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Eltrombopag is used to increase platelet levels in certain people with low levels of platelets. It works by signaling the body to make more platelets. Common side effects include nausea, fever, and cough. It is important to keep all appointments for blood tests and other tests while taking eltrombopag. 

Uses

What is eltrombopag used for?

Eltrombopag is commonly used for certain people with the following conditions.

Eltrombopag may also be used for other conditions as determined by your health care provider.

How does eltrombopag work (mechanism of action)?

Eltrombopag signals the body to make more platelets, which are cells that help the blood to clot.

How is eltrombopag supplied (dosage forms)?

Brands and other names

  • Alvaiz
  • Promacta

Dosage forms and strengths

  • 9 mg, 18 mg, 36 mg, 54 mg oral tablets (Alvaiz)
  • 12.5 mg, 25 mg, 50 mg, 75 mg oral tablets (Promacta)
  • 12.5 mg, 25 mg packets of powder for oral suspension (Promacta Kit)

How should I store eltrombopag?

Eltrombopag should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep eltrombopag in the container that it comes in.

Side Effects

What are the most common side effects of eltrombopag?

The most common side effects of eltrombopag are listed below. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of eltrombopag that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of eltrombopag?

While less common, the most serious side effects of eltrombopag are described below, along with what to do if they happen.

Severe Allergic Reactions. Eltrombopag may cause allergic reactions, which can be serious. Stop taking eltrombopag and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking eltrombopag. If you have hepatitis C, taking eltrombopag with ribavirin and interferon may increase the risk of liver damage. Keep all appointments for blood tests so that your health care provider can check the health of your liver. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Confusion
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Blood Clots. Eltrombopag may increase the risk of blood clots in your arteries or veins, including a blood clot in the lungs (pulmonary embolism), legs, thigh, pelvis, other areas (deep venous thrombosis or DVT), or the liver (portal vein thrombosis). This risk may be higher in people who have certain health conditions. Stop taking eltrombopag and get emergency help if you have any of the following signs of these blood clots. 

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Stomach pain or tenderness
  • Pain, swelling, or tenderness in your arm or leg
  • Nausea, vomiting, or diarrhea

Vision Problems. Eltrombopag may increase your risk for getting cataracts or for worsening of cataracts that you already have. Cataracts happen when the lens of your eye gets cloudy. Keep all appointments to have your eyes checked before and during treatment with eltrombopag. Tell your health care provider if you have any vision changes while taking eltrombopag.

Warnings & Precautions

Who should not use eltrombopag?

Allergies to Ingredients. People who are allergic to any of the following should not take eltrombopag.

  • Alvaiz
  • Eltrombopag
  • Promacta
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific eltrombopag products they stock.

What should I know about eltrombopag before using it?

Do not take eltrombopag unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share eltrombopag with other people, even if they have the same condition as you. It may harm them.

Keep eltrombopag out of the reach of children.

There are several forms of eltrombopag and they may need to be taken in different ways. Read and follow the instructions that come with your medicine and ask your health care provider if you are not sure how to take the eltrombopag form you are prescribed.

Do not chew, cut, or crush eltrombopag tablets or mix them with food or liquids.

Take eltrombopag without food or with a meal or snack that has no more than 50 mg of calcium. Calcium may bind to eltrombopag and make the medicine not work as well.

If you are taking eltrombopag liquid, make sure you understand how to prepare and measure a dose. Take the prepared dose within 30 minutes of mixing. If you do not take it within 30 minutes of mixing, throw it away. Use the measuring devices that come with the product to measure each dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist if you are not sure how to prepare your dose.

Keep all appointments for blood tests and other tests while you are taking eltrombopag. Tell your health care provider about any bleeding or bruising since this could mean that your platelet levels are too high or too low.

What should I tell my health care provider before using eltrombopag?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if eltrombopag is right for you.

In particular, make sure that you discuss any of the following.

Blood Conditions. Tell your health care provider if you have a blood condition called myelodysplastic syndromes (MDS). Eltrombopag could cause MDS to get worse or turn into a blood cancer called acute myeloid leukemia.

Other Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following. 

East Asian or Southeast Asian Ancestry. Tell your health care provider if you are of East Asian or Southeast Asian ancestry. Your health care provider may need to adjust your dose of eltrombopag.

Other Medicines and Supplements. Eltrombopag may interact with other medicines and supplements. Before taking eltrombopag, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how eltrombopag could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. If you can become pregnant, you should use effective birth control while taking eltrombopag and for at least seven days after your last dose.

Breastfeeding. It is not known if eltrombopag passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop eltrombopag.

 

Interactions

Does eltrombopag interact with foods or drinks?

Do not take eltrombopag within two hours before or four hours after eating foods with more than 50 mg of calcium, such as dairy products, fortified juices, or some fruits or vegetables. Calcium or other minerals may make eltrombopag not work as well. 

It is unknown if drinking alcohol will affect eltrombopag, but low platelet levels can increase your risk of bleeding. Since alcohol can also increase your risk of bleeding, it is best to limit the amount of alcohol you drink.

Does eltrombopag interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking eltrombopag.

  • An antacid, laxative, or supplement containing aluminum, calcium, iron, magnesium, selenium, or zinc
  • A statin, such as atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin, or simvastatin, which is a medicine to lower cholesterol
  • Bosentan, which is a medicine to treat pulmonary arterial hypertension
  • Ezetimibe, which is a medicine to treat high cholesterol
  • Glyburide or repaglinide, which are medicines to treat type 2 diabetes
  • Olmesartan or valsartan, which are angiotensin II receptor blockers (ARBs) used to treat high blood pressure, heart failure, and other heart conditions
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Certain medicines used to treat cancer, such as imatinib (Gleevec, Imkeldi), irinotecan, lapatinib (Tykerb), mitoxantrone, or topotecan 
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
  • Sulfasalazine (Azulfidine), which is a medicine used for certain inflammatory conditions, such as ulcerative colitis or rheumatoid arthritis
  • A medicine for hepatitis C
  • A blood thinner, which is a medicine used to treat or prevent blood clots

Eltrombopag may alter the blood levels of some other medicines. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with eltrombopag. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much eltrombopag?

If you or someone else has used too much eltrombopag, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of eltrombopag?

If you forget to take a dose of eltrombopag, wait and take your next scheduled dose. Do not take more than one dose of eltrombopag in a day.

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