Background: Two pharmaceutical agents have been approved for treatment of idiopathic pulmonary fibrosis (IPF): pirfenidone and nintedanib. Objectives: We investigated the need of dose reduction in consecutive patients treated with nintedanib in relation to gender and body max index, comparing the population over and under 80 years of age. Methods: We retrospectively reviewed the data of all consecutive IPF patients treated with nintedanib for at least 3 months. Data on age, gender, body max index, side effects, and duration of therapy after enrolment were recorded. Results: A total of 82 patients has been evaluated. All dose reductions were related to side effects and/or toxicities. The need for a dose reduction was significantly more frequent in patients aged 80 years or older (50 vs. 26.8%, p = 0.039), independently from their body mass index. A total of 52% of males >80 years and only 16% of males <80 years reduced the dose (p = 0.002). Conclusions: Male gender and not body mass index in IPF patients aged ≥80 years treated with nintedanib seems to influence dose reduction.