Pirfenidone 200 mg (Pirfenex)

Description

Pirfenidone 200 mg is an anti-fibrotic and anti-inflammatory medication primarily used to treat idiopathic pulmonary fibrosis (IPF), a chronic and ultimately fatal lung disease characterized by progressive scarring of lung tissue. The scarring causes irreversible loss of the tissue’s ability to transport oxygen, resulting in shortness of breath and other respiratory complications.

Mechanism of Action

Pirfenidone works by:

• Inhibiting TGF-β: Transforming growth factor-beta (TGF-β) is a key player in the process of fibrosis. Pirfenidone inhibits TGF-β, which reduces collagen synthesis and the deposition of extracellular matrix.
• Reducing Inflammation: By inhibiting the production of pro-inflammatory cytokines, such as TNF-α and IL-1β, pirfenidone reduces the inflammatory response that contributes to fibrosis.
• Antioxidant Properties: It helps reduce oxidative stress, which is implicate in the pathogenesis of IPF.

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Pirfenidone 200 mg Dosage and Administration

• Initial Dose: Typically, treatment begins with a lower dose that is gradually increasing over two weeks to minimize side effects.
• Maintenance Dose: The usual maintenance dose is 801 mg (three 267 mg tablets) take three times a day with food. However, in some cases, lower doses, such as 200 mg, may prescribe depending on patient tolerance and specific circumstances.
• Administration: It is essential to take pirfenidone with food to reduce gastrointestinal side effects.

Indications

Pirfenidone is indicate for:

• Idiopathic Pulmonary Fibrosis (IPF): Approved by regulatory bodies like the FDA and EMA for the treatment of mild to moderate IPF.
• Other Potential Indications: Research is ongoing to evaluate its effectiveness in other fibrotic conditions, such as scleroderma-related interstitial lung disease and liver fibrosis.

Efficacy

• Clinical Trials: Pirfenidone has been shown to slow the progression of IPF in several clinical trials, such as the CAPACITY and ASCEND trials. Patients on pirfenidone experience a slower decline in lung function compared to those on placebo.
• Quality of Life: Studies suggest an improvement in exercise tolerance and a reduction in the rate of acute exacerbations of IPF.

What are the Side Effects of Pirfenidone 200 mg?

Common side effects of pirfenidone include:

• Gastrointestinal Issues: Nausea, diarrhea, indigestion, and vomiting.
• Skin Reactions: Rash and photosensitivity (increased sensitivity to sunlight).
• Fatigue: Feeling tired or weak.
• Loss of Appetite: Anorexia and weight loss.

Precautions and Contraindications

• Liver Function: Patients with liver impairment should use pirfenidone with caution. Regular liver function tests are recommended.
• Photosensitivity: Patients should avoid excessive sun exposure and use sunblock or protective clothing to prevent skin reactions.
• Drug Interactions: Pirfenidone can interact with other medications, such as CYP1A2 inhibitors (e.g., ciprofloxacin), which may increase its levels in the blood.

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