Promacta (eltrombopag) is a prescription drug that’s used to treat certain blood disorders. This drug can interact with other medications and some supplements. For example, Promacta can interact with calcium supplements and rosuvastatin (Crestor).
Promacta is used to treat:
- low platelet levels due to chronic (long-term) immune thrombocytopenia in adults and some children
- low platelet levels due to chronic hepatitis C in adults
- severe aplastic anemia in adults and some children
Promacta contains the active ingredient* eltrombopag. The drug comes in two forms: an oral tablet and a powder that you’ll mix with water to make a liquid suspension (a type of liquid mixture).
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Promacta’s possible interactions. And for more information about Promacta, including details about its uses, see this article.
* An active ingredient is what makes a drug work.
Before you start taking Promacta, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Promacta interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Promacta?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Promacta. Keep in mind that this table does not include all drugs that may interact with Promacta. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| certain cholesterol medications | • statins, such as rosuvastatin (Crestor) • ezetimibe (Zetia) | can increase the risk of side effects from the cholesterol drug |
| certain blood pressure medications | • olmesartan (Benicar) • valsartan (Diovan) | can increase the risk of side effects from the blood pressure medication |
| certain diabetes drugs | • glyburide (Diabeta) • repaglinide | can increase the risk of side effects from the diabetes drug |
| certain cancer drugs | • imatinib (Gleevec) • irinotecan (Camptosar, Onivyde) • topotecan (Hycamtin) | can increase the risk of side effects from the cancer drug |
| certain laxatives | • magnesium hydroxide (Phillips’ milk of magnesia) • magnesium citrate (Citroma) | can make Promacta less effective |
| certain antacids | • aluminum hydroxide/magnesium hydroxide (Maalox, Mylanta) • calcium carbonate (TUMS) | can make Promacta less effective |
| methotrexate (Trexall) | — | can increase the risk of side effects from methotrexate |
| bosentan (Tracleer) | — | can increase the risk of side effects from bosentan |
| certain migraine drugs | • atogepant (Qulipta) • ubrogepant (Ubrelvy) | can increase the risk of side effects from the migraine drug |
Promacta is not known to interact with alcohol.
However, Promacta and heavy alcohol use can cause some similar side effects, such as liver problems. You may be more likely to experience this side effect if you drink excessively during your Promacta treatment.
If you have questions about consuming alcohol during Promacta treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Promacta.
Interaction with certain cholesterol medications
Promacta can interact with certain cholesterol medications, which are prescribed to treat high cholesterol.
Examples of cholesterol medications include:
What could happen
Taking Promacta with certain cholesterol medications can raise your risk of side effects from the cholesterol drug, such as muscle pain.
Promacta can cause the cholesterol drug to build up in your body. This can raise your risk of side effects or make the side effects that you experience more severe.
What you can do
If you take Promacta with certain cholesterol medications, your doctor may prescribe a lower dosage of the cholesterol medication for you. You should not take a higher dose of either medication than your doctor prescribes.
If you have questions about taking Promacta with cholesterol medications, talk with your doctor or pharmacist.
Interaction with certain laxatives
Promacta can interact with certain laxatives, which help to relieve occasional constipation.
Examples of laxatives that may interact with Promacta include:
- magnesium hydroxide (Phillips’ milk of magnesia)
- magnesium citrate (Citroma)
What could happen
Taking Promacta with certain laxatives can make Promacta less effective.
Certain laxatives contain ingredients that attach to Promacta in the digestive tract. When this occurs, your body absorbs less Promacta into your bloodstream than usual. This reduces the level of the drug in your body, which may prevent Promacta from working effectively.
What you can do
To help avoid an interaction, you should take Promacta at least 2 hours before or 4 hours after you take these laxatives.
If you experience constipation during your Promacta treatment, talk with your doctor or pharmacist. They can suggest other ways to manage constipation. This may include increasing your intake of water and dietary fiber. They may also recommend a different type of laxative that doesn’t interact with Promacta.
If you have questions about taking Promacta with certain laxatives, talk with your doctor or pharmacist.
Interaction with certain antacids
Promacta can interact with certain antacids, which help to relieve heartburn and indigestion (upset stomach). These include antacids that contain aluminum, calcium, or magnesium.
Examples of these medications:
- calcium carbonate (TUMS, Pepto Kids)
- aluminum hydroxide/magnesium hydroxide (Maalox, Mylanta)
What could happen
Taking Promacta with these antacids can make Promacta less effective.
Certain antacids contain ingredients that attach to Promacta in the digestive tract. When this occurs, your body absorbs less Promacta into your bloodstream. This decreases the level of the drug in your body, which could make Promacta less effective.
What you can do
To avoid an interaction, you should take Promacta at least 2 hours before or 4 hours after you take antacids that contain aluminum, calcium, or magnesium.
If you’re experiencing heartburn or indigestion during your Promacta treatment, talk with your doctor or pharmacist. They can suggest other ways to manage your symptoms, such as avoiding certain foods. They may also recommend a different medication for managing your symptoms.
If you have questions about taking Promacta with certain antacids, talk with your doctor or pharmacist.
Promacta may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Promacta.
Does Promacta interact with supplements?
Before you start taking Promacta, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Promacta and herbs
There are currently no reports of Promacta interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Promacta.
Promacta interactions with vitamins and mineral supplements
Promacta can interact with certain minerals. Examples include aluminum, calcium, magnesium, iron, selenium, and zinc.
Many multivitamins and other dietary supplements contain minerals. Examples include:
- calcium supplements, such as Caltrate
- zinc supplements, such as Cold-EEZE
- iron supplements, such as ferrous sulfate
- magnesium supplements, such as MagOx
- multivitamins, such as Centrum
These minerals can attach to Promacta in the digestive tract. When this occurs, your body absorbs less Promacta into your bloodstream. This decreases the level of the drug in your body, which could make Promacta less effective.
Because of this risk, you should take Promacta at least 2 hours before or 4 hours after you take any supplements containing the minerals listed above. If you have questions about taking supplements during your Promacta treatment, talk with your doctor.
Does Promacta interact with food?
Consuming foods that contain certain minerals may make Promacta less effective if they are in your digestive tract at the same time. To help prevent interactions, you should take Promacta at least 2 hours before or 4 hours after you consume foods or drinks that contain:
- dairy products, such as cheese, coffee creamer, or milk
- orange juice or other beverages with added calcium
Taking Promacta with these foods (or too close together) could lower the level of the drug in your body. This may make Promacta less effective.
If you have questions about eating certain foods with Promacta, talk with your doctor.
Does Promacta interact with vaccines?
There are currently no reports of Promacta interacting with vaccines. If you have questions about getting certain vaccines during your Promacta treatment, talk with your doctor.
Does Promacta interact with lab tests?
There are currently no reports of Promacta interacting with lab tests. If you have questions about having certain lab tests during your treatment with Promacta, talk with the healthcare professional ordering the test.
Does Promacta interact with cannabis or CBD?There are currently no reports of Promacta interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Promacta.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Promacta contains the active drug eltrombopag, which doesn’t have specific contraindications. (An active ingredient is what makes a drug work. Contraindications are factors that may prevent a doctor from prescribing the drug due to the risk of harm.)
Still, some people should take this medication with caution. This is because having certain medical conditions or other factors may raise the risk of interactions with Promacta. Before taking Promacta, talk with your doctor about your health history. They’ll determine whether Promacta is right for you.
Health conditions or other factors that might interact with Promacta include:
Allergic reaction. If you’ve had an allergic reaction to Promacta or any of its ingredients, your doctor will likely not prescribe Promacta. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Breastfeeding. It’s not known whether Promacta is safe to take while breastfeeding. But to be safe, your doctor may recommend that you do not take this drug while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Cataracts. Promacta may cause cataracts. If you already have cataracts, taking Promacta could make your condition worse. Your doctor may recommend regular eye doctor visits to monitor or treat your cataracts during Promacta treatment.
Certain Asian ancestry. People of East Asian or Southeast Asian ancestry may have a higher risk of side effects from Promacta. If you’re of this ancestry, your doctor may prescribe a lower dosage to reduce your risk of side effects. To learn more, talk with your doctor.
Myelodysplastic syndromes (MDS). Taking Promacta may lead to blood cancer in people with MDS. If you have this condition, talk with your doctor before starting Promacta treatment. They may suggest a different treatment option for you.
Pregnancy. It’s not known whether Promacta is safe to take during pregnancy. But to be safe, your doctor may recommend that you do not take this drug while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Promacta.
Problems with bleeding or blood clots. Promacta may cause blood clots, especially if you already have a higher risk of blood clots. Before taking Promacta, let your doctor know if you have a condition that makes bleeding or blood clots more likely. Examples include a genetic (inherited) clotting disorder or a history of blood clots. Your doctor can determine whether Promacta is safe for you.
Taking certain steps can help you avoid interactions with Promacta. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Promacta treatment.
It’s also important to understand Promacta’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Promacta exactly as prescribed can also help prevent interactions.
If you still have questions about Promacta and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Do I need to space out when I take my medications or vitamins throughout the day to avoid interactions with Promacta?
- Could I still take Promacta even if it interacts with one of my health conditions?
- Is there an alternative to Promacta I may be able to take that has fewer interactions?
To learn more about Promacta, see these articles:
- All About Promacta
- Promacta Side Effects: What You Need to Know
- Promacta and Cost: What You Need to Know
- Dosage Details for Promacta
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
