Nerandomilast (Jascayd®)

Nerandomilast (Jascayd®)

What is nerandomilast?
Nerandomilast is an oral medication approved for the treatment of idiopathic pulmonary fibrosis (IPF). Nerandomilast has been shown to slow the progression of lung function decline of IPF in clinical trials. 

How does nerandomilast work? 
Nerandomilast works by interfering with the pathway that creates scar tissue (fibrosis) and inflammation in the lung tissue. Nerandomilast does not improve the function of the lungs. Instead, the disease progresses more slowly over time. 

Who should take nerandomilast? 
The FDA has approved the use of nerandomilast for adult patients living with IPF.  Only you and your healthcare provider can determine the best approach to treating your condition. We encourage you to consult with your healthcare provider to determine whether this drug is appropriate for you. Some patients may decide not to take this medication after consideration of the potential benefits and side effects.

How should nerandomilast be taken?
Nerandomilast is available in 18mg and 9mg tablets. The usual dose is 18mg by mouth twice daily, approximately 12 hours apart. The dose can be reduced to 9mg twice daily at the discretion of the treating healthcare provider. If you are also taking pirfenidone, you should only take the 18 mg dosage of nerandomilast. This medication may be swallowed whole or dissolved in water and can be taken with or without food.

How can I obtain nerandomilast?
Nerandomilast is only available by prescription through a specialty pharmacy. A prior authorization is required. Prior authorization is the process through which your care team requests clearance from the insurance company to prescribe you the medication. Once the prior authorization is approved, the specialty pharmacy will coordinate with you to either mail the medication to your home or arrange pick up.

Will my insurance pay for nerandomilast?
Insurance coverage will vary by insurer and your individual policy. We recommend that you directly contact your insurance provider to determine your specific coverage.  The supplier of nerandomilast  has set up programs to help patients afford their medications. You can contact CareConnect4Me™ at 1-844-527-2293. We recommend that you contact these programs directly as they will assist you in working with your insurance company as well.

There are also several organizations that can help those living with pulmonary fibrosis with financial and insurance issues. You can contact Accessia Health at 1-800-366-7741, the HealthWell Foundation at 1-800-675-8416, the Patient Advocate Foundation at 1-800-532-5274, or The Assistance Fund at 1-855-845-3663 to find out more and  if they can provide assistance.

What side effects can occur from nerandomilast? 
Common side effects include diarrhea, COVID-19, upper respiratory tract infection, depression, decreased weight and appetite, nausea, fatigue, headache, vomiting, back pain, and dizziness.

How will my doctor monitor me while I am taking nerandomilast? 
If you have side effects, your healthcare provider might add additional medications, adjust your dosage, or temporarily or permanently stop nerandomilast.

Can I take nerandomilast if I am already taking nintedanib or pirfenidone? 
Nerandomilast was studied in patients on nintedanib and patients on pirfenidone. Discuss with your healthcare provider if you should take nerandomilast alone or in addition to nintedanib or pirfenidone. Patients on pirfenidone should only take the 18mg dose of nerandomilast due to a drug interaction.

What drug interactions should I know about? 
Due to an interaction between pirfenidone and nerandomilast that reduces levels of nerandomilast in the 
body, patients who are on pirfenidone should only take the higher 18mg dose of nerandomilast.  

Some medications, such as ketoconazole, itraconazole, posaconazole, voriconazole, clarithromycin, erythromycin, diltiazem and verapamil may increase levels of nerandomilast. If you are taking one of these medications you should discuss with your healthcare provider if any adjustments need to be made.

Rifampicin, carbamazepine, phenytoin, phenobarbital, and St. John’s wort may decrease efficacy of nerandomilast. Discuss with your healthcare provider if you are taking any of these medications.

Are there some people who should not take nerandomilast? 
Nerandomilast is not recommended in patients with end stage kidney disease or severe liver disease.  Those who are pregnant, considering pregnancy, or breastfeeding should consult with their health care provider regarding the use of nerandomilast.