Positives

• In one phase 2 study, patients on pirfenidone showed mean predicted FVC increases of 12.74% versus 4.35% on placebo, with 55% reporting clinically meaningful quality-of-life improvement PMC.
  
  
• In real-world Taiwan data, only about 4% of patients discontinued pirfenidone for adverse events, with most tolerating long-term therapy PMC.
  
  

Negatives

• Patients commonly describe gastrointestinal upset, photosensitivity skin reactions, and elevated liver enzymes severe enough to drop dose or stop the drug European Respiratory Review.
  
  
• Up to 16-20% of patients in real-world cohorts ultimately stopped pirfenidone, most often for skin or GI adverse events PubMed.
  
  

Hurdles & Side Effects

• Pirfenidone is FDA-approved only for idiopathic pulmonary fibrosis, leaving post-COVID patients to access it off-label and often without insurance coverage Pulmonary Fibrosis Foundation.
  
  
• Patients describe needing strict sun avoidance, food-with-dose timing, and frequent liver enzyme monitoring as ongoing burdens of staying on therapy PMC.