Starting Esbriet (pirfenidone)Your first 90 days with idiopathic pulmonary fibrosis (IPF): the steps, the dates and who to call

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Fill in with your doctor's office

First dose date

Doctor who prescribed it

Doctor's office phone

Specialty pharmacy name

Specialty pharmacy phone

Call your doctor right away about:

Yellowing of your skin or the whites of your eyes; dark or brown, tea-colored urine; pain on the upper right side of your belly; bleeding or bruising more easily than normal; feeling tired; skin blisters, a rash, sores in the mouth, hives or any other severe skin symptom.

Also tell your doctor's office about:

Nausea, vomiting, diarrhea, indigestion, heartburn or stomach pain that gets worse or does not go away
A sunburn or a rash
Any new medicine before you start it, especially fluvoxamine or ciprofloxacin
A break of 14 days or more from Esbriet, before you take it again

Esbriet Co-pay Program and Legacy Patient Program (Legacy Pharma)1-866-435-8080

Monday to Friday, 9 AM to 5 PM Eastern, per the patient site (the prescriber site says 6 PM)

The drugmaker's support program, for questions about getting the medicine and paying for it. Answer calls from the specialty pharmacy; a missed call can delay your delivery.

Scan for your full plan, with every date added to your phone calendartrialfriend.com/p/esbriet

How you take it

Tablets 3 times a day, with breakfast, lunch and dinner. You start with 1 small tablet each time, and the dose builds up over 2 weeks.

Before your first dose

A blood test of your liver, because Esbriet can affect the liver.
A full medicine check. Some medicines, such as fluvoxamine and ciprofloxacin, raise Esbriet levels and can change your dose.
If you smoke, a talk with your doctor about stopping, because smoking lowers the amount of Esbriet in your blood.
Sun protection, because Esbriet can make your skin burn more easily. That means sunscreen of SPF 50 or higher, a hat and clothes that cover your skin.
Your insurance approves the medicine. Some plans want generic pirfenidone tried first. Legacy Pharma, the drugmaker, may help with costs at 1-866-435-8080.

The first 90 days

Before day 1Liver blood test before your first dose
Week beforeInsurance approval, brand or generic
Day 1First dose, 1 tablet 3 times a day
Day 8Week 2, 2 tablets 3 times a day
Day 15Full dose, 3 tablets with each meal
About day 30, then every 30 daysLiver test, then monthly
Around day 38, then every 30 daysFirst refill, about 5 weeks in
Day 90Three months in

Trial Friend, trialfriend.com. From the Esbriet FDA label dated June 9, 2025 and the drugmaker's program, checked November 9, 2026. Not medical advice: Trial Friend is not a medical provider, and your doctor decides your dose and tests.