Eltrombopag

Eltrombopag is a thrombopoietin receptor agonist medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Chronic immune thrombocytopenia in adults and children when response to other treatments is inadequate.
• Thrombocytopenia associated with chronic hepatitis C, to allow or optimise interferon-based antiviral therapy where this approach is used.
• Severe aplastic anaemia, including use with immunosuppressive therapy or in patients with inadequate response to previous therapy, under specialist supervision.

Eltrombopag dosing is individualised according to the condition being treated, platelet count, liver function, ethnicity, other medicines, and response to treatment. It is usually taken once daily, and the dose is adjusted by the doctor based on regular blood tests. It should generally be taken on an empty stomach or as directed, and separated from dairy products, antacids, iron, calcium, magnesium, aluminium, zinc, or multivitamins because these reduce absorption. Do not change the dose or stop treatment without medical advice.

• Common side effects may include headache, nausea, diarrhoea, abdominal discomfort, tiredness, cough, upper respiratory tract infection, and rash.
• Blood tests may show increased liver enzymes or bilirubin.
• Serious side effects can include liver injury, blood clots, very high platelet counts, worsening blood counts after stopping, cataracts, and in some bone marrow disorders possible progression of disease.
• Seek urgent medical help for yellowing of the skin or eyes, dark urine, severe abdominal pain, chest pain, shortness of breath, sudden weakness, vision changes, or swelling/pain in a limb.

Use Eltrombopag carefully in people with liver disease, kidney disease, a history of blood clots, risk factors for thrombosis, cataracts, bone marrow disorders, or myelodysplastic syndromes. Regular platelet counts, complete blood counts, and liver function tests are important during treatment. It is not intended to make platelet counts normal; the aim is to reduce bleeding risk. Use this medicine only under the guidance of a registered doctor or pharmacist.

• Antacids, dairy products, calcium, iron, magnesium, aluminium, zinc, selenium, and multivitamin/mineral supplements can markedly reduce absorption; doses usually need to be separated as instructed by the doctor.
• High-calcium meals can reduce absorption and should be avoided near the time of dosing unless the prescriber advises otherwise.
• Eltrombopag may increase exposure to some statins, such as rosuvastatin, pravastatin, pitavastatin, atorvastatin, and fluvastatin; dose adjustment or monitoring may be needed.
• Some antivirals and immunosuppressants, including ciclosporin, may affect Eltrombopag levels or response.
• Medicines that affect bleeding or clotting, such as anticoagulants and antiplatelet drugs, require careful medical monitoring.

• Do not use Eltrombopag in anyone with known hypersensitivity or serious allergic reaction to eltrombopag or any tablet ingredient.
• Do not use it without a confirmed diagnosis and a doctor’s prescription, because low platelets can have many causes requiring different treatment.

There are limited human data on use of Eltrombopag during pregnancy. It should be used in pregnancy only if the expected benefit justifies the potential risk, under specialist advice. It is not known whether eltrombopag passes into human breast milk; breastfeeding decisions should be made with the doctor, considering the importance of treatment and possible risk to the infant.

Store tablets at room temperature, away from excess heat, moisture, and direct light. Keep in the original packaging and out of the reach of children. Do not use after the expiry date, and return unused or expired medicine to a pharmacy when possible.