Different types of medications are often part of an IPF treatment plan. Some are used to slow the progression of fibrosis, while others help relieve symptoms.
Antifibrotics
Antifibrotics are the primary medications used to treat IPF, and there are currently three options approved by the U.S. Food and Drug Administration (FDA), says Guillermo Garrido, MD, a board-certified physician with Orlando Health Medical Group Pulmonary and Sleep Medicine, based in Orlando, Florida, with a special interest in advanced and interstitial lung disease.
Rather than reversing the scarring that has already occurred, antifibrotics help slow the rate at which the lungs build scar tissue and help preserve lung function over time, says D’Souza. Because of this, they’re typically started at or soon after diagnosis, depending on the individual, he adds.
Antifibrotic medications used to treat IPF include:
- nintedanib (Ofev)
- pirfenidone (Esbriet)
- nerandomilast (Jascayd)
All three are taken by mouth. Nerandomilast received FDA approval in 2025, making it the first new treatment approved for IPF in more than a decade.
It works through a different mechanism than the other two antifibrotics and is generally used as an alternative for people who are not able to tolerate nintedanib or pirfenidone, says D’Souza.
Side effects of these medications vary, but they may include:
- Diarrhea
- Nausea or vomiting
- Loss of appetite or weight loss
- Elevated liver enzymes
- Fatigue
- Headache or dizziness
Some people may experience sun sensitivity or a skin rash with pirfenidone, so protecting your skin from sun exposure is important.
Your healthcare team will monitor you for side effects and may adjust your dose or treatment if needed.
Corticosteroids
Corticosteroids (commonly referred to simply as steroids) may be prescribed during flare-ups, also called acute exacerbations, says D’Souza. These medications help reduce lung inflammation and may relieve symptoms during these episodes.
There’s limited evidence on how much they improve outcomes, so they’re generally reserved for short-term use.
Steroid medications used in IPF include prednisone (Deltasone, Predone, Sterapred) and methylprednisolone (Medrol).
Common side effects may include:
- Trouble sleeping
- Weight gain
- Upset stomach
- Insomnia
- Swelling in the legs and midsection
- High blood pressure
- High blood sugar levels
- Mood changes, such as irritability or anxiety
- Increased risk of infection
Acid Reflux Medications
Many people with IPF also have gastroesophageal reflux disease (GERD), or acid reflux.
When stomach acid flows back up into the esophagus, small amounts can sometimes reach the airways or be inhaled into the lungs. This can irritate lung tissue and may worsen symptoms like coughing or shortness of breath.
Medications used to treat GERD work by either blocking acid production in the stomach or reducing how much acid is released.
While research is still ongoing, these medications are used to manage GERD symptoms rather than treat IPF.
Acid reflux medications that may be used include:
- omeprazole (Prilosec)
- esomeprazole (Nexium)
- famotidine (Pepcid)
Side effects of these medications may include:
- Headache
- Nausea or upset stomach
- Diarrhea or constipation
Cough Suppressants
A persistent, dry cough is a common and often frustrating symptom of IPF, and it can be difficult to control with standard cough medications.
Your doctor may recommend a cough suppressant to help, though what works varies from person to person, says D’Souza.
Depending on your symptoms, your healthcare team may recommend over-the-counter or prescription options.
Cough suppressants that may be used in IPF include dextromethorphan (Delsym, Robitussin) and benzonatate (Tessalon Perles).
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