化合物详情

Likelihood score: D (possible rare cause of clinically apparent liver injury).

IDENTIFICATION AND USE: Pirfenidone is a white solid. It is used as medication for the treatment of idiopathic pulmonary fibrosis. HUMAN EXPOSURE AND TOXICITY: Reports of angioedema (some serious) such as swelling of the face, lips and/or tongue which may be associated with difficulty breathing or wheezing have been reported with use of pirfenidone in the post-marketing setting. ANIMAL STUDIES: In a 24-month carcinogenicity study in rats, pirfenidone caused statistically significant dose-related increases of the combination of hepatocellular adenoma and carcinoma in male rats at doses of 750 mg/kg and above (AUC exposure approximately 1.9 times adult exposure at the MRDD). There were statistically significant increases of the combination of hepatocellular adenoma and carcinoma and the c...

/OTHER TOXICITY INFORMATION/ Elevations in serum transaminase (ALT and/or AST) concentrations exceeding 3 times the upper limit of normal (ULN) have occurred in patients receiving pirfenidone; concomitant elevations in bilirubin concentrations have been reported rarely. ALT or AST elevations of at least 3 times the ULN were reported in 3.7% of patients receiving pirfenidone compared with 0.8% of patients receiving placebo in clinical studies; ALT or AST elevations of 10 times the ULN or greater occurred in 0.3% of pirfenidone-treated patients. Increases in liver enzymes were reversible following dosage modification or interruption of therapy. No cases of liver transplant or death due to liver failure related to pirfenidone use have been reported to date; however, the manufacturer states...

References: DOI:10.1016/j.drudis.2016.02.015

Cigarette smoking reduces peak plasma concentrations and systemic exposure to pirfenidone by 32 and 54%, respectively. The manufacturer recommends that patients be encouraged to stop smoking prior to initiation of pirfenidone and to avoid smoking during therapy.

In the event of a suspected overdosage, appropriate supportive medical care should be provided, including monitoring of vital signs and observation of the clinical status of the patient.