Medications Directory

Approved indications: Jascayd is an oral preferential PDE4B inhibitor approved to treat idiopathic pulmonary fibrosis (IPF) in adults, including those who are also on background antifibrotic therapy such as nintedanib or pirfenidone.

Off-label and investigational uses: Nerandomilast (Jascayd) has shown benefit in large phase 3 trials for progressive pulmonary fibrosis and other fibrosing interstitial lung diseases, but these uses are not yet FDA-approved; some specialists may consider off-label use in select adults based on this evidence and individual risk–benefit discussions.

Efficacy in IPF: In clinical trials, patients taking Jascayd had a smaller decline in forced vital capacity (FVC, a key lung function measure) over 52 weeks than those on placebo, meaning lung function worsened more slowly.

Onset and clinical outcomes: Separation of lung function curves from placebo was seen within the first few months and maintained through one year; most people do not feel dramatically better day to day, but the medicine is intended to slow progression and may help preserve activity levels and reduce the risk of rapid decline over time.

Comparison with other drugs: The magnitude of FVC slowing is broadly similar to what has been seen with established antifibrotics like nintedanib and pirfenidone, and Jascayd can be used alone or alongside these drugs so that many patients receive combination therapy tailored to what they can tolerate.

Standard adult dosing: For adults with idiopathic pulmonary fibrosis, the usual dose is 18 mg of Jascayd taken by mouth twice daily, about 12 hours apart, with or without food; this is also the recommended dose when Jascayd is used together with pirfenidone or nintedanib.

Dose adjustments: If side effects are not tolerated, the dose can be reduced to 9 mg twice daily in many patients, but not in those also taking pirfenidone, who should remain on 18 mg twice daily. When Jascayd is given with a strong CYP3A inhibitor (for example, certain azole antifungals, some macrolide antibiotics, or specific HIV and hepatitis C medicines), the Jascayd dose should be reduced to 9 mg twice daily. The maximum recommended dose is 18 mg twice daily.

How to take it: Swallow the tablets whole with water without crushing or chewing. If you cannot swallow tablets, one tablet can be placed in a glass of plain, non‑carbonated room‑temperature water, stirred regularly for about 15–20 minutes until broken into very small pieces, then drunk within 2 hours, followed by another half-glass of water to rinse and swallow any remaining medicine.

Missed dose: If you miss a dose, skip it and take your next dose at the regular time; do not take an extra tablet or more than 18 mg twice daily to make up for a missed dose.

Overdose: If you take more Jascayd than prescribed, contact your healthcare provider or a poison control center right away, or go to the nearest emergency department so you can be monitored and treated for any symptoms.

Common side effects (often in the first weeks to months):

• Diarrhea (very common, sometimes severe, especially when combined with nintedanib).
• Weight loss and decreased appetite.
• Nausea, vomiting, headache, fatigue, dizziness, and back pain.
• COVID‑19 infection and other upper respiratory tract infections.
• Mood changes, including depression or feeling unusually low.

Most of these effects are mild to moderate and can often be managed with diet changes, anti-diarrheal medicines, or dose reduction to 9 mg twice daily when allowed.

Serious or rare adverse effects needing urgent attention:

• Severe or persistent diarrhea with signs of dehydration, such as feeling very weak, light-headed, or urinating much less than usual.
• New or worsening depression, suicidal thoughts, or other major mood or behavior changes.
• Severe fatigue or weakness, intense stomach pain, or signs that may suggest vasculitis (unusual rash with fever, joint pain, or nerve symptoms).
• Any sudden worsening of breathing, chest pain, or signs of serious infection.

Warnings and precautions: Jascayd may increase the risk of fetal loss based on animal studies, so pregnancy requires careful discussion and it is generally avoided unless potential benefits clearly outweigh risks; it is unknown whether the drug passes into human breast milk, so breastfeeding decisions should be individualized with a clinician. The medicine is approved only for adults, and its safety and effectiveness in children are not known. People with kidney or liver problems, low body weight or difficulty maintaining weight, or a history of depression or suicidal thoughts should be monitored more closely.

Overall safety compared with other IPF drugs: In trials, serious adverse events and treatment discontinuations with Jascayd were similar to placebo, with side effects dominated by gastrointestinal symptoms and mood changes rather than liver or skin reactions seen with some other antifibrotic therapies; clinicians choose between or combine drugs based on each patient’s other illnesses, preferences, and tolerability.

Reporting side effects and safety updates: Side effects can be reported to the drug manufacturer or to the FDA’s MedWatch program by phone or online, and updated safety information is provided through FDA safety communications, prescribing information, and professional society or manufacturer websites.

Interactions with other medicines: Jascayd is broken down mainly by the CYP3A enzyme system, so strong CYP3A inhibitors (such as some azole antifungals, macrolide antibiotics, and certain HIV or hepatitis C drugs) can raise Jascayd levels and require the dose to be lowered to 9 mg twice daily, while moderate or strong CYP3A inducers (such as rifampin, carbamazepine, phenytoin, or St John’s wort) should generally be avoided because they may reduce its effectiveness.

Use with other IPF treatments and OTC products: Jascayd can be used together with nintedanib or pirfenidone; however, diarrhea and weight loss are more frequent when it is combined with nintedanib, so your team may adjust other medicines or use anti-diarrheal treatments. Always tell your clinician and pharmacist about all prescription drugs, over-the-counter medicines, vitamins, and herbal supplements before starting Jascayd.

Food, alcohol, and lifestyle interactions: There are no specific food restrictions, and you may take Jascayd with or without meals, but taking it consistently the same way each day may help with stomach upset. Alcohol can add to dizziness and may worsen weight loss or mood symptoms, so heavy drinking is discouraged and any alcohol use should be discussed with your clinician.

Health conditions requiring caution: Let your prescriber know if you have liver or kidney disease, a history of depression or suicidal thoughts, significant unintentional weight loss, or difficulty maintaining weight, as you may need closer follow-up or dose changes.

Monitoring needs: During treatment, your healthcare team will usually monitor lung function tests (such as spirometry and forced vital capacity), body weight, mood and mental health, and overall symptoms; they may also order blood tests or other studies based on your other conditions and medicines.

Q: Will Jascayd cure my idiopathic pulmonary fibrosis?
A: No, Jascayd does not cure IPF; it is used to slow down the loss of lung function over time so the disease progresses more slowly.

Q: How long will I need to take Jascayd?
A: Most people take Jascayd long term, for as long as it continues to help slow disease progression and is tolerated, with your clinician reviewing the need for ongoing therapy at regular visits.

Q: Can I take Jascayd with other IPF medicines like nintedanib or pirfenidone?
A: Yes, many trial participants took Jascayd together with nintedanib or pirfenidone, and your doctor may use it alone or in combination, adjusting doses and managing side effects such as diarrhea as needed.

Q: When should I contact my doctor about side effects from Jascayd?
A: You should contact your doctor promptly if you have severe or persistent diarrhea, rapid weight loss, new or worsening depression or suicidal thoughts, or any sudden worsening of breathing, as these may require dose changes or additional treatment.