Do you or a family member have a lung condition called 'Idiopathic Pulmonary Fibrosis'? Simply put, this is a condition in which the lungs become scarred and gradually harden. Your doctor may have prescribed a medication called Pirfenidone to treat this condition. The name may sound a little scary, but don't worry. Let's talk about this medication in a simple and clear way and what you need to know about it when using it.
What kind of medicine is Pirfenidone (Esbriet)?
Pirfenidone is a medicine used to treat a condition called Idiopathic Pulmonary Fibrosis (IPF). Its main function is to slow down the rate of scarring in the lungs. Although this medicine cannot cure the disease completely, it can slow down the rate at which the disease gets worse and help you feel some relief. It comes in the form of tablets or capsules. Your doctor will recommend the one that is best for you.
Things you need to tell your doctor before starting medication
Before starting this medication, it is very important to give your doctor a complete picture of your health condition. Because that information will determine whether this medication is right for you or not, and what the dosage should be. If you have any of the conditions listed below, be sure to tell your doctor about it.
| Your condition or habit | Why should you inform the doctor? |
|---|---|
| Kidney disease | This medicine is removed from the body by the kidneys. If there is a problem with the kidneys, the medicine may accumulate in the body and increase the side effects. |
| Liver disease | Pirfenidone can affect the liver. If you already have liver problems, you should be especially careful. |
| Smoke tobacco | Smoking can reduce the effectiveness of this medication, so talk to your doctor about quitting smoking if you are taking this medication. |
| Other allergies | If you have any allergies to pirfenidone or other medicines, foods, or dyes, be sure to tell your doctor. |
| Being pregnant or trying to get pregnant | There is still not enough information about the safety of this medication during pregnancy, so it is important to talk to your doctor about this. |
| Breastfeeding | It is not clear whether this medicine passes to the baby through breast milk. Therefore, if you are breastfeeding, inform your doctor. |
How exactly do I use this medicine?
For a medicine to work properly, it must be taken exactly as prescribed.
- Take with food: This is the most important thing. Always take Pirfenidone with a meal. Taking it on an empty stomach increases the risk of side effects such as nausea and stomach upset.
- Take with a glass of water: Swallow the tablet/capsule whole with a glass of water.
- Take it at the right time: Take the right dose at the right time as prescribed by your doctor. If you are told to take it three times a day, you can take it with breakfast, lunch, and dinner.
- Don't stop taking your medication on your own: Never stop taking your medication without your doctor's advice.
- If given to children: This medicine is not usually given to children. However, if given in a special case, follow the advice of a pediatrician.
What to do if you overdose?
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately . Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
What if I miss a dose of medicine?
If you forget to take a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose. If you have missed a dose for 14 days or more, be sure to talk to your doctor before starting again.
Can there be problems with other medications? (Drug Interactions)
Yes, Pirfenidone can interact with some other medications you are taking. Therefore, it is very important to tell your doctor about all medications you are taking.
When you say medication, it includes not only the medication prescribed by doctors, but also everything you buy from a pharmacy, such as painkillers, vitamins, herbal products, traditional medicines, and dietary supplements.
Some medications that can cause problems with pirfenidone include:
- Some antibiotics (e.g. ciprofloxacin)
- Some asthma medications (e.g. zafirlukast, zileuton)
- Some medications for depression or anxiety
- Medicines for irregular heartbeat (e.g. amiodarone)
- Some medications for seizures (e.g. carbamazepine, phenytoin)
- Medicines such as cimetidine for stomach acid
This list is not complete, so it's best to give your doctor a list of everything you take.
Things we need to be especially careful about when taking medicine
Protect yourself from the sun!
This is very important. Your skin may become very sensitive to sunlight while taking pirfenidone. This means that even if you are normally not harmed by the sun, your skin may quickly burn, become red, and become inflamed, much like a severe sunburn.
- Avoid the sun: Avoid going out in the sun as much as possible, especially between 10-11 am and 3-4 pm.
- Wear protective clothing: If going outside, wear long-sleeved clothing, pants, a hat, and sunglasses.
- Use sunscreen: Use a good sunscreen with an SPF of 30 or higher, which protects against both UVA and UVB rays. Apply it 20 minutes before going outside and reapply every two to three hours.
- Avoid tanning beds: Do not use devices that artificially tan the skin.
Be aware of side effects
Like any medicine, Pirfenidone can cause side effects. However, not everyone gets them. Some of them are normal and go away after a few days. But some of them we need to be very careful about.
| Side effects that should be reported to your doctor or ETU immediately | |
|---|---|
| Allergic Reactions | Skin rash, itching, swelling of the face, lips or tongue, difficulty breathing. |
| Symptoms of Liver Injury | Dark yellow or brown urine, yellowing of the eyes or skin (jaundice), pain in the upper right side of the stomach, loss of appetite, extreme tiredness, pale stools. |
| Severe Sunburn | Severe redness, blistering, or pain of the skin after sun exposure. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| |
How do you protect your medicine?
- Keep out of reach of children: This is very important. Medicines are not toys for children.
- Store at room temperature: Store at room temperature, between 15 and 30 degrees Celsius. Keep away from excessive heat and moisture.
- Discard after expiration: Do not use medications that have passed the expiration date on the bottle. Dispose of them safely.
Take-Home Message
- Always take Pirfenidone with a meal . Do not take it on an empty stomach.
- Your skin will be very sensitive to sunlight while taking this medicine. Therefore, protect yourself from the sun , wear sunscreen, and wear protective clothing.
- Give your doctor a complete list of all other medications, vitamins, and herbal products you are taking.
- Do not stop taking the medication without medical advice.
- Seek immediate medical attention if you develop signs of liver damage (yellowing of the eyes, dark urine) or severe allergic reactions.
- If you have any concerns or questions, discuss them with your doctor. Don't be afraid, clear your doubts.
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