Esbriet, as a long-term treatment for idiopathic pulmonary fibrosis (IPF), needs to be continuously used under the guidance of a doctor. Its safety and efficacy have been validated in clinical trials, but adverse reactions need to be monitored regularly.

Clinical basis for long-term medication

(1) Therapeutic characteristics: Pirfenidone delays the progression of IPF disease by inhibiting fibrosis, and long-term maintenance treatment is required to sustain benefits.

(2) Research data: Phase III clinical trials have shown that continuous medication for 3 years can significantly slow down lung function decline (reducing FVC annual decline rate by 47.9%).

2 Long term medication precautions

(1) Dosage maintenance: Starting from the 15th day, a maintenance dose of 801mg should be maintained three times a day, taken with meals to alleviate gastrointestinal reactions.

(2) Regular monitoring: Liver function, kidney function, and skin reactions should be checked every 3-6 months. If ALT/AST elevation occurs, the dosage should be adjusted in a timely manner.

Long term medication for special populations

(1) Patients with liver and kidney dysfunction: Children Pugh A/B grade or mild to moderate kidney damage patients need to reduce their dosage and strengthen monitoring. Patients with severe liver and kidney dysfunction should not use it.

(2) Elderly patients: Patients over 65 years old do not need to adjust the dosage, but attention should be paid to drug interactions (such as CYP1A2 inhibitors).

4. Management of common side effects of long-term medication

(1) Tolerable reactions: fatigue (26%), headache (22%), gastrointestinal symptoms, etc. usually alleviate with prolonged medication time.

(2) Intervention needed: Severe skin photosensitivity requires strict sun protection, and liver dysfunction requires timely medical attention.