Eltrombopag is a thrombopoietin receptor agonist medication that encourages the blood to clot by increasing the production of platelets in the bone marrow. It is prescribed for patients with thrombocytopenia, a condition in which there is an abnormally low level of platelets in the blood, which is caused by chronic idiopathic thrombocytopenia purpura (ITP), a blood disorder. Eltrombopag is only used after other treatments have failed, such as other medications and surgical spleen removal. As of 2011, not all doctors in the U.S. are able to prescribe this medication. They must be enrolled in a special program, called a restricted access program.
Patients are strongly urged to review the accompanying medication guide each time they refill their prescription, and they will also need to sign a waiver form before taking the drug if they are in a restricted access program in the U.S. Adults will typically begin with a dosage of 50 milligrams (mg) of eltrombopag, taken once daily. A standard dosage for children has not yet been established, as of 2011. The only available form of this drug is as a tablet to be taken orally, or by mouth. It should only be taken on an empty stomach, at least two hours following a meal or one hour prior to eating.
Special precautions must be followed when taking eltrombopag. Patients must be vigilant to follow all dosing instructions carefully. They must discuss with a doctor their use of multivitamins, antacids, and any other products that could contain calcium, iron, and aluminum, as well as zinc, selenium, and magnesium. This includes dairy products and any juices or foods that are fortified with calcium or other minerals. The use of these products must be restricted to at least four hours before or after taking this drug.
Patients taking eltrombopag will likely have their platelet levels monitored through weekly blood tests. They should notify their doctors about any side effects they experience, particularly those that persist or become severe. Side effects can include nausea, vomiting, and muscle pain. Red patches inside the eyelids or on the whites of the eyes may develop. Some people may notice unusually heavy or long menstrual periods, numbness, or heartburn.
More serious side effects require a doctor's urgent care. Patients should go to the emergency room if they suffer from rapid heartbeat, hyperventilation, or are coughing up blood. Swelling or redness in a leg, pain while breathing, and an abrupt cold sweat may develop. Difficult speech, fainting, and dizziness have been reported, as well as vision changes, weakness in a limb, and pain in the chest, stomach, or jaw.
Serious complications may also develop, such as a platelet level that is too high. This may lead to a blood clot and a possible heart attack or stroke. The bone marrow may also begin to manufacture abnormal blood cells or lower levels of blood cells, which may potentially be life-threatening. Some patients may develop cataracts, a vision condition. Eltrombopag may also cause severe liver damage, which can lead to symptoms such as jaundice, dark urine, and pain in the upper stomach area.
It is essential for the patient to disclose their other medical conditions before taking eltrombopag, particularly if they are pregnant or breastfeeding. Those who are of Asian descent may need to take a lower dosage of eltrombopag. Other medications and supplements should also be discussed, such as blood thinners, acetaminophen, and aspirin. Cholesterol drugs, narcotics, and methotrexate may interact with this drug.