Pirfenidone
Dosing in kidney impairment
Renal Impairment Pirfenidone should be used with caution in patients with mild (CL cr 50 to 80 mL/min), moderate (CL cr 30 to 50 mL/min), or severe (CL cr less than 30 mL/min) renal impairment [see Clinical Pharmacology ]. Monitor for adverse reactions and consider dosage modification or discontinuation of pirfenidone as needed [ see Dosage and Administration ] .
The safety, efficacy, and pharmacokinetics of pirfenidone have not been studied in patients with end-stage renal disease requiring dialysis. Use of pirfenidone in patients with end-stage renal diseases requiring dialysis is not recommended.
Dosing in liver impairment
Testing Prior to Pirfenidone Capsules Administration Conduct liver function tests prior to initiating treatment with pirfenidone capsules [see Warnings and Precautions ].
Preparation and administration
If patients experience significant adverse reactions (i.e., gastrointestinal, photosensitivity reaction or rash, severe cutaneous adverse reactions (SCAR)), consider temporary dosage reductions or interruptions of pirfenidone capsules to allow for resolution of symptoms. If a SCAR is confirmed, permanently discontinue pirfenidone capsules [see Warnings and Precautions (5.1 , 5.2 , 5.3 , 5.4) ] .