ELTROMBOPAG

Eltrombopag is a thrombopoietin (TPO) receptor agonist that binds and activates human TPO receptor and initiates signal transduction pathways inducing marrow progenitor cells proliferation and differentiation thus increasing platelet production.

Eltrombopag is used in the following conditions:

  • Idiopathic thrombocytopenic purpura
  • Severe aplastic anaemia
  • Thrombocytopenia associated with chronic hepatitis C

Eltrombopag should not be used by people with the following conditions:

  • Liver problems
  • Gastrointestinal problems

Eltrombopag can give rise to the following side effects:

Significant: Thromboembolic events (e.g. portal vein thrombosis), cataract formation, retinal haemorrhages, abnormal LFT, increased ALT, AST, bilirubin, risk of reticulin fibre bone marrow deposition, risk of bone marrow fibrosis w/ cytopenia; haematopoietic malignancies progression (e.g. myelodysplastic syndrome), cytogenic abnormalities, QT prolongation.

Nervous: Headache, insomnia, fatigue, paraesthesia, depression, anxiety, sleep disorder, confusional state, agitation, irritability, dizziness, attention disturbance, lethargy, memory impairment, vertigo, flu-like symptoms, asthenia, malaise, syncope.

CV: Peripheral oedema.

GI: Dyspepsia, nausea, vomiting, diarrhoea, constipation, mouth ulceration, toothache, oral herpes, gastroenteritis, decreased/increased appetite, dysgeusia, ascites, abdominal pain, dry mouth, abdominal distention or discomfort, GERD, haemorrhoids, gastritis, oesophageal varices, gingival bleeding, oral pain, dysphagia, discoloured faeces, swollen tongue, GI motility disorder, flatulence.

Resp: Nasopharyngitis, upper resp tract infection, rhinitis, cough, oropharyngeal pain, rhinorrhea, bronchitis, pharyngitis, dyspnoea, chest pain, chest discomfort, epistaxis.

Hepatic: Malignant hepatic neoplasm, hepatic encephalopathy, jaundice.

Genitourinary: UTI, chromaturia.

Endocrine: Menorrhagia, abnormal wt loss, hyper/hypoglycaemia, increased creatinine phosphokinase (CPK).

Haematologic: Anaemia, hemolytic anaemia, lymphopenia; decreased WBC, Hb, neutropenia, splenic infarction, Fe overload.

Musculoskeletal: Myalgia, arthralgia, muscle spasms, back pain, pain in extremity, musculoskeletal pain, bone pain.

Ophthalmologic: Dry eye, retinal exudates, ocular icterus, eye pruritus, octural icterus, blurring of vision, visual impairment, vitreous floaters.

Dermatologic: Rash, pruritus, alopecia, ecchymosis, petechiae, urticaria, skin lesion.

Others: Pyrexia, chills, pain.

Potentially Fatal: Severe hepatotoxicity.

Precautions

Take extra caution in patients with the following conditions:

  • Patient w/ risk factors for thromboembolism
  • Advanced age
  • Prolonged period of immobilisation
  • Malignancies
  • Surgery/trauma
  • Smokers
  • Obese patients
  • Patients of East Asian origin
  • Patient on contraceptives and hormone therapy
  • Hepatic and renal impairment
  • Children
  • Pregnancy and lactation

This drug is not intended to normalise platelet count.

 

Interactions

Eltrombopag can interact with the following medicines:

  • Ciclosporin
  • Lopinavir-ritonavir
  • CYP1A2 and CYP2C8 inducers (e.g. rifampicin)
  • Polyvalent cations (e.g. Fe, Ca, Mg, Al, selenium, Zn)
  • CYP1A2 and CYP2C8 inhibitor (e.g. fluvoxamine)
  • Rosuvastatin
  • Interferon
  • Ribavirin

Symptoms of overdose are:

  • Excessive increase in platelet count that may lead to thrombotic/thromboembolic complications
  • Mild rash
  • Transient bradycardia
  • Increased ALT/AST
  • Fatigue

 

Available Brand:

  • Promacta

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