Patient leaflet - PIRFENIDONE 534 MG FILM-COATED TABLETS
i.what pirfenidone is and what it is used for
Pirfenidone contains the active substance pirfenidone and it is used for the treatment of mild to moderate Idiopathic Pulmonary Fibrosis (IPF) in adults.
IPF is a condition in which the tissues in your lungs become swollen and scarred over time, and as a result makes it difficult to breathe deeply. This makes it hard for your lungs to work properly. Pirfenidone helps to reduce scarring and swelling in the lungs, and helps you breathe better.
2.what you need to know before you take pirfenidone
Do not take pirfenidone
- if you are allergic to pirfenidone or any of the other ingredients of this medicine (listed in section 6)
- if you have previously experienced angioedema with pirfenidone, including symptoms such as swelling of the face, lips and/or tongue which may be associated with difficulty breathing or wheezing
- if you are taking a medicine called fluvoxamine (used to treat depression and obsessive compulsive disorder [OCD])
- if you have severe or end stage liver disease
- if you have severe or end stage kidney disease requiring dialysis.
If any of the above affects you, do not take pirfenidone. If you are unsure ask your doctor or pharmacist.
READING DIRECTION
Warnings and precautions
Talk to your doctor or pharmacist before taking pirfenidone
- You may become more sensitive to sunlight (photosensitivity reaction) when taking pirfenidone. Avoid the sun (including sunlamps) whilst taking pirfenidone. Wear sunblock daily and cover your arms, legs and head to reduce exposure to sunlight (see section 4: Possible side effects).
-
– You should not take other medicines, such as tetracycline antibiotics (such as doxycycline), which may make you more sensitive to sunlight.
-
– You should tell your doctor if you suffer from kidney problems.
- You should tell your doctor if you suffer from mild to moderate liver problems.
- You should stop smoking before and during treatment with pirfenidone. Cigarette smoking can reduce the effect of pirfenidone
- Pirfenidone may cause dizziness and tiredness. Be careful if you have to take part in activities where you have to be alert and coordinated.
- Pirfenidone can cause weight loss. Your doctor will monitor your weight whilst you are taking this medicine.
Pirfenidone may cause serious liver problems and some cases have been fatal. You will need a blood test before you start taking pirfenidone and at monthly intervals for the first 6 months and then every 3 months thereafter whilst you are taking this medicine to check whether your liver is working properly. It is important that you have these regular blood tests for as long as you are taking pirfenidone.
s s
LA
Children and adolescents
Do not give pirfenidone to children and adolescents under the age of 18.
Other medicines and pirfenidone
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
This is especially important if you are taking the following medicines, as they may change the effect of pirfenidone.
Medicines that may increase side effects of pirfenidone:
- enoxacin (a type of antibiotic)
- ciprofloxacin (a type of antibiotic)
- amiodarone (used to treat some types of heart disease)
- propafenone (used to treat some types of heart disease)
- fluvoxamine (used to treat depression and obsessive compulsive disorder (OCD)).
Medicines that may reduce how well pirfenidone works:
- omeprazole (used in the treatment of conditions such as indigestion, gastroesophageal reflux disease)
- rifampicin (a type of antibiotic).
Pirfenidone with food and drink
Do not drink grapefruit juice whilst taking this medicine. Grapefruit may prevent pirfenidone from working properly.
Pregnancy and breast-feeding
As a precautionary measure, it is preferable to avoid the use of pirfenidone if you are pregnant, planning to become pregnant, or think you might be pregnant as the potential risks to the unborn child are unknown.
If you are breast-feeding or plan to breast-feed speak to your doctor or pharmacist before taking pirfenidone. As it is unknown whether pirfenidone passes into breast milk, your doctor will discuss the risks and benefits of taking this medicine while breastfeeding if you decide to do so.
Driving and using machines
Do not drive or use machines if you feel dizzy or tired after taking pirfenidone.
Pirfenidone contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
3. How to take pirfenidone
Treatment with pirfenidone should be started and overseen by a specialist doctor experienced in the diagnosis and treatment of IPF.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Your medicine will usually be given to you in increasing doses as follows:
- for the first 7 days take a dose of 267 mg (1 yellow tablet), 3 times a day with food (a total of 801 mg/day)
- from day 8 to 14 take a dose of 534 mg (2 yellow tablets or 1 orange tablet), 3 times a day with food (a total of 1,602 mg/day)
- from day 15 onwards (maintenance), take a dose of 801 mg (3 yellow tablets or 1 brown tablet), 3 times a day with food (a total of 2,403 mg/day).
The recommended maintenance daily dose of pirfenidone is 801 mg (3 yellow tablets or 1 brown tablet) three times a day with food, for a total of 2403 mg/day.
Swallow the tablets whole with a drink of water, during or after a meal to reduce the risk of side effects such as nausea (feeling sick) and dizziness. If symptoms continue, see your doctor.
Dose reduction due to side effects
Your doctor may reduce your dose if you suffer from side effects such as, stomach problems, any skin reactions to sunlight or sun lamps, or significant changes to your liver enzymes.
Ifyou take more pirfenidone than you should
Contact your doctor, pharmacist or nearest hospital casualty department immediately if you have taken more tablets than you should and take your medicine with you.
If you forget to take pirfenidone
If you forget a dose, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose. Each dose should be separated by at least 3 hours. Do not take more tablets each day than your prescribed daily dose.
Ifyou stoptaking pirfenidone
In some situations, your doctor may advise you to stop taking pirfenidone. If for any reason you have to stop taking pirfenidone for more than 14 consecutive days, your doctor will restart your treatment with a dose of 267 mg 3 times a day, gradually increasing this to a dose of 801 mg 3 times a day.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
3 6 z $ 3 S
§ S 3
4. possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop taking pirfenidone and tell your doctor immediately
t If you experience swelling of the face, lips and/or tongue, itching, hives, difficulty breathing or wheezing, or feeling faint, which are signs of angioedema, a serious allergic reaction or anaphylaxis.
t If you experience yellowing of the eyes or skin, or dark urine, potentially accompanied by itching of the skin, pain on the upper right side of your stomach area (abdomen), loss of appetite, bleeding or bruising more easily than normal, or feeling tired. These may be signs of abnormal liver function and could indicate liver injury, which is an uncommon side effect of pirfenidone.
pther side effects may include
Talk to your doctor if you get any side effects.
Very common side effects (may affect more than 1 in 10 people):
t skin reactions after going out in the sun or using sunlamps
t feeling sick (nausea)
t tiredness
t diarrhoea
t indigestion or stomach upset
t loss of appetite
t headache.
Common side effects (may affect up to 1 in 10 people):
t infections of the throat or the airways going into the lungs and/ or sinusitis
t bladder infections
t weight loss
t difficulty sleeping
t dizziness
t feeling sleepy
t changes in taste
t hot flushes
t shortness of breath
t cough
t stomach problems such as acid reflux, vomiting, feeling bloated, abdominal pain and discomfort, heart burn, feeling constipated and passing wind
t blood tests may show increased levels of liver enzymes
t skin problems such as itchy skin, skin redness or red skin, dry skin, skin rash
t muscle pain, aching joints/joint pains
t feeling weak or feeling low in energy
t chest pain
t sunburn
Uncommon side effects (may affect up to 1 in 100 people):
t Low levels of sodium in the blood. This may cause headache, dizziness, confusion, weakness, muscle cramps or nausea and vomiting.
Rare side effects (may affect up to 1 in 1,000 people): t blood tests may show decrease in white blood cells.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side affects you can help provide more information on the safety of this medicine.
5. how to store pirfenidone
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the bottle label, blister and carton after EXP. The expiry date refers to the last day of that month.
This medicine does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
-
6. Contents ofthe pack and other information
What pirfenidone contains
t The active substance is Pirfenidone.
Pirfenidone 267mg film-coated tablets: Each film-coated tablet contains 267mg of Pirfenidone
Pirfenidone 534mg film-coated tablets: Each film-coated tablet contains 534 mg of Pirfenidone
Pirfenidone 801mg film-coated tablets: Each film-coated tablet contains 801 mg of Pirfenidone
- The other ingredients are: