Front Desk: 469-391-0070
Pirfenidone: Uses, Dosage, Side Effects, and Cost Guide
Summary of Key Points
Pirfenidone is a medication used to treat lung conditions such as idiopathic pulmonary fibrosis (IPF) and other forms of pulmonary fibrosis. It works by reducing inflammation in the lungs and slowing the progression of scarring. It is important for patients to follow their prescribed dosage and consult their healthcare provider before making any changes. Since Pirfenidone may cause side effects, regular monitoring is essential.
Names of Medication
US Brand Name: Esbriet (Pirfenidone)
The generic name is the official medical name of the drug, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.
Pharmacologic Category
Antifibrotic Agent
Anti-inflammatory Agent
Pirfenidone Dosage and Treatment Guidelines
Pirfenidone is prescribed for various lung conditions. It is essential to follow the dosing instructions provided by your healthcare provider. Always consult your doctor before adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized advice.
Idiopathic Pulmonary Fibrosis (IPF)
The typical starting dose is 267 mg three times a day, gradually increasing to 801 mg three times a day. Treatment is usually long-term.
Pulmonary Fibrosis
The dosage is the same as for IPF, starting at 267 mg three times a day and increasing to 801 mg three times a day. The duration of treatment depends on the progression of the disease.
Interstitial Lung Disease
The starting dose is 267 mg three times a day, increasing to 801 mg three times a day. The length of treatment varies based on the patient’s condition.
Systemic Sclerosis
The dose is 267 mg three times a day, increasing to 801 mg three times a day. Treatment is typically long-term.
Sarcoidosis
The starting dose is 267 mg three times a day, increasing to 801 mg three times a day. The duration of treatment depends on the severity of the disease.
Asbestosis
The dose is 267 mg three times a day, increasing to 801 mg three times a day. Treatment is usually long-term.
Silicosis
The dose is 267 mg three times a day, increasing to 801 mg three times a day. The length of treatment varies.
Chronic Hypersensitivity Pneumonitis
The dose is 267 mg three times a day, increasing to 801 mg three times a day. The duration of treatment depends on disease progression.
Radiation-Induced Lung Injury
The dose is 267 mg three times a day, increasing to 801 mg three times a day. The length of treatment is based on the patient’s response.
Cystic Fibrosis
The dose is 267 mg three times a day, increasing to 801 mg three times a day. Treatment is typically long-term.
Dosage Forms and Strengths of Pirfenidone
Capsules: 267 mg
Tablets: 267 mg, 534 mg, 801 mg
Administration Instructions for Pirfenidone
Pirfenidone should be taken with food to minimize the risk of stomach upset. Swallow the capsules or tablets whole; do not crush, chew, or split them. If you miss a dose, take it as soon as you remember, unless it is close to your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once.
Pirfenidone Side Effects and Adverse Reactions
Like all medications, Pirfenidone can cause side effects. Some are common and mild, while others may be more serious. If you experience any side effects, contact your healthcare provider. You can also schedule a telemedicine visit with one of our doctors for further guidance.
Common Side Effects of Pirfenidone
- Nausea: A frequent side effect, especially when starting treatment. Taking the medication with food can help reduce nausea.
- Fatigue: Feeling unusually tired is common. Rest and staying hydrated can help manage this symptom.
- Rash: Skin irritation or rash may develop. If this occurs, consult your doctor.
- Diarrhea: Some patients experience loose stools. It is important to stay hydrated if this happens.
- Headache: Mild headaches may occur, particularly in the early stages of treatment.
Serious Side Effects of Pirfenidone
- Elevated Liver Enzymes: A less common but serious side effect. Your doctor may monitor your liver function through blood tests.
- Photosensitivity: Increased sensitivity to sunlight, which can lead to sunburn more easily. Use sunscreen and wear protective clothing when outdoors.
Contraindications for Pirfenidone
A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. It is important to know if any of these apply to you before starting Pirfenidone.
Contraindications for Pirfenidone
Severe liver disease: Pirfenidone is processed by the liver, and if your liver is not functioning properly, the medication can accumulate in your body and cause serious side effects.
Severe kidney disease: If your kidneys are not working well, Pirfenidone may not be cleared from your body efficiently, leading to higher drug levels and an increased risk of side effects.
Allergy to Pirfenidone: If you have had an allergic reaction to Pirfenidone in the past, you should not take it again. Allergic reactions can be serious and may include symptoms such as rash, swelling, or difficulty breathing.
If you have any of these conditions, consult with one of our healthcare providers through telemedicine before starting Pirfenidone. They can help you find a safer alternative.
Drug to Drug Interactions with Pirfenidone
Some medications can interact with Pirfenidone, either increasing the likelihood of side effects or reducing its effectiveness. It is important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements.
Medications That May Interact with Pirfenidone
Fluvoxamine (Luvox): This antidepressant can raise the levels of Pirfenidone in your body, which may increase the risk of side effects.
Ciprofloxacin (Cipro): This antibiotic may also elevate Pirfenidone levels, potentially leading to more pronounced side effects.
Omeprazole (Prilosec): This medication for acid reflux may reduce the effectiveness of Pirfenidone.
Always discuss your medications with your healthcare provider to avoid harmful interactions. Our telemedicine providers can review your medication list to ensure that Pirfenidone is safe for you.
Pirfenidone in Pregnancy
Is It Safe to Take Pirfenidone When Pregnant?
There is limited information on the safety of Pirfenidone during pregnancy. Animal studies suggest there may be some risk to the fetus, but there are no well-controlled studies in humans. As a result, Pirfenidone is generally not recommended during pregnancy unless the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, consult your healthcare provider to discuss the best treatment options. Our telemedicine providers can help you weigh the risks and benefits of continuing Pirfenidone during pregnancy.
Pirfenidone While Breastfeeding
Is It Safe to Take Pirfenidone While Breastfeeding?
It is not known whether Pirfenidone passes into breast milk, and its effects on a nursing infant are unclear. Due to this uncertainty, it is generally advised to avoid breastfeeding while taking Pirfenidone. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to discuss alternative treatments or the possibility of discontinuing breastfeeding while on Pirfenidone.
Estimated Cost of Pirfenidone Medication
The cost of Pirfenidone can vary depending on your location and pharmacy. Without insurance, a 30-day supply of Pirfenidone using a GoodRx coupon is estimated to cost between $9,000 and $10,000. Be sure to check with your pharmacy for the most accurate pricing, and consider using discount programs like GoodRx to help reduce costs.
Possible Alternatives to Pirfenidone
If Pirfenidone is not suitable for you, other treatments or lifestyle changes may help manage your condition. Always discuss alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers can assist you in exploring these options.
Idiopathic Pulmonary Fibrosis (IPF) Alternatives
Nintedanib (Ofev): Another medication that can slow the progression of IPF.
Oxygen therapy: Supplemental oxygen can improve breathing and enhance quality of life.
Lung transplant: In severe cases, a lung transplant may be considered.
Pulmonary Fibrosis Alternatives
Anti-inflammatory medications: These may help reduce lung inflammation in certain types of pulmonary fibrosis.
Physical therapy: Pulmonary rehabilitation can improve lung function and overall fitness.
Interstitial Lung Disease (ILD) Alternatives
Corticosteroids: These medications help reduce lung inflammation.
Immunosuppressive drugs: Medications like azathioprine or mycophenolate may help control the immune system’s response.
Systemic Sclerosis Alternatives
Immunosuppressive therapy: Medications such as methotrexate or cyclophosphamide may help manage lung involvement in systemic sclerosis.
Physical therapy: Regular exercise and physical therapy can help maintain lung function.
Sarcoidosis Alternatives
Corticosteroids: These are often the first-line treatment for sarcoidosis.
Immunosuppressive drugs: Medications like methotrexate or azathioprine may be used if corticosteroids are not effective.
Asbestosis Alternatives
Oxygen therapy: Supplemental oxygen can help alleviate symptoms.
Smoking cessation: Quitting smoking can slow the progression of lung damage.
Silicosis Alternatives
Bronchodilators: These medications help open the airways, making breathing easier.
Regular monitoring: Frequent checkups help track disease progression.
Chronic Hypersensitivity Pneumonitis Alternatives
Avoiding triggers: Identifying and avoiding substances that cause lung inflammation is key to managing this condition.
Corticosteroids: These medications help reduce lung inflammation.
Radiation-Induced Lung Injury Alternatives
Corticosteroids: These may help reduce inflammation caused by radiation therapy.
Supportive care: Oxygen therapy and pulmonary rehabilitation can improve lung function.
Cystic Fibrosis Alternatives
CFTR modulators: Medications like ivacaftor (Kalydeco) target the underlying cause of cystic fibrosis.
Airway clearance techniques: Regular chest physiotherapy helps clear mucus from the lungs.
Recent Updates on Pirfenidone Research
Recent studies continue to explore the benefits of Pirfenidone in treating various forms of lung fibrosis. Research suggests that Pirfenidone may slow the progression of fibrosis in conditions beyond idiopathic pulmonary fibrosis, such as systemic sclerosis and chronic hypersensitivity pneumonitis. Additionally, ongoing clinical trials are investigating Pirfenidone’s potential to treat other lung diseases, including radiation-induced lung injury and sarcoidosis. While these findings are promising, more research is needed to confirm Pirfenidone’s effectiveness in these conditions.
If you have questions about Pirfenidone or would like to learn more about how it may help with your condition, schedule a telemedicine appointment with one of our healthcare providers today.
