If you have a certain kind of lung disease, your doctor might suggest Ofev as a treatment option for you.

Ofev is a prescription medication that’s used long term to treat the following conditions in adults:

The active ingredient in Ofev is nintedanib. (An active ingredient is what makes a drug work.) Ofev comes as capsules that you swallow.

For more information about Ofev, including details about its uses, see this in-depth article on the drug.

Like other drugs, Ofev can cause mild to serious side effects. Keep reading to learn more.

Some people may experience mild to serious side effects from taking Ofev. Examples of Ofev’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Keep in mind this list doesn’t include all side effects Ofev may cause. The “mild side effects” and “serious side effects” below contain information about additional side effects of Ofev.

Like most medications, Ofev can cause side effects. Examples of mild side effects that have been reported with Ofev include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop using Ofev unless your doctor recommends it.

Ofev may cause mild side effects other than the ones listed above. See the Ofev prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Ofev, visit MedWatch.

Serious side effects can occur with Ofev treatment, but they aren’t common.

Serious side effects that have been reported with Ofev include:

If you develop serious side effects while taking Ofev, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Ofev. But this side effect wasn’t reported in studies.

Get answers to some frequently asked questions about Ofev’s side effects.

Do Ofev’s side effects vary depending on the capsule strength (100 mg or 150 mg)?

Possibly. But in studies of the drug, researchers didn’t compare side effects of the two strengths.

The recommended dosage of Ofev for most adults is 150 milligrams (mg) taken twice daily. If you develop side effects with this dosage, your doctor may reduce your dosage to 100 mg per day. If your symptoms don’t get better, they may have you pause or stop your Ofev treatment. Remember, you should not change your dosage or stop taking Ofev unless your doctor recommends it.

If you have questions about the side effects that you may experience with your current dosage, talk with your doctor or pharmacist.

How do the side effects of Ofev and Esbriet compare?

Both Ofev and Esbriet (pirfenidone) are used to treat idiopathic pulmonary fibrosis (scarring in the lungs with no known cause) in adults.

These drugs share certain mild side effects, including nausea, diarrhea, and decreased appetite. They can also cause some similar serious side effects, such as liver damage. But some of their side effects vary.

Doctors sometimes prescribe Ofev along with Esbriet to treat idiopathic pulmonary fibrosis. In a study of people taking these drugs together, the side effects were similar to those seen when either drug is taken alone. More common side effects in this study included diarrhea, nausea, and vomiting.

To learn more about the side effects of Ofev and Esbriet, talk with your pharmacist or doctor.

Are there foods that raise my risk of side effects from Ofev?

It’s possible. Although there aren’t foods known to interact with Ofev, the drug can cause digestive side effects. These may include diarrhea, nausea and vomiting, and belly pain. Foods that also cause these symptoms may raise your risk of digestive side effects with Ofev.

For example, spicy or greasy foods may cause digestive side effects in some people. If this applies to you, then eating these foods while taking Ofev may raise your risk of digestive side effects.

If you’re concerned about your diet raising your risk of digestive side effects from Ofev, talk with your doctor. They may be able to help identify foods that are triggers for you.

Learn more about some of the side effects Ofev may cause.

Hair loss

Some people may experience hair loss from Ofev. But in studies, hair loss was one of the more rare side effects reported in people taking Ofev.

In rare cases, Ofev can also cause low thyroid levels, which can cause hair loss.

What might help

Talk with your doctor if you’re concerned about hair loss while taking Ofev. Your doctor may want to check your thyroid levels. If they’re low, your doctor may prescribe a drug such as Synthroid (levothyroxine). Treating low thyroid hormone levels can also treat your hair loss.

If your hair loss isn’t caused by thyroid problems, your doctor may suggest other options to treat this issue.


Diarrhea was the most common side effect reported in Ofev’s studies. Diarrhea caused by Ofev may be mild or serious, but most cases tend to be mild.

Diarrhea can occur at any time while you’re taking Ofev, but it’s most common during the first 3 months of treatment.

In studies, some people had to take a lower Ofev dose due to diarrhea. In rare cases, people have stopped their Ofev treatment due to diarrhea.

What might help

Let your doctor know right away if you have diarrhea while taking Ofev. Your doctor will likely first recommend drinking plenty of water and taking a medication such as Imodium (loperamide).

If your diarrhea doesn’t go away or if it worsens, your doctor will likely lower your Ofev dose to see if this helps ease your diarrhea.

If you have severe diarrhea that doesn’t go away even with treatment, your doctor will likely recommend that you stop taking Ofev.

If you’re concerned about experiencing diarrhea during your Ofev treatment, talk with your doctor.

Liver damage

In rare cases, serious liver damage occurred in studies of people taking Ofev. Since its approval, fatal cases of liver damage have been reported in people who took the drug. But the risk of developing liver problems while taking Ofev isn’t known. If you’re concerned about your risk of liver damage with Ofev, talk with your doctor before starting treatment.

Liver problems caused by Ofev are most likely to happen during the first 3 months that you take the drug. But this side effect can occur any time during your treatment.

Certain people may have a higher risk of liver-related side effects, including liver damage, from taking Ofev. This includes:

  • people who weigh less than 65 kilograms (about 143 pounds)
  • females*
  • people of Asian descent
  • adults ages 65 years and older

Symptoms of liver damage can include:

  • jaundice (yellowing of your skin or the whites of your eyes)
  • confusion
  • fatigue (low energy)
  • nausea, vomiting, and diarrhea
  • passing stool that is bloody, black, or pale
  • dark or tea-colored urine
  • pain on the right side of your belly

Because of this risk, doctors typically will not prescribe Ofev for people who already have moderate to severe liver problems. And they’ll usually prescribe a lower dosage for people with mild liver problems.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

What might help

Before and during your Ofev treatment, you’ll have certain blood tests done to monitor your liver health. These tests check the levels of liver enzymes and bilirubin in your blood. High levels of liver enzymes or bilirubin can be a sign of liver problems.

If you notice symptoms of liver damage while taking Ofev, call your doctor right away. Depending on your symptoms and test results, your doctor may lower your Ofev dosage. Or they may have you permanently stopping taking Ofev and switch to a different treatment.

Holes or tears in your stomach or intestines

Although it isn’t common, taking Ofev may cause holes or tears in the stomach or intestines. Symptoms can include:

What might help

Call your doctor right away if you have any of the symptoms listed during your Ofev treatment. Your doctor will likely order imaging like an X-ray or CT scan to check your stomach and intestines. They may recommend surgery to fix any holes or tears. If these holes or tears have healed on their own, your doctor may prescribe an antibiotic to help prevent infection.

Allergic reaction

Like most drugs, Ofev can cause an allergic reaction in some people. Allergic reactions weren’t reported in Ofev’s studies. But symptoms of skin rash and itching have been reported since the drug was approved for use. These can be symptoms of an allergic reaction.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Ofev, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Ofev, they may have you switch to a different treatment.

Keeping track of side effects

During your Ofev treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Ofev affects you. They can then use this information to adjust your treatment plan if needed.

Ofev may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Ofev is a good treatment option for you.

Talk with your doctor about your health history before starting Ofev. The list below includes factors to consider.

Heart problems. Ofev can cause high blood pressure and heart attack. If you have heart problems (such as heart disease), you may have a higher risk of these side effects while taking Ofev. Due to this risk, doctors are cautious about prescribing Ofev to people with heart problems. Your doctor can discuss the risks and benefits of taking Ofev with you.

Liver problems. In rare cases, Ofev can cause liver damage. If you already have liver problems (such as alcoholic liver disease), taking Ofev may worsen your condition. Due to this risk, doctors typically won’t prescribe Ofev to people with moderate or severe liver problems. People with mild liver problems can usually take a lower dose of Ofev. Your doctor can tell you more about how severe your liver problems are and whether it’s safe for you to take Ofev.

History of blood clots. In rare cases, Ofev can cause blood clots in your arteries. You may have a higher risk of this side effect if you’ve had blood clots in the past. Your doctor can tell you more about the risks and benefits of taking Ofev.

Bleeding problems. Bleeding, including severe bleeding, has happened in people taking Ofev. If you or an immediate family member have a bleeding problem (such as hemophilia), Ofev may not be safe for you to take. Talk with your doctor to learn more about your treatment options.

Smoking tobacco. Smoking tobacco may cause your body to not absorb Ofev as well. This can make the drug less effective at treating your condition. You should avoid smoking while using Ofev. For resources that could help you quit smoking before you take Ofev, talk with your doctor.

Recent abdominal surgery. In rare cases, Ofev can cause holes or tears in your stomach or intestines. If you’ve recently had abdominal surgery, you have a higher risk for this side effect. Your doctor can tell you when it may be safe for you to begin taking Ofev based on the date and type of surgery.

Allergic reaction. If you’ve had an allergic reaction to Ofev or any of its ingredients, your doctor will likely not prescribe Ofev. Ask them what other medications are better options for you.

Alcohol and Ofev

There are no known interactions between Ofev and alcohol. But Ofev and alcohol can cause similar side effects, including diarrhea, nausea, and liver damage. So drinking alcohol during your Ofev treatment can raise your risk of these side effects. Or it can make certain side effects that you experience more severe.

If you drink alcohol, talk with your doctor about how much (if any) is safe to drink while you’re taking Ofev.

Pregnancy and breastfeeding while taking Ofev

Ofev is not safe to take during pregnancy because it may cause harm to a fetus.

If you can become pregnant, your doctor will have you take a pregnancy test before prescribing Ofev for you. They’ll also recommend that you use birth control while taking the drug and for at least 3 months after your last dose.

Breastfeeding is not recommended while taking Ofev. It’s not known whether Ofev is safe to use while breastfeeding. It’s unknown whether the drug passes into breast milk and if so, whether it could cause side effects in a breastfed child.

If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor about your treatment options.

The sections above describe mild or serious side effects that Ofev may cause.

If you’re considering treatment with Ofev, talk with your doctor or pharmacist. Asking questions about Ofev’s side effects can help you determine whether this drug may be right for you. Some example questions to get you started include:

  • How do Ofev’s side effects compare with those of other medications used to treat my condition?
  • Will taking Ofev weaken my immune system?
  • If I have side effects from Ofev, is there a lower dose I can try?

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.