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Care During Chemotherapy and Beyond

Eltrombopag

(el TROM boe pag)

Trade Name(s): Promacta®

Eltrombopag is the generic name for the trade name drug Promacta. In some cases, health care professionals may use the trade name, Promacta, when referring to the generic drug name, eltrombopag.

Drug Type: Eltrombopag is a hematopoietic agent, specifically, a thrombopoietic agent. This medication is classified as a "colony stimulating factors." (For more detail, see "How Eltrombopag Works" below)

What Eltrombopag Is Used For

  • This drug is used to stimulate the growth and development of platelets in the bone marrow.
  • It is used for patients with low platelet levels who also have the condition of aplastic anemia, chronic immune thrombocytopenia, or chronic hepatitis C associated thrombocytopenia.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Eltrombopag Is Given

  • This medication is taken by mouth as a tablet. (In special circumstances, the medication may be prepared as an oral suspension, a liquid. It must be mixed and used quickly if taken as a liquid.)
  • Take eltrombopag on an empty stomach (at least 1 hour before or 2 hours after a meal).
  • Take eltrombopag at least 2 hours before or four hours after foods that are high in calcium (including dairy foods).
  • The schedule of how often you take this medication is determined by your provider.
  • Take eltrombopag at approximately the same time each day.
  • Take eltrombopag exactly as prescribed.
  • Swallow eltrombopag tablets whole with at least 8 ounces of water. Do not crush, open, chew or dissolve capsules.
  • Do not change your dose or stop eltrombopag unless your health care provider tells you to do so.
  • If you miss a dose of eltrombopag, it should be taken as soon as possible on the same day with return to the normal schedule the following day. Do not take extra capsules of eltrombopag to make up the next dose.
  • Do not take more than 1 dose of eltrombopag at one time. Call your health care provider and go to the emergency room right away if you take too much.
  • Store tablets at room temperature (68° F to 77° F); keep medication in original container; protect from high humidity, moisture and light. If mixing and using a suspension, it may be stored up to 30 minutes at room temperature.
  • Keep out of reach from children and pets.
  • Safely throw away any eltrombopag that is out of date or unused (ask your provider for directions on how to discard the medication).

The amount (dose) of eltrombopag that you will take depends on many factors, including your height and weight, your general health or other health problems, and the type of condition you have. There is a dose adjustment if you are of East Asian ethnicity. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of eltrombopag:

  • Most people will not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset, duration, and severity.
  • Most side effects will improve with continued therapy.
  • Side effects are generally quite manageable. There are many options to minimize or prevent the side effects of medication.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • The frequency of side effects with eltrombopag vary based on the underlying condition (aplastic anemia, immune thrombocytopenia, or chronic hepatitis C).

If you have chronic immune thrombocytopenia:

The following side effects (occurring in 3-29%) for patients taking eltrombopag:

If you have aplastic anemia:

The following side effects are (occurring in 10-29%) for patients taking eltrombopag. These side effects were observed in clinical trials, though most were not shown to occur with any greater frequency than in patients in the same trials that were taking a placebo:

If you have chronic hepatitis C:

The following side effects are common (occurring in greater than 30%) for patients taking eltrombopag:

These are less common side effects (occurring in 10-29%) for patients receiving eltrombopag. These side effects were observed in clinical trials, through most were not shown to occur with any greater frequency than in patients in the same trials that were taking a placebo:

If you have chronic hepatitis C and are taking interferon and ribavirin, a serious side effect of eltrombopag may be increased risk of serious and potentially life threatening liver toxicity.

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here.

You should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Liver problems identified by:
    • Yellowing of your skin or the whites of your eyes
    • Severe nausea and vomiting
    • Pain on the right side of your stomach
    • Dark, tea colored urine
    • Bleeding or bruising more easily than normal

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting eltrombopag, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • There are potential drug interactions with eltrombopag and multivitamins, calcium, aluminum hydroxide (antacid), iron, magnesium, selenium, sucralfate, and zinc as well some other medications.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking eltrombopag.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. This drug is in pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus). Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking eltrombopag. Barrier methods of contraception, such as condoms, are recommended and for 3 months after last dose of eltrombopag.
  • Do not breast feed while taking eltrombopag.

Self-Care Tips

  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • If needed, follow regimen of anti-diarrhea medication as prescribed by your health care professional.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
  • Ask your health care provider for advice on what you may use if headache, muscle or joint aches develop.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills. Ask your provider what is safe for you to use if needed.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Eltrombopag

You will be checked regularly by your doctor while you are taking eltrombopag to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) and your liver function.

How Eltrombopag Works

Colony Stimulating Factors:

In the body, bone marrow (soft sponge-like material found inside bones) produces blood cells. There are three major types of blood cells: white blood cells which fight infection, red blood cells which carry oxygen to and remove waste products from organs/tissues, and platelets which enable the blood to clot. Colony stimulating factors (growth factors) are substances that stimulate the production of certain blood cells and promote their ability to function.

Eltrombopag is a growth factors that stimulates platelet production via the thrombopoietin (TPO) receptor. Eltrombopag is a thrombopoietin nonpeptide agonist which increases platelet counts by binding to and activating the TPO receptor. It activates pathways within the cell to increase the production and differentiation (development) of marrow progenitor (parent) cells to encourage platelet production.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Reference:

  • Eltrombopag. Lexicomp Online® [updated August 2, 2017; cited 2017 August 7]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; August 7, 2017.

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