Ofev (nintedanib) is a prescription drug that’s used to treat certain inflammatory lung conditions. This drug can interact with other medications and some supplements. For example, Ofev can interact with certain antibiotics and corticosteroids, such as prednisone (Rayos).
Ofev is prescribed for adults to:
- treat chronic (long-term) interstitial lung disease with worsening fibrosis (scar formation)
- treat idiopathic pulmonary fibrosis
- slow down worsening of systemic sclerosis-associated interstitial lung disease (SSc-ILD)
Ofev contains the active ingredient nintedanib. It comes as an oral capsule.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ofev’s possible interactions. And for more information about Ofev, including its uses, see this article.
Before you start taking Ofev, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Ofev interacts with herbs or vitamins and supplements, see the “Are there other interactions with Ofev?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Ofev. Keep in mind that this table does not include all drugs that may interact with Ofev. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| certain antibiotics | • clarithromycin • rifampin (Rimactane) | can increase the risk of side effects from Ofev or make Ofev less effective, depending on the antibiotic |
| corticosteroids | • prednisone (Rayos) • dexamethasone (Hemady) | can increase the risk of gastrointestinal perforation as a side effect of Ofev and the corticosteroid |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • aspirin • ibuprofen (Advil) | can increase the risk of gastrointestinal perforation as a side effect of Ofev and the NSAID |
| certain antifungals | • ketoconazole • itraconazole (Sporanox, Tolsura) | can increase the risk of side effects from Ofev |
| certain antiepileptic drugs | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) | can make Ofev less effective |
| anticoagulants | • warfarin (Jantoven) • apixaban (Eliquis) | can increase the risk of bleeding as a side effect of anticoagulants |
| medications containing cobicistat | • cobicistat (Tybost) • cobicistat/elvitegravir/ emtricitabine/tenofovir alafenamide fumarate (Genvoya) • cobicistat/elvitegravir/ emtricitabine/tenofovir disoproxil fumarate (Stribild) | can increase the risk of side effects from Ofev |
| medications containing ritonavir | • nirmatrelvir/ritonavir (Paxlovid) • lopinavir/ritonavir (Kaletra) | can increase the risk of side effects from Ofev |
| certain antiandrogens | • apalutamide (Erleada) • enzalutamide (Xtandi) | can make Ofev less effective |
Ofev is not known to interact with alcohol. But Ofev and alcohol can cause some similar side effects, such as diarrhea, nausea, and headache. If you drink alcohol, you may be more likely to experience these side effects if you drink it during your Ofev treatment.
If you have questions about consuming alcohol while taking Ofev, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Ofev.
Interaction with certain antibiotics
Ofev can interact with certain antibiotics used to treat infections caused by bacteria.
Examples of antibiotic medications that interact with Ofev include:
- clarithromycin
- erythromycin (Eryc, others)
- rifampin (Rimactane)
What could happen
Taking Ofev with clarithromycin or erythromycin can increase the amount of Ofev in your system. This occurs because these antibiotics reduce the activity of certain enzymes and proteins that help remove Ofev from your body. This raises your risk of side effects from Ofev.
However, rifampin can lower the amount of Ofev in your system. Rifampin can increase the activity of certain enzymes that help remove Ofev from your body. This can make Ofev less effective at treating your condition.
What you can do
If you take Ofev, your doctor may prescribe antibiotics besides clarithromycin or erythromycin. If you must take either antibiotic, your doctor will monitor you closely for side effects from Ofev. If you need to take clarithromycin or erythromycin long term, your doctor may prescribe a lower Ofev dosage.
Your doctor will likely avoid prescribing rifampin together with Ofev due to this interaction. They can discuss alternatives to rifampin with you instead. Or they may discuss alternatives to Ofev for treating your lung condition.
If you have questions about antibiotics that interact with Ofev and how they may affect you, talk with your doctor or pharmacist.
Interaction with corticosteroids
Ofev can interact with corticosteroids, which are used to treat numerous conditions related to inflammation.
Examples of corticosteroid medications:
- prednisone (Rayos)
- dexamethasone (Hemady)
- budesonide (Uceris, others)
What could happen
Based on how Ofev works, the drug can cause gastrointestinal perforation (holes in your digestive tract) as a side effect. While this wasn’t reported in the drug’s studies, it has happened since Ofev was approved for use. Taking a corticosteroid together with Ofev increases your risk of this side effect.
What you can do
If you’re taking Ofev, your doctor may try to avoid prescribing corticosteroids to prevent this interaction.
If this interaction cannot be avoided, your doctor will monitor you closely for symptoms of gastrointestinal perforations during treatment. Symptoms to watch for include severe stomach pain, nausea and vomiting, and passing less gas or stool than usual.
Immediately contact your doctor if you think you’re having symptoms of this side effect. If your symptoms feel severe, call 911 or go to an emergency room or urgent treatment center.
Ofev may have other interactions. They could occur with supplements, foods, vaccines, or lab tests. See below for details. Note that the information below does not include all possible interactions with Ofev.
Does Ofev interact with supplements?
Before you start taking Ofev, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ofev interactions with herbs
Ofev can interact with St. John’s wort, which some people may take to manage symptoms of depression and other conditions. Taking this herb with Ofev can make Ofev less effective. Your doctor will likely suggest you do not take Ofev and St. John’s wort together due to this interaction.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products during your treatment with Ofev.
Ofev interactions with vitamins
There are currently no reports of Ofev interacting with vitamins, but this doesn’t mean vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Ofev.
Does Ofev interact with food?
Grapefruit and grapefruit juice can interact with Ofev. Consuming grapefruit or grapefruit juice can increase the amount of Ofev in your system and raise your risk of side effects caused by the drug.
If you have questions about foods to avoid while taking Ofev, talk with your doctor.
Does Ofev interact with vaccines?
There are currently no reports of Ofev interacting with vaccines. If you have questions about getting certain vaccines during your Ofev treatment, talk with your doctor.
Does Ofev interact with lab tests?
There are currently no reports of Ofev interacting with lab tests. If you have questions about having certain lab tests during your treatment with Ofev, talk with the healthcare professional ordering the test.
Does Ofev interact with cannabis or CBD?There are currently no reports of Ofev interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Ofev.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ofev. Before taking Ofev, talk with your doctor about your health history. They’ll determine whether Ofev is right for you.
Health conditions or other factors that might interact with Ofev include:
Bleeding condition: Treatment with Ofev may increase the risk of bleeding. If you have a bleeding condition such as hemophilia, you may be at higher risk of developing a bleed from taking Ofev. Your doctor can provide more information on your risk of bleeding if you take Ofev based on your condition.
Blood clots in the past: In rare cases, Ofev can cause blood clots as a side effect. If you’ve had a blood clot in the past, you may be at higher risk of this effect if you take Ofev. Talk with your doctor to learn more about your risks and whether other treatments for your condition are safer options.
Heart condition: In rare cases, blood clots can occur as a side effect of Ofev. If you have certain heart conditions, such as coronary artery disease, you may be at higher risk if you take Ofev. Your doctor can provide more information on whether Ofev is safe to take with your heart condition.
Liver condition: Having a liver condition, such as cirrhosis, can cause an increased level of Ofev in your system. This can raise your risk of side effects caused by the medication. In addition, Ofev can cause liver-related side effects. If you have an existing liver condition, taking Ofev could worsen your condition. If you have a mild liver condition, your doctor will likely prescribe a lower Ofev dosage. But if your liver condition is moderate or severe, they likely won’t prescribe Ofev.
Recent abdominal surgery: In rare cases, Ofev can cause gastrointestinal perforation ((holes in your digestive tract) as a side effect. If you’ve recently had abdominal surgery, you may be at higher risk of this side effect. Talk with your doctor to learn more about whether Ofev is safe for you to take if you’ve recently had abdominal surgery.
Smoking: Cigarette smoking can lower the amount of Ofev in your system. This can make the drug less effective. If you smoke cigarettes, talk with your doctor about ways to quit smoking before you start treatment with Ofev. Or your doctor can recommend treatments besides Ofev. But if you smoke cigarettes, you are advised not to smoke while taking Ofev.
Pregnancy: It’s not known whether Ofev is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Ofev.
Breastfeeding: Breastfeeding while taking Ofev is not recommended. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Ofev or any of its ingredients, your doctor will likely not prescribe Ofev. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.
Taking certain steps can help you avoid interactions with Ofev. Before starting treatment, talk with your doctor and pharmacist. Things to discuss include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Ofev treatment
It’s also important to understand Ofev’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Ofev exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.