• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

1. What Pirfenidone is and what it is used for
2. What you need to know before you take Pirfenidone
3. How to take Pirfenidone
4. Possible side effects
5. How to store Pirfenidone
6. Contents of the pack and other information

• 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.

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 co-ordinated.
• Pirfenidone can cause weight loss. Your doctor will monitor your weight whilst you are taking this medicine.
• Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in association with pirfenidone treatment. Stop using pirfenidone and seek medical attention immediately if you notice any of the symptoms related to these serious skin reactions described in section 4.

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.

Do not give Pirfenidone to children and adolescents under the age of 18.

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).

Do not drink grapefruit juice whilst taking this medicine. Grapefruit may prevent Pirfenidone from working properly.

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 breast-feeding if you decide to do so.

Do not drive or use machines if you feel dizzy or tired after taking Pirfenidone.

Pirfenidone contains less than 1 mmol sodium (23 mg) per tablet that is to say essentially ‘sodium-free’.

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

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 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.

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.

Talk to your doctor if you get any side effects.

Very common side effects (may affect more than 1 in 10 people):

• infections of the throat or the airways going into the lungs and/or sinusitis
• feeling sick (nausea)
• stomach problems such as acid reflux, vomiting and feeling constipated
• diarrhoea
• indigestion or stomach upset
• weight loss
• decreased appetite
• difficulty sleeping
• tiredness
• dizziness
• headache
• shortness of breath
• cough
• aching joints/joint pains

Common side effects (may affect up to 1 in 10 people):

• bladder infections
• feeling sleepy
• changes in taste
• hot flushes
• stomach problems such as feeling bloated, abdominal pain and discomfort, heart burn, and passing wind
• blood tests may show increased levels of liver enzymes
• skin reactions after going out in the sun or using sunlamps
• skin problems such as itchy skin, skin redness or red skin, dry skin, skin rash
• muscle pain
• feeling weak or feeling low in energy
• chest pain
• sunburn

Uncommon side effects (may affect up to 1 in 100 people):

• low levels of sodium in the blood. This may cause headache, dizziness, confusion, weakness, muscle cramps or nausea and vomiting
• blood tests may show decrease in white blood cells.

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 website www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

267 mg tablet

The active substance is pirfenidone. Each film-coated tablet contains 267 mg of pirfenidone.

The other ingredients are: lactose, croscarmellose sodium, silica colloidal anhydrous, magnesium stearate.

The film coat consists of: polyvinyl alcohol (E1203), titanium dioxide (E171), macrogol (E1521), talc (E553b), iron oxide yellow (E172).

534 mg tablet

The active substance is pirfenidone. Each film-coated tablet contains 534 mg of pirfenidone.

The other ingredients are: lactose, croscarmellose sodium, silica colloidal anhydrous, magnesium stearate.

The film coat consists of: polyvinyl alcohol (E1203), titanium dioxide (E171), macrogol (E1521), talc (E553b), iron oxide yellow (E172) and iron oxide red (E172).

801 mg tablet

The active substance is pirfenidone. Each film-coated tablet contains 801 mg of pirfenidone.

The other ingredients are: lactose, croscarmellose sodium, silica colloidal anhydrous, magnesium stearate.

The film coat consists of: polyvinyl alcohol (E1203), titanium dioxide (E171), macrogol (E1521), talc (E553b), iron oxide red (E172) and iron oxide black (E172).

267 mg tablet

Pirfenidone 267 mg film-coated tablets are yellow, oval, biconvex film-coated tablets, debossed with “267”.

534 mg tablet

Pirfenidone 534 mg film-coated tablets are orange, oval, biconvex film-coated tablets, debossed with “534”.

801 mg tablet

Pirfenidone 801 mg film-coated tablets are brown, oval, biconvex film-coated tablets, debossed with “801”.

The bottle packs contain 90 tablets or 180 tablets.

The blister packs contain 21, 42, 63, 84, 105, 126, 147, 168, 189, 210, 231, 252 film-coated tablets.

The 267 mg 2-week treatment initiation pack contain 63 film-coated tablets (3 blisters of 21 film-coated tablets or multipack consisted of 1 pack containing 1 blister of 21 film-coated tablets and 1 pack containing 2 blisters of 21 film-coated tablets).

The continuation pack contain 252 film-coated tablets (12 blisters of 21 film-coated tablets or multipack consisted of 3 packs each containing 4 blisters of 21 film-coated tablets).

The blisters strips are each marked with the following symbols and abbreviated names of the day as a reminder to take a dose three times a day:

(sunrise; morning dose)

(sun; daytime dose)

(moon; evening dose).

Mon. Tue. Wed. Thu. Fri. Sat. Sun.

Not all pack sizes may be marketed.

Manufacturer

Or