 4.

Contents of the pack

1. What is Nintedanib Teva and what is it used for
2. What you need to know before you take Nintedanib Teva
3. How to take Nintedanib Teva
4. Possible side effects
5. Storage of Nintedanib Teva
6. Contents of the pack and other information

1. What is Nintedanib Teva and what is it used for

Nintedanib Teva contains the active substance nintedanib, a medicine that belongs to the class of tyrosine kinase inhibitors, and is used to treat idiopathic pulmonary fibrosis (IPF), other chronic fibrosing interstitial lung diseases (ILD) with a progressive phenotype, and systemic sclerosis-associated interstitial lung disease (SSc-ILD) in adults.

Idiopathic Pulmonary Fibrosis (IPF)

IPF is a disease that causes thickening, hardening, and scarring of the lung tissue over time. As a result, scarring reduces the ability to transfer oxygen from the lungs to the bloodstream, making it difficult to breathe deeply. Nintedanib helps reduce the development of further scarring and hardening of the lungs.

Other Chronic Fibrosing Interstitial Lung Diseases (ILD) with a Progressive Phenotype

In addition to IPF, there are other disorders in which the lung tissue becomes thickened, hardened, and scarred over time (pulmonary fibrosis) and continues to worsen (progressive phenotype). Some examples of these disorders include hypersensitivity pneumonitis, autoimmune ILD (such as ILD associated with rheumatoid arthritis), idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILD. Nintedanib reduces the development of new scarring and hardening of the lungs.

Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)

Systemic sclerosis (SSc), also known as scleroderma, is a rare chronic autoimmune disease that affects the connective tissue in many parts of the body. SSc causes fibrosis (scarring and hardening) of the skin and other internal organs, such as the lungs. When the lungs are affected by fibrosis, it is called interstitial lung disease (ILD), and thus the disease is called SSc-ILD. Fibrosis in the lungs reduces the ability to transfer oxygen to the bloodstream and reduces the ability to breathe. Nintedanib reduces the development of new scarring and hardening of the lungs.

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

Do not take Nintedanib Teva

• 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

Consult your doctor or pharmacist before starting treatment with Nintedanib Teva:

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

Tell your doctor immediately while taking this medicine

• if you have diarrhea. It is important to treat diarrhea early (see section 4);
• if you have vomiting or feel like vomiting (nausea);
• if 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;
• if you have severe stomach pain, fever, chills, dizziness, vomiting, or abdominal stiffness or swelling, as these could be symptoms of 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 these may increase this risk;
• if 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;
• if you have pain, swelling, redness, or warmth in a limb, as these could be symptoms of a blood clot in one of your veins (a type of blood vessel);
• if 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;
• if you have a significant bleeding;
• if 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

Children and adolescents under 18 years should not take Nintedanib Teva.

Other medicines and Nintedanib Teva

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including herbal medicines and medicines obtained without a prescription.

Nintedanib 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:

• 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 Nintedanib Teva. Consult your doctor.

Contraception

• Women who may become pregnant must use a highly effective method of contraception to prevent pregnancy when starting to take Nintedanib Teva, while taking Nintedanib Teva, and for at least 3 months after stopping treatment.
• Consult 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, consult your doctor to assess an alternative contraceptive method more suitable for you.
• Tell your doctor or pharmacist immediately if you become pregnant or think you may be pregnant during treatment with nintedanib.

Breastfeeding

Do not breastfeed your baby during treatment with Nintedanib Teva, as it may harm the baby.

Driving and using machines

Nintedanib Teva 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 Teva

Follow the instructions for administration of this medicine exactly as told by your doctor or pharmacist. If you are unsure, consult your doctor or pharmacist again.

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 ensure that you maintain 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, i.e., 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 Teva 100 mg capsules per day.

If you do not tolerate the recommended dose of two nintedanib 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 more Nintedanib Teva than 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 take Nintedanib Teva

Do not take two capsules together if you have missed your previous dose. You should take your next dose of nintedanib according to the schedule established by your doctor or pharmacist.

If you stop taking Nintedanib Teva

Do not stop taking nintedanib without consulting 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 Teva:

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 this medicine.

Consult 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 like vomiting (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
• Severe liver problems
• Low platelet count (thrombocytopenia)
• High blood pressure (hypertension)
• Yellowing of the skin and the whites of the eyes due to high bilirubin levels (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 like vomiting (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 and the whites of the eyes due to high bilirubin levels (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)

Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)

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

• Feeling like vomiting (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 and the whites of the eyes due to high bilirubin levels (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, pharmacist, or nurse, even if you think they might be unrelated to the medicine. You can also report side effects directly through the Spanish Medicines Monitoring 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 Teva

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 and on the blister after EXP. The expiry date is the last day of the month stated.

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.

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 Teva 100 mg soft capsules EFG

• The active substance is nintedanib. Each capsule contains 100 mg of nintedanib (as esilate).
• The other ingredients are:
  • Capsule content: medium-chain triglycerides, semi-synthetic solid glycerides, and dioleoyl triglycerol)
  • Capsule shell: gelatin, glycerol, titanium dioxide (E171), red iron oxide (E172), yellow iron oxide (E172), and purified water.
  • Printing ink: shellac, carminic acid (E 120), propylene glycol (E 1520), and simethicone.

Appearance of the product and package contents

Nintedanib Teva 100 mg capsules are soft gelatin capsules, oblong, opaque, and peach-colored, containing a viscous yellow suspension, engraved on one side in red "NT 100" and approximately 16 mm in length.

Nintedanib Teva 100 mg soft capsules are available in cardboard boxes with perforated single-dose OPA/Al/PVC-Aluminum blisters of 30 and 60 soft capsules.

Only certain pack sizes may be marketed.

Marketing authorization holder and manufacturer

Holder

Teva Pharma, S.L.U.

Anabel Segura, 11, Edificio Albatros B 1ª planta

Alcobendas 28108, Madrid

Spain

Manufacturer

Pharmadox Healthcare Limited

KW20A Kordin Industrial Park

Paola PLA 3000

Malta

Adalvo Limited

Malta Life Sciences Park Building 1 Level 4

Sir Temi Zammit Buildings

San Gwann Industrial Estate, SGN 3000

Malta

Teva Operations Poland Sp. z.o.o.

Ul. Mogilska 80

31-546 Cracow

Poland

QUALIMETRIX S.A.

579 MESOGEION AVENUE AGIA PARASKEVI,

Athens, 15343, Greece

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

Austria Nintedanib ratiopharm 100 mg – soft capsules

Belgium Nintedanib Teva 100 mg soft capsules/capsules molles/Weichkapseln

Czech Republic Nintedanib Teva

Germany Nintedanib-ratiopharm 100 mg soft capsules

Denmark Nintedanib Teva

Estonia Nintedanib Teva

Greece Nintedanib/Teva

Spain Nintedanib Teva 100 mg soft capsules EFG

Finland Nintedanib ratiopharm 100 mg capsule, soft

France NINTEDANIB TEVA 100mg, soft capsule

Croatia Nintedanib Teva 100 mg, 150 mg soft capsules

Iceland Nintedanib Teva

Italy Nintedanib Teva

Lithuania Nintedanib Teva 100 mg soft capsules

Latvia Nintedanib Teva 100 mg soft capsules

Luxembourg Nintedanib Teva 100 mg soft capsules

Netherlands Nintedanib Teva 100 mg, soft capsules

Norway Nintedanib Teva

Poland Nintedanib Teva

Portugal Nintedanib Zidrium

Romania Nintedanib Teva 100 mg, 150 mg soft capsules

Sweden Nintedanib Teva

Slovakia Nintedanib Teva 100 mg soft capsules

Date of last revision of this leaflet: March 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/)

You can access detailed and up-to-date information about this medicine by scanning the QR code included in the packaging with your mobile phone (smartphone). You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/89430/P_89430.html

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