Vijayaganesh Kasinathan
Written & Compiled by Pharmacist Vijayaganesh Kasinathan, B.Pharm, M.Pharm
Dr. Simi Paknikar
Medically Reviewed by Dr. Simi Paknikar, MD
Last Updated on Sep 28, 2017
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General Information on Pirfenidone

Generic Name : Pirfenidone

Pronunciation : pir-FEN-i-done

Latest prescription information about Pirfenidone. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, its storage instructions and warnings if any when taken during pregnancy. Also listed are the International and Indian trade name(s) of the drug and its price list.
Therapeutic Classification : Miscellaneous

Trade Names/Brand Names of Pirfenidone

Overview of Pirfenidone

Pirfenidone is a novel drug with anti-inflammatory and antifibrotic properties which improves lung function in idiopathic pulmonary fibrosis(IPF).

Why is Pirfenidone Prescribed? (Indications)

Pirfenidone is prescribed for treating idiopathic pulmonary fibrosis which is a severe irreversible disease marked by a progressive decline in lung function. The scarring of lungs is caused by some unknown origin.

The exact mechanism of action of pirfenidone is not known. Pirfenidone is thought to reduce the lung fibrosis (scarring and thickening of lungs) by decreasing the release or activity of naturally occurring substances in the body such as certain growth factors. 

When should Pirfenidone not to be taken? (Contraindications)

Pirfenidone is not recommended in patients with:

End stage renal disease who require dialysis.
Severe liver impairment or damage.

It is also contraindicated in patients taking fluvoxamine treatment.

What is the dosage of Pirfenidone?

The recommended daily maintenance dosage for adults is 801mg (3 capsules of 267mg each) three times a day to be taken with food.
The maximum daily dosage should not exceed 2403mg.

In treating idiopathic pulmonary fibrosis, the dosage can be started as per the following schedule:

From day 1 to 7 - 1 capsule per day
From day 7 to 14 - 2 capsules per day
From day 15 - 3 capsules per day

Patients who miss pirfenidone for 14 days or more should restart the treatment with initial 2 week schedule to reach the full maintenance dosage schedule that starts from day 15.
Patients who miss less than 14 days, the dosage before the interruption can be continued. They should not take two doses at the same time and more than three doses per day.

How should Pirfenidone be taken?

Pirfenidone comes as a capsule to be taken by mouth.
It is usually taken with food to avoid gastric discomfort.
The capsules to be taken at the same time every day.

What are the warnings and precautions for Pirfenidone?

Liver enzymes could increase during pirfenidone therapy. The levels to be monitored for either temporary dosage adjustment or discontinuation of the therapy.
Rashes and sensitivity to sunlight, tanning beds and other fluorescent lamps can occur. Avoid direct sun exposure by using sunscreen (SPF- sun protection factor- 50 or even higher), protective clothing and sun glasses.
The safety of pirfenidone in children is not known.

What are the side effects of Pirfenidone?

  Gastrointestinal: Nausea, vomiting, gastritis, GERD (gastro oesophageal reflux disease), loss of appetite, indigestion, abdominal pain, abdominal distension
  Skin: Photosensitivity, rash, itching and dry skin
  Central Nervous System: Dizziness, insomnia, and fatigue
  Respiratory: Sinusitis and upper respiratory infections
  Others: Increased liver enzymes, joint pain, weight loss

What are the other precautions for Pirfenidone?

Cigarette smoking during the therapy should be stopped as smoking causes increased clearance of drug from the body leading to decreased effectiveness of the drug.
Increased calorie intake may be required in patients with excessive weight loss due to pirfenidone.

What are the Drug Interactions of Pirfenidone?

Increase in the toxicity of pirfenidone may occur with the following drugs and hence their combined use with pirfenidone should be avoided.

Anti depressants such as fluvoxamine, fluoxetine and paroxetine
Antibiotics such as ciprofloxacin and chloramphenicol

Decrease in the circulating plasma levels of pirfenidone could occur with drugs such as omeprazole.

What are the storage conditions for Pirfenidone?

Store in a tightly closed container.
Discard the medicine safely if the medicine is out of date or damaged.

Last Updated : 9/28/2017

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