Esbriet side effects and how to avoid them

Esbriet is a brand-name medication manufactured by Genentech. It is classified as a transforming growth factor inhibitor and is used for the treatment of idiopathic pulmonary fibrosis (IPF). While Esbriet is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Esbriet include gastrointestinal side effects. Less common, but more serious side effects, can include liver problems.

Learn more about the side effects of Esbriet and what you can do to avoid them.

What is Esbriet used for?

Esbriet contains pirfenidone as the active ingredient and is used for the treatment of idiopathic pulmonary fibrosis (IPF), a lung disease. IPF is a condition where scar tissue is formed deep within the lungs. This scar tissue over time becomes thicker and more rigid making it more difficult for the lungs to work properly and harder for you to breathe. The lack of oxygen caused by this affects how other organs function in your body causing other medical complications. Exactly what causes IPF is not known, but the disease is progressive and can be life-threatening. Esbriet will slow the progression of the disease but will not cure IPF.

Pirfenidone belongs to a class of medications called pyridones. Pirfenidone’s mechanism of action is thought to be through reducing lung scarring, by reducing the production of growth factors and procollagens I and II. (Procollagens are used to produce collagen, a protein that usually adds strength and support to many body tissues). The exact mechanism of action for pirfenidone in treating IPF is not fully understood.

How often should Esbriet be taken?

Esbriet is available as tablets: 267 mg, and 801 mg, and as capsules: 267 mg.

Esbriet is started on a dose of one capsule or tablet a day on the first week of treatment. It is gradually increased weekly by one tablet or capsule a week until you are taking one capsule or tablet three times a day. Esbriet is taken with food.

Temporary dose reduction, interruption, or permanent discontinuation of treatment may be required for the management of adverse reactions. Your doctor will carry out blood tests and liver function tests before and during treatment.

If you forget to take a dose, take it as soon as you can. If it is almost time for your next dose, skip the missed dose and take your next dose at the usual time.

You are advised to read the medication guide provided with this medicine for the complete drug information and patient information, and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What are the side effects of Esbriet?

The most common side effects of Esbriet in clinical trials (incidence of ≥10%) include:

  • Nausea, vomiting, diarrhea, dyspepsia, heartburn (gastroesophageal reflux disease), indigestion, stomach pain, loss of appetite, weight loss
  • Tiredness, headaches, dizziness
  • Joint pain
  • Skin sensitivity to light, skin rash
  • Upper respiratory tract infection
  • Sinusitis, stuffy nose, sore throat, sneezing
  • Non-cardiac chest pain
  • Insomnia (trouble sleeping)
  • Photosensitivity reactions and sunburn – avoid sunlamps and tanning booths. Use sunscreen or sunblock (SPF 50) and wear protective clothing when going outdoors

Esbriet can cause more serious side effects, including:

  • Severe abdominal pains, vomiting, diarrhea
  • Pain or burning in the throat
  • Liver injury – yellow color to eyes or skin (jaundice), darker stools and dark urine, tiredness, easily bruised

If you experience any of these serious side effects, stop taking Esbriet and seek medical attention immediately. You are encouraged to report adverse effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

Does Esbriet cause shortness of breath?

Esbriet may cause serious allergic reactions. Symptoms may include swelling of the face, lips, or tongue, and difficulty in breathing. Speak to your healthcare provider immediately for medical advice if you have these side effects.

Does Esbriet cause joint pain?

Joint pain is a common side effect of Esbriet.

Esbriet drug interactions

Esbriet can interact with other medications including:

  • Treatment for irregular heartbeats – amiodarone
  • Antibiotic treatment – ciprofloxacin, enoxacin
  • Treatment for cancer – capmatinib, pexidartinib, rucaparib, vemurafenib
  • Antidepressants – fluvoxamine
  • Immunosuppressive medication – leflunomide, teriflunomide
  • Treatment for high cholesterol – lomitapide, mipomersen
  • Treatment for hypertension and chronic angina pectoris – mibefradil
  • Medication for Cushing’s disease – osilodrostat

Before taking Esbriet, be sure to tell your doctor about all of the medications you are taking to ensure they are safe to take at the same time.

Esbriet warnings & precautions

Don’t take Esbriet if you:

  • Are allergic to the active ingredient pirfenidone
  • Have had an allergic reaction to any of the other ingredients in Esbriet

Talk to your doctor before taking Esbriet if you:

  • Are taking any of the medications that could interact with Esbriet
  • Have liver problems
  • Have kidney disease or are receiving dialysis treatment
  • Smoke
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed – It is not known if Esbriet passes into breast milk

You should always check with your doctor or pharmacist before taking any medication, including Esbriet, to make sure it is safe for you.

What happens if you stop taking Esbriet?

Do not stop taking Esbriet without speaking to your doctor first. Stopping it suddenly could make your condition worse. If you stop taking Esbriet for more than 14 days, you will need to restart treatment with 1 capsule 3 times a day.

Does Esbriet cause memory loss?

Memory loss is a common side effect in those taking Esbriet. It is more common in males who are over 60 and have been taking Esbriet for between 1 to 6 months.

How long can you take Esbriet?

Esbriet is a long-term treatment. Your doctor will monitor your liver function while you are taking this medication and will decide if and when you need to stop using it.

Can you drink alcohol with Esbriet?

Alcohol is not known to interact with Esbriet and it is safe to consume in small amounts. You are advised to consume no more than the weekly units for men or women.

Which is better Esbriet or Ofev?

Which medication is better will depend on each individual and their condition as well as the side effects they experience. Generally, Ofev has a rating of 8.5 out of 10, compared to Esbriet’s 5.5 out of 10.

What is the duration of treatment with Esbriet?

Esbriet is a long-term treatment. Your doctor will monitor your liver function while you are taking this medication and will decide if and when you need to stop using it. In trials, Esbriet was used for an average of 62 weeks but treatment ranged from 2 to 118 weeks.

How to avoid Esbriet side effects

The best way to avoid side effects is to take Esbriet as directed by your doctor. Follow your doctor’s instructions carefully and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Esbriet that has been recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Esbriet. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

5. Check your feet

If you have diabetes, check your feet regularly for any cuts, sores, or redness. Tell your doctor if you experience problems with your feet while taking Esbriet.

6. Know the signs and symptoms of Esbriet side effects

Signs and symptoms of side effects include gastrointestinal disturbances. If you experience any of these symptoms speak to your doctor for medical advice.

7. Monitor your weight

Esbriet may cause weight loss. If you experience this side effect while taking Esbriet, get medical advice from your doctor.

8. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Esbriet.

9. Get regular medical check ups

It is important to get regular medical check ups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Esbriet as needed.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

Share this page

Other articles on

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.