The contraindications for Esbriet mainly involve specific liver function states, end-stage renal disease, and usage restrictions in special populations, which must be strictly followed to avoid serious adverse reactions.

1. Taboos related to liver function

(1) Child Pugh C-grade liver dysfunction: The use of pirfenidone is prohibited due to a lack of safety and pharmacokinetic data.

(2) History of drug-induced liver injury: Patients with severe liver injury related to pirfenidone in the past should not use it, and the medication should be permanently stopped when ALT/AST>5 times ULN needs to be monitored.

2 contraindications related to renal function

(1) End stage renal disease requires dialysis: the pharmacokinetics of this population have not been studied, and it is clearly not recommended to use it.

3 taboos for special populations

(1) Pregnancy period: Lack of medication data for pregnant women poses potential fetal risks, and the necessity of treatment needs to be evaluated.

(2) Children under 18 years old: Safety and efficacy have not been established, use is prohibited.

4 Other taboo situations

(1) History of severe photosensitive reactions: It is contraindicated for individuals with severe skin reactions such as Stevens Johnson syndrome who have previously used it.

(2) Combination use of potent CYP1A2 inducers: Smoking may reduce efficacy and should be used after quitting smoking.