What's the difference between pirfenidone and nintedanib?

How you take them

Pirfenidone requires three daily doses (totaling 2,403 mg) and must be taken with food. Nintedanib is two daily doses of 150 mg each, also taken with food. Nintedanib's simpler schedule appeals to some patients, though both require consistent adherence.

Known effects and side effects

Both slow lung function decline in idiopathic pulmonary fibrosis. Pirfenidone commonly causes nausea, sun sensitivity, and photosensitivity reactions. Nintedanib frequently causes diarrhea, which can be severe. Neither drug reverses existing lung damage. Clinical trials show both are modestly effective; neither is dramatically more powerful than the other.

Choosing between them

Your choice often depends on which side effects you can tolerate better. If diarrhea is a concern, pirfenidone might suit you; if nausea is your issue, nintedanib might work better. Some people try one, switch if side effects are unmanageable, and find the other more tolerable. Discuss with your doctor which aligns with your lifestyle and other medications.