In October of 2025, the United States Food and Drug Administration (FDA) made a big announcement: Jascayd (nerandomilast) tablets have been approved to treat idiopathic pulmonary fibrosis (IPF). This is the first new FDA-approved IPF therapy in more than 10 years. Soon after, the FDA approved Jascayd for progressive pulmonary fibrosis (PPF) as well.
Patient-Friendly Q&A: Jascayd and Current IPF Treatments
Q1) What is Jascayd?
Jascayd (nerandomilast) is an oral medicine approved in the U.S. for adults with idiopathic pulmonary fibrosis (IPF). It targets an enzyme called PDE4B to help reduce inflammation and fibrosis. It’s the first new IPF drug approved in the U.S. in more than 10 years.
Q2) How is Jascayd taken?
The usual dose is 18 mg twice a day about 12 hours apart, with or without food. If side effects are troublesome, your doctor may lower it to 9 mg twice a day—except when you’re also taking pirfenidone, in which case the label keeps Jascayd at 18 mg twice daily. Click here to see detailed prescribing information.
Q3) Can I take Jascayd with my current IPF medicine?
The Jascayd label specifically addresses concomitant pirfenidone use (see dosing note above). Any combination should be personalized by your pulmonologist based on your labs, symptoms, and goals.
Q4) What side effects should I watch for with Jascayd?
Common ones include diarrhea, nausea/vomiting, decreased appetite, weight loss, headache, fatigue, dizziness, and upper-respiratory infections; mood changes (e.g., depression) are noted. Report side effects promptly; dose adjustments/supportive care can help.
Q5) How do Jascayd, Esbriet, and Ofev differ?
- Jascayd: oral PDE4B inhibitor; BID (twice daily with or without food) dosing; first new option in years.
- Esbriet (pirfenidone): Long-used antifibrotic; three times daily with food; photosensitivity & GI effects are common management points.
- Ofev (nintedanib): Tyrosine-kinase inhibitor; twice daily with food; diarrhea and liver-enzyme monitoring are key.
Q6) Will any of these medicines “cure” IPF?
No. All three aim to slow lung-function decline, not reverse existing scarring. The goal is to preserve function and quality of life as long as possible.
Q7) How soon can people actually get Jascayd?
After FDA approval, pharmacies/health systems and insurers need to add it to formularies. Availability can lag during rollout; your care team can check local access and prior-authorization needs.
Q8) What labs or check-ins are typical?
Your team may monitor weight/nutrition and side effects on Jascayd; with Ofev, liver tests are routine; with Esbriet, clinicians also manage GI effects and sun sensitivity. Follow your center’s plan.
Q9) If I have side effects, should I stop on my own?
Don’t stop or change doses without guidance. Many issues can be managed (e.g., anti-diarrheals for Ofev; food/sun protection with Esbriet; adjustments with Jascayd). Call your clinic.
Q10) How do I decide which is right for me?
Discuss your lung function, comorbidities (especially liver disease), other meds, dosing preferences, and side-effect history with your pulmonologist. Some centers also consider clinical trials or combination strategies when appropriate.
To better understand how Jascayd compares to other FDA-approved medications, see the table below.
| Comparison: IPF Medicines (Adults) | |||
|---|---|---|---|
| Feature | Jascayd® (nerandomilast) | Esbriet® (pirfenidone) | Ofev® (nintedanib) |
| What it’s for | Idiopathic Pulmonary Fibrosis (IPF) | IPF | IPF; also some other fibrosing ILDs |
| How it works | PDE4B inhibitor (anti-inflammatory & antifibrotic) | Antifibrotic / anti-inflammatory (mechanism not fully defined) | Tyrosine-kinase inhibitor (targets VEGFR/FGFR/PDGFR) |
| Typical dose | 18 mg twice daily ~12 hrs apart; with or without food. Dose may be lowered to 9 mg BID if not tolerated | Titrated over 2 weeks to 801 mg three times daily (total 2403 mg/day) with food. | 150 mg twice daily ~12 hrs apart with food (100 mg BID if mild liver impairment). |
| Can it be combined? | Label allows use with pirfenidone; recommended Jascayd dose remains 18mg BID. Prescribing information PI | Sometimes used alone; combination with Jascayd is referenced in Jascayd label. PI | Usually used alone; discuss any dual-therapy plans with your clinician. PI |
| Common side effects | Diarrhea, nausea, vomiting; ↓appetite, weight loss; headache, fatigue; dizziness; URTI; mood changes (e.g., depression). | Nausea, stomach upset, diarrhea, heartburn; fatigue; rash; headache; URTI; dizziness; ↓appetite; weight loss. | Diarrhea (very common), nausea, vomiting, stomach pain; possible liver enzyme elevations; ↓appetite, weight loss, headache. |
| Key monitoring / cautions | Review mood changes; GI tolerance; overall weight/nutrition; drug interactions per label. | Photosensitivity & GI tolerance; liver tests as directed; food with each dose. | Liver function monitoring; take with food; manage diarrhea early; dose adjust if needed. |
| What trials showed | Slowed FVC decline vs placebo (e.g., FIBRONEER-IPF). | Slows lung-function decline vs placebo (legacy approvals). | Slows lung-function decline vs placebo (legacy approvals). |
| Practical notes | First new US IPF med in over a decade (FDA Oct 2025). Access may depend on formularies/insurance at rollout. | Long-standing option; TID dosing and GI/photosensitivity management are common talking points. | Long-standing option; twice-daily with food; diarrhea management plan is important. |
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