Highlights for eltrombopag

  1. Eltrombopag oral tablet is available as a brand-name drug. It’s not available as a generic drug. Brand name: Promacta.
  2. Eltrombopag comes in two forms: oral tablet and oral suspension.
  3. Eltrombopag oral tablet is used to treat low platelet levels due to chronic immune thrombocytopenia (ITP) or chronic hepatitis C virus infection. It’s also used to treat severe aplastic anemia.

Important warnings

FDA warning: Liver problems warning

  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • This drug may increase your liver enzymes. This can lead to liver damage. Your doctor will check your liver function when you first start taking this drug and during treatment. If your liver isn’t working well, your doctor may lower your dosage or stop your treatment with this drug.

Other warnings

  • Disease progression warning: If you have myelodysplastic syndrome (MDS), this drug can cause your condition to progress to acute myeloid leukemia (AML). For people with MDS, this drug also increases the risk of death. Don’t use this drug if you have MDS.
  • Blood clots warning: This drug increases platelet counts. This may cause blood clots. If you have other blood clot risk factors, ask your doctor if this drug is safe for you.
  • Cataracts warning: This drug may cause cataracts (a clouding of the lens in your eyes). If you already have cataracts, this drug may make your condition worse. Your doctor will give you an eye exam before starting your treatment with this drug. They will also check you for signs of eye problems during treatment. If you develop cataracts, your doctor will lower your dosage or stop your treatment with this drug.

What is eltrombopag?

Eltrombopag is a prescription drug. It comes as an oral tablet and an oral suspension.

Eltrombopag oral tablet is available as the brand-name drug Promacta. It’s not available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Eltrombopag is used to treat:

  • Low platelet levels due to chronic immune thrombocytopenia (ITP). This is a bleeding disorder. Eltrombopag is given to people who haven’t responded well to other drugs or surgery.
  • Low platelet counts due to chronic hepatitis C virus infection. This drug is used before and during treatment with the drug pegylated interferon and ribavirin.
  • Severe aplastic anemia. Aplastic anemia is when you have bone marrow failure, which results in low levels of platelets, red blood cells, and white blood cells. This drug is given when other drugs haven’t worked well.

Eltrombopag is not used to treat myelodysplastic syndrome (MDS).

How it works

Eltrombopag belongs to a class of drugs called thrombopoietin (TPO) receptor agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Eltrombopag works by increasing cells in your bone marrow. It causes these cells to make more platelets. This effect lowers your risk of bleeding.

  • If you have any signs of unusual bleeding or bruising while taking eltrombopag, call your doctor right away. Your doctor may tell you to stop taking this drug if you’re also taking blood-thinning medications.

Eltrombopag side effects

Eltrombopag oral tablet may cause drowsiness. It can also cause other side effects.

More common side effects

The more common side effects of eltrombopag can include:

  • anemia
  • nausea
  • fever
  • tiredness
  • cough
  • headache
  • diarrhea
  • flu
  • loss of appetite

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Liver problems. Symptoms can include:
    • yellowing of your skin or the whites of your eyes
    • dark urine
    • unusual tiredness
    • stomach pain on your right side
    • confusion
    • swelling of your abdomen
  • Blood clots, such as:
    • Deep vein thrombosis. This is a blood clot in your legs. Symptoms can include:
      • pain in your calf, foot, or leg
      • swelling or tenderness of your legs
    • Pulmonary embolism. This is a blood clot in your lungs. Symptoms can include:
      • chest pain
      • shortness of breath
      • cough
  • Cataracts (clouding of the lens in your eyes). Symptoms can include:
    • blurry or cloudy vision
    • sensitivity to light
    • trouble seeing at night
    • seeing halos (circles) around lights

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Eltrombopag may interact with other medications

Eltrombopag oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with eltrombopag are listed below.

Interactions that increase your risk of side effects

Increased side effects from other drugs: Taking eltrombopag with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

  • Bosentan, ezetimibe, glyburide, olmesartan, repaglinide, rifampin, valsartan, imatinib, irinotecan, lapatinib, methotrexate, mitoxantrone, sulfasalazine, and topotecan
    • Your doctor may lower your dosage of these drugs if needed.
  • Cholesterol-lowering drugs such as rosuvastatin, atorvastatin, fluvastatin, pitavastatin, pravastatin, and simvastatin
    • Increased side effects can include muscle pain. Your doctor may lower the dosage of your cholesterol drugs.

Interactions that can make your drugs less effective

When used with eltrombopag, these drugs can make eltrombopag less effective. This means it won’t work as well to treat your condition. This is because the amount of eltrombopag in your body may be decreased. Examples of these drugs include:

  • Antacids, vitamins, or supplements that contain calcium, aluminum, iron, selenium, zinc, or magnesium
    • To avoid interactions, you should take eltrombopag two hours before or four hours after taking any of these products.

    Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Eltrombopag warnings

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue
  • skin rash
  • itchiness

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Food interactions warning

Foods that contain calcium may make eltrombopag less effective. These foods include dairy products, such as milk and cheese. Take this drug at least two hours before eating calcium-rich foods, or four hours after eating calcium-rich foods.

Warnings for people with certain health conditions

For people with myelodysplastic syndrome (MDS): This drug can cause your condition to progress to acute myeloid leukemia (AML). It also raises your risk of death. Don’t use this drug if you have MDS.

For people with liver problems: If you have liver problems or a history of liver disease, you may not be able to process this drug well. This medication may also decrease your liver function, making your liver disease worse. Ask your doctor if this medication is safe for you.

For people with blood clotting disorders: This drug may increase your risk of blood clots. Ask your doctor if this medication is safe for you.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the pregnancy when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the pregnancy.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: This drug may pass into breast milk and cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: If you’re older than 65 years, you may have a higher risk of side effects from this drug. Your kidneys and liver may process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This drug has not been studied in children younger than 1 year with chronic immune thrombocytopenia. It should not be used in children younger than 1 year for this condition.

This drug has not been studied in children with chronic hepatitis C virus infection or severe aplastic anemia. It should not be used in people younger than 18 years with these conditions.

When to call the doctor

  • Call your doctor if you start taking any new medications while taking this drug.

How to take eltrombopag

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug form and strengths

Brand: Promacta

  • Form: oral tablet
  • Strengths: 12.5 mg, 25 mg, 50 mg, 75 mg, 100 mg

Dosage for chronic immune thrombocytopenia

Adult dosage (ages 18–64 years)

  • Starting dosage: 50 mg once per day.
  • Dosage changes: Your doctor will test your blood each week to check if this drug is working for you. Based on your platelet counts, your doctor will increase or decrease your dosage.
  • Maximum dosage: 75 mg once per day.

Child dosage (ages 6–17 years)

  • Starting dosage: 50 mg once per day.
  • Dosage changes: The doctor will test your child’s blood each week to check if this drug is working. Based on your child’s platelet counts, the doctor will increase or decrease your child’s dosage.
  • Maximum dosage: 75 mg once per day.

Child dosage (ages 1–5 years)

  • Starting dosage: 25 mg once per day.
  • Dosage changes: Your child’s doctor will test your child’s blood each week to check if this drug is working. Based on your child’s platelet counts, the doctor will increase or decrease your child’s dosage.
  • Maximum dosage: 75 mg once per day.

Child dosage (ages under 1 year)

It has not been confirmed that this drug is safe and effective for use in people younger than 1 year for this condition.

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different treatment schedule. This can help keep levels of this drug from building up too much in your body.

Special dosage considerations

  • For people with mild to severe liver disease: The typical starting dosage is 25 mg once per day.
  • For people with East Asian ancestry: The typical starting dosage is 25 mg once per day.
  • For people with liver disease and East Asian ancestry: The typical starting dosage is 12.5 mg once per day.

Dosage for low platelet counts from chronic hepatitis C

Adult dosage (ages 18–64 years)

  • Starting dosage: 25 mg once per day.
  • Dosage changes: Your doctor will test your blood each week to check if this drug is working for you. Based on your platelet counts, your doctor will increase or decrease your dosage every 2 weeks. They will change your dosage in increments of 25 mg.
  • Maximum dosage: 100 mg once per day.

Child dosage (ages 0–17 years)

It has not been confirmed that this drug is safe and effective for use in people younger than 18 years for this condition.

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different treatment schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for severe aplastic anemia

Adult dosage (ages 18–64 years)

  • Starting dosage: 50 mg once per day.
  • Dosage changes: Your doctor will test your blood every two weeks to check if this drug is working for you. Based on your platelet counts, your doctor will increase or decrease your dosage. They will change your dosage in increments of 50 mg.
  • Maximum dosage: 150 mg once per day.

Child dosage (ages 0–17 years)

It has not been confirmed that this drug is safe and effective for use in people younger than 18 years for this condition.

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different treatment schedule. This can help keep levels of this drug from building up too much in your body.

Special dosage considerations

  • For people with mild to severe liver disease: The typical starting dosage is 25 mg once per day.
  • For people with East Asian ancestry: The typical starting dosage is 25 mg once per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Eltrombopag oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your platelet counts may decrease. If your platelet level drops dangerously low, it can cause bleeding. This can lead to serious problems.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could cause dangerously high levels of platelets in your body. Symptoms of an overdose of this drug can include:

  • blood clots, with symptoms such as:
    • pain, redness, and tenderness in your legs
    • chest pain
    • trouble breathing
  • rash
  • tiredness
  • very slow heart rate

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, wait and take your next scheduled dose. Do not take more than one dose of this drug in one day.

How to tell if the drug is working: You may not be able to feel if the drug is working. Your doctor will test your blood cell levels every week or every other week to check if this drug is working for you. If you’ve reached a stable platelet count, it may mean that this drug is working.

Important considerations for taking eltrombopag

Keep these considerations in mind if your doctor prescribes eltrombopag for you.

General

  • Do not take this drug with food. Take it on an empty stomach. Take it 1 hour before a meal, or 2 hours after a meal.
  • Take this drug at the same time each day. Take it at the time(s) recommended by your doctor.

Storage

  • Store the tablets at room temperature. Keep them at a temperature between 59°F and 86°F (15°C and 30°C).
  • Keep this drug in the bottle it came in.
  • The bottle may contain a desiccant packet. This keeps your medication dry and protects it from moisture. Do not remove the desiccant packet.
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Keep this drug away from light.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues during your treatment. This can help make sure you stay safe while you take this drug. These issues include:

  • Liver function. Your doctor will test your liver function before and during your treatment with this drug. If your liver isn’t working well, your doctor may lower your dosage or stop your treatment with this drug.
  • Blood cell and platelet levels. Your doctor will test your blood cell levels each week or every other week. This helps your doctor decide your dosage of this drug. They’ll test your blood until your platelet count is stable. Once you’ve reached a stable platelet count, your doctor will test your blood levels once per month.
  • Eye function. This drug may cause cataracts. Your doctor will do an eye examination before and during your treatment with this drug. If you develop eye problems, your doctor may reduce your dosage or stop your treatment with this drug.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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 other healthcare professional before taking any medication. The drug information contained here in 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.