Drug & supplement interaction

Apple Cider Vinegar + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Apple Cider Vinegar and Nintedanib Esylate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Nintedanib Esylate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Apple Cider Vinegar and Nintedanib Esylate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nintedanib Esylate and Apple Cider Vinegar in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Apple Cider Vinegar safety at a glance

Apple Cider Vinega... overall Use caution Generally safe in food amounts but undiluted or large doses can cause harm.
Pregnancy Use caution Amounts used in food are likely fine, but avoid large medicinal or unpasteurized amounts unless your doctor approves.
Breastfeeding Use caution Food amounts are likely fine, but there is little safety data on large or supplement doses.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Pharmacist analysis

The use of apple cider vinegar or the amounts of ACV in supplements is unlikely to cause clinically significant drug interactions at recommended dosages.

However, it is important to be aware of potential interactions, especially with medications that lower blood glucose levels, as these interactions have been theoretically proposed, but as I've written in my analysis on individual interaction detail pages, even this interaction is unlikely to be clinically significant for most.

In terms of side effects, it is uncommon for individuals to experience any adverse effects from taking ACV, but some mild side effects, such as nausea and indigestion, have been reported. It is important to consider that these side effects could be additive if taken with other medications that cause similar symptoms.

As always, it is important to consult with a healthcare provider before starting any new supplement, including ACV, to ensure its safe and appropriate use for your specific medical situation.

—

Still wondering about combining Nintedanib Esylate and Apple Cider Vinegar? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nintedanib Esylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nintedanib Esylate is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Apple Cider Vinegar has documented interactions with 4 drug classes — the most serious being digoxin (lanoxin) (moderate), diuretic drugs (moderate) and insulin (moderate) — and none of Nintedanib Esylate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Apple Cider Vinegar Does Interact With Other Medications

Apple Cider Vinegar has 89 moderate, 73 minor known drug interactions in our database — Nintedanib Esylate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 89 Minor 73 No known interaction 2,668 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against Apple Cider Vinegar

Covers the 2,830 medications we’ve checked against Apple Cider Vinegar. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Apple Cider Vinegar and Nintedanib Esylate May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • A skin rash Additional detail

    Apple Cider Vinegar

    “Topically, apple cider vinegar may cause chemical burns. There is one published report of an individual who developed a chemical burn caused by a single topical application of apple cider vinegar containing 5% acetic acid to the skin. Another case of chemical burn has been reported for a 14-year-old patient who applied apple cider vinegar to the skin for 3 days to remove a nevi.”

    Apple Cider Vinegar · Natural Medicines adverse-effect record, reported in burns.

    4 sources cited
    1. 91662. Bunick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol 2012;67(4):e143-4. PubMed
    2. 93074. Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun;8(6):50.
    3. 101172. Luu LA, Flowers RH, Kellams AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019;36(5):634-639. PubMed
    4. 13183. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc 2005;105:1141-4. PubMed

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

Reported for Apple Cider Vinegar but not commonly for Nintedanib Esylate: trouble swallowing, bone thinning and low potassium.

Effects for Nintedanib Esylate come from the ADVERSE REACTIONS section of its FDA label; effects for Apple Cider Vinegar come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 188 voluntary FDA FAERS reports for Nintedanib Esylate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Nintedanib Esylate Products Have a Food Rule — Apple Cider Vinegar Should Not Break It

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Apple Cider Vinegar on an empty stomach out of habit, keep them separate — and take Nintedanib Esylate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Nintedanib Esylate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Recommended dosage: 150 mg taken orally twice daily approximately 12 hours apart taken with food.

From the Dosage and Administration section of the FDA label we read for Nintedanib Esylate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Apple Cider Vinegar or Nintedanib Esylate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Apple Cider Vinegar or Nintedanib Esylate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Apple Cider Vinegar only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

One more smart check

Taking Apple Cider Vinegar as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,329 real supplement products containing Apple Cider Vinegar, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Apple Cider Vinegar. Even though Apple Cider Vinegar itself has no known interaction with Nintedanib Esylate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Apple Cider Vinegar and Nintedanib Esylate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Apple Cider Vinegar
Top 10%

#135 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,978 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Apple Cider Vinegar reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Apple Cider Vinegar and Nintedanib Esylate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Apple Cider Vinegar

What is Apple Cider Vinegar?

Apple Cider Vinegar
  • Blood sugar support
  • Weight management
  • Digestive upset
  • Appetite control
  • Skin and hair care

Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of these uses is limited and mixed, and the modest effects seen in small studies are not a substitute for proven treatments. When diluted and used in small amounts it is generally safe for most people, but undiluted vinegar can harm teeth and the throat.

Fermented juice of apples (Malus domestica) · Liquid vinegar, capsules, tablets, gummies, powders

An interaction check asks whether these two react with each other — it does not ask whether Apple Cider Vinegar is a good idea for someone in your situation. Here is what our Apple Cider Vinegar record says about it on its own.

Apple Cider Vinegar: dosing

There is no official or proven dose of apple cider vinegar for any health condition. In small studies, people often diluted a small amount (such as a tablespoon or two) of liquid ACV in a large glass of water taken with meals.If you choose to use ACV, always dilute it well in water to protect your teeth and throat, and consider rinsing your mouth afterward.

From our Apple Cider Vinegar monograph — the full record covers uses, side effects and every documented interaction.

Read the full Apple Cider Vinegar monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & Apple Cider Vinegar

Browse every other medication we’ve checked against Apple Cider Vinegar — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
89Moderate
73Minor
2,667No known interaction
89 Moderate 73 Minor 2,667 No interaction
Moderate

89 interactions

Showing 60 of 89 moderate interactions — see all 89 on the Apple Cider Vinegar page.

Minor

73 interactions

Showing 60 of 73 minor interactions — see all 73 on the Apple Cider Vinegar page.

No interaction 2,667 drugs checked — show the list

We also checked Apple Cider Vinegar against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,667 medications checked with no known interaction — see the full Apple Cider Vinegar list.

See the full Apple Cider Vinegar interactions page
See every supplement checked against Nintedanib Esylate, ranked by severity
Evidence & sources

Apple Cider Vinegar References

The 11 references that drive our Apple Cider Vinegar monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3. PubMed
  2. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc 2005;105:1141-4. PubMed
  3. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol 2007;7:46. PubMed
  4. Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004;27:281-2. PubMed
  5. Lhotta, K., Hofle, G., Gasser, R., and Finkenstedt, G. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80(2):242-243. PubMed
  6. Bunick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol 2012;67(4):e143-4. PubMed
  7. Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun;8(6):50.
  8. Luu LA, Flowers RH, Kellams AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019;36(5):634-639. PubMed
  9. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther 2021;21(1):179. PubMed
  10. Feise NK, Johnston CS. Commercial vinegar tablets do not display the same physiological benefits for managing postprandial glucose concentrations as liquid vinegar. J Nutr Metab 2020;2020:9098739. PubMed
  11. Gheflati A, Bashiri R, Ghadiri-Anari A, Reza JZ, Kord MT, Nadjarzadeh A. The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: A randomized contro

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Apple Cider Vinegar and Nintedanib Esylate Together: Common Questions

Is it safe to take Apple Cider Vinegar with Nintedanib Esylate?
We do not list a known interaction between Apple Cider Vinegar and Nintedanib Esylate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Apple Cider Vinegar and Nintedanib Esylate have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Apple Cider Vinegar and Nintedanib Esylate at the same time of day?
At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Apple Cider Vinegar on an empty stomach out of habit, keep them separate and take Nintedanib Esylate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Nintedanib Esylate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Apple Cider Vinegar and Nintedanib Esylate combination checked?
Interactions in our licensed database are recorded against drug classes. Nintedanib Esylate is filed under 5 classifications, and Apple Cider Vinegar has documented interactions with 4 drug classes — none of Nintedanib Esylate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Apple Cider Vinegar interact with any other medications?
Yes. Apple Cider Vinegar has 162 documented drug interactions in our database — Nintedanib Esylate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Nintedanib Esylate interact with any supplements?
Yes. Nintedanib Esylate has documented interactions with 285 supplements in our database — Apple Cider Vinegar is not one of them. The Nintedanib Esylate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Apple Cider Vinegar monograph Uses, safety profile, and every drug interaction in one place Nintedanib drug information The full plain-English guide to this medication Nintedanib Esylate supplement interactions Every supplement checked against Nintedanib Esylate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 11 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nintedanib Esylate and Apple Cider Vinegar?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.