Esbriet (pirfendone) 267mg 270 Capsules

Esbriet is a medication containing the active ingredient Pirfenidone, used primarily in the treatment of idiopathic pulmonary fibrosis (IPF). It is manufactured by Genentech, a member of the Roche Group. Pirfenidone is classified as an anti-fibrotic and anti-inflammatory agent, helping to slow down disease progression and improve patients’ quality of life by reducing lung scarring and preserving lung function.

How It Works

Pirfenidone, the active component in Esbriet, works through multiple pathways to exert its anti-fibrotic and anti-inflammatory effects: 1. **Inhibition of TGF-β**: – Transforming Growth Factor-beta (TGF-β) is a key mediator in the fibrotic process, leading to the accumulation of extracellular matrix and collagen deposition. Pirfenidone inhibits TGF-β signaling, reducing fibroblast proliferation and collagen synthesis. 2. **Reduction of Pro-inflammatory Cytokines**: – Pirfenidone decreases the production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6). By modulating these cytokines, Pirfenidone reduces inflammation in the lung tissue. 3. **Antioxidant Properties**: – Pirfenidone exhibits antioxidant effects, protecting cells from oxidative stress-induced damage. This property helps mitigate the harmful effects of free radicals on lung tissue. 4. **Inhibition of Fibroblast Proliferation**: – By directly targeting fibroblasts, Pirfenidone reduces their proliferation and differentiation into myofibroblasts, key players in the fibrotic process. This action helps limit excessive scar tissue formation in the lungs.

Indications

Esbriet is primarily indicated for the treatment of **Idiopathic Pulmonary Fibrosis (IPF)**, a chronic and progressive lung disease characterized by scarring of lung tissue. The main indications include:

• Idiopathic Pulmonary Fibrosis (IPF):
  • Esbriet is indicated for the treatment of adult patients with mild to moderate idiopathic pulmonary fibrosis to slow the decline in lung function and improve survival rates.

Side Effects

Esbriet may cause a variety of side effects, ranging from mild to severe. Here are some of the most common and serious side effects associated with its use:

• Common Side Effects:
  • Nausea
  • Diarrhea
  • Fatigue
  • Dyspepsia (indigestion)
  • Anorexia
  • Dizziness
  • Skin rash
  • Photosensitivity reactions (sensitivity to sunlight)
  • Headache
  • Weight loss
• Serious Side Effects:
  • **Liver Dysfunction**:
    • Elevation of liver enzymes (ALT, AST, and bilirubin) can occur, leading to liver injury. Regular monitoring of liver function tests is recommended.
  • **Severe Photosensitivity**:
    • Severe sunburn or blistering can occur with exposure to sunlight. Patients should use sun protection measures to minimize this risk.
  • **Allergic Reactions**:
    • Hypersensitivity reactions, including angioedema, have been reported. Immediate medical attention is required if symptoms of an allergic reaction occur.
  • **Gastrointestinal Disorders**:
    • Severe gastrointestinal symptoms, such as persistent nausea, vomiting, and abdominal pain, may require dose adjustment or discontinuation of therapy.

Contraindications

Esbriet is contraindicated in certain situations, and patients should be screened carefully before starting treatment:

• Severe Liver Impairment:
  • Esbriet is contraindicated in patients with severe hepatic impairment or end-stage liver disease due to the increased risk of liver toxicity.
• Severe Renal Impairment:
  • Patients with severe renal impairment (eGFR < 30 mL/min/1.73 m²) or those undergoing dialysis should not use Esbriet.
• Hypersensitivity to Pirfenidone:
  • Patients with known hypersensitivity to Pirfenidone or any component of the formulation should avoid using Esbriet.
• Use of Strong CYP1A2 Inhibitors:
  • Concurrent use of strong CYP1A2 inhibitors, such as fluvoxamine, is contraindicated due to increased Pirfenidone exposure and potential toxicity.

Pricing Information

Below is a table detailing the price of Esbriet in various countries. Prices may vary based on the healthcare system, availability, and dosage requirements.

Country	Price (per 270 Capsules)	Reference
United States	$9,500 – $10,500	GoodRx
United Kingdom	£5,000 – £6,000	NHS BNF
Australia	AUD $13,000 – $14,000	PBS
Canada	CAD $12,000 – $13,500	DrugBank
Germany	€7,000 – €8,000	Apotheken Umschau

Top 5 Global Brands

Several pharmaceutical companies produce medications for idiopathic pulmonary fibrosis and related conditions. Here are some of the top global brands:

• Esbriet (Pirfenidone) – Roche/Genentech
• Ofev (Nintedanib) – Boehringer Ingelheim
• Pirfenex (Pirfenidone) – Cipla
• Etopen (Pirfenidone) – Sun Pharma
• Pirespa (Pirfenidone) – Shionogi