Eltrombopag 50 mg, or Promacta, is a drug prescribed most notably to treat low blood platelets in patients with specified medical conditions. Eltrombopag is an agonist of the thrombopoietin receptor and is essential to activating platelet production in the bone marrow. Eltrombopag has significantly improved the quality of life for patients suffering from chronic immune thrombocytopenia (ITP), hepatitis C-related thrombocytopenia, and severe aplastic anemia.

Indications and Uses

Promacta (Eltrombopag) is FDA approved for the following therapeutic indications:

Chronic Immune Thrombocytopenia (ITP):

In patients 1 year of age and older who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.

Hepatitis C-associated Thrombocytopenia:

In patients with chronic hepatitis C to enable the initiation and maintenance of interferon-based treatment.

Severe Aplastic Anemia (SAA):

For the treatment of patients with severe aplastic anemia who have had an unsatisfactory response to immunosuppressive therapy or as initial therapy in combination with standard immunosuppressive therapy.

Mechanism of Action

Eltrombopag is a non-peptide thrombopoietin receptor agonist. It operates by binding to the thrombopoietin (TPO) receptor (or c-Mpl receptor) on bone marrow precursor cells. It activates the growth and development of megakaryocytes—the bone marrow cells that produce platelets—thus raising platelet levels in the blood.

In contrast to natural TPO, Eltrombopag binds at a distinct location on the receptor, minimizing the possibility of cross-reacting antibodies and autoimmune effects.

Dosage and Administration

Eltrombopag is available in film-coated 50 mg tablets, administered once daily. The treatment regimen varies depending on the indication, age of the patient, baseline platelet count, and liver function.

For ITP: Starting dose typically 50 mg once daily in adults. Dosages are titrated based on platelet response to a maximum of 75 mg/day.

For Hepatitis C: The starting dose is generally 25 mg daily, titrated as needed while on antiviral therapy.

For Severe Aplastic Anemia: Dosage at initiation and dose adjustments depend on whether the drug is used alone or in combination.

Note: Eltrombopag should be taken on an empty stomach or at least 2 to 4 hours before meals that contain polyvalent cations (such as calcium, magnesium, or iron) because these can have a significant debilitating impact on absorption.

Key Benefits

Good Platelet Production: Clinically proven to raise platelet counts in thrombocytopenic patients with various etiologies.

Oral Convenience: Available in once-daily oral tablet form, eliminating the need for injectable therapy.

Flexible Indications: Indicated for use in a range of serious hematologic and hepatic diseases.

Improved Quality of Life: Decreases frequency of platelet transfusions and hospitalizations, giving patients more independence.

Side Effects and Precautions

Common side effects of Promacta are:

Nausea

Headache

Fatigue

Diarrhea

Upper respiratory infections

Serious but less common adverse reactions are:

Hepatotoxicity (elevated liver tests)

Thromboembolic events (blood clots)

Cataracts

Bone marrow fibrosis

They should receive routine liver function tests and complete blood counts (CBC) while on therapy. Therapy should be interrupted in the event of the development of significant liver toxicity or the lack of response following an adequate trial.

Contraindications and Interactions

Eltrombopag is not indicated for patients with a documented history of hypersensitivity to the drug or its excipients. Caution should be used in patients with:

History of thromboembolism

Hepatic dysfunction

Cataracts

Drug interaction may occur with polyvalent cation-fixing products (e.g., antacids or milk), statins, and certain antiviral drugs. These may impair absorption or add to the potential for toxicity. Patients must inform their practitioner of all drugs and supplements consumed.

Storage and Handling

Store at 20°C to 25°C (68°F to 77°F).
Keep away from moisture and direct light.
Keep out of the reach of children.

Conclusion

Eltrombopag 50 mg (Promacta) is a well-tolerated and efficacious medication for the therapy of thrombocytopenia in a wide variety of medical illnesses. Its selective pharmacology, oral convenience, and proven clinical efficacy have made it a standard-of-care treatment in chronic ITP, hepatitis C-induced thrombocytopenia, and severe aplastic anemia. But like all potent drugs, it needs to be avidly monitored and titrated by a clinician.

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1. What is the purpose of eltrombopag 50mg?
Eltrombopag is used to treat people with chronic immune thrombocytopenia (ITP), a blood condition characterized by insufficient platelets in the blood. After a splenectomy (splenic removal operation) and other medications (such as immunoglobulin or steroids) have not been effective enough, this medication is taken.

2. Eltrombopag: is it safe?
Most patients were able to maintain safe platelet counts with low dosages of eltrombopag. To reach and sustain the desired platelet count, some patients required more time and a greater dosage, particularly those who had received extensive pretreatment and had a longer ITP duration prior to therapy.

3. What is eltrombopag’s generic name?
There is a brand-name medication called Eltrombopag oral tablet. It isn’t a generic medication. Promacta is the brand name. Eltrombopag is available as an oral tablet or as an oral suspension.

4. What is the original Eltrombopag brand?
Eltrombopag is a drug used to treat severe aplastic anemia and thrombocytopenia, which is characterized by extremely low platelet counts. It is marketed under several trade names, including Promacta. Eltrombopag is marketed by Novartis and distributed outside of the United States under the brand name Revolade. It is an agonist of the thrombopoietin receptor.

5. What kind of injection is used to boost platelet counts?
Romiplostim increases platelet production in the bone marrow. Injections of romiplostim are also used to treat acute radiation syndrome in patients who have had high radiation exposures (myelosuppressive doses).