Eltrombopag Olamine interactions

Food & lifestyle

• dairy products

  Moderate

  Absorption

  Food may reduce the oral bioavailability of eltrombopag. The calcium content of this meal may have also contributed to this decrease in exposure. In another study, adult subjects administered a single 25 mg dose of eltrombopag for oral suspension with a high-calcium, moderate-fat, moderate-calorie meal exhibited a 79% decrease in Cmax and 75% decrease in AUC of eltrombopag. Administration of eltrombopag 2 hours after the high-calcium meal decreased eltrombopag Cmax by 48% and AUC by 47%, while administration 2 hours before the high-calcium meal decreased eltrombopag Cmax by 14% and AUC by 20%.

  What to do: Eltrombopag should be taken on an empty stomach one hour before or two hours after a meal. Additionally, eltrombopag should be taken at least 2 hours before or 4 hours after any products that contain polyvalent cations such as antacids, mineral supplements, dairy products, and fortified juices.

  2 sources

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):

• high-fat foods

  Moderate

  Absorption

  Food may reduce the oral bioavailability of eltrombopag. In healthy volunteers, a standard high-fat breakfast significantly decreased plasma eltrombopag peak plasma concentration (Cmax) by 65% and systemic exposure (AUC) by 59% and delayed Tmax by one hour.

  What to do: Eltrombopag should be taken on an empty stomach one hour before or two hours after a meal. Additionally, eltrombopag should be taken at least 2 hours before or 4 hours after any products that contain polyvalent cations such as antacids, mineral supplements, dairy products, and fortified juices.

  2 sources

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):

Conditions

Conditions in which Eltrombopag Olamine needs care, as documented in this source.

• Hepatic Insufficiency

  Major

  Eltrombopag can cause liver enzyme elevations. Monitor ALT, AST and bilirubin prior to treatment initiation, and every 2 weeks during dose adjustment phase and then monthly. If abnormalities are confirmed, monitor serum liver tests weekly until resolved or stabilized. Treatment should be discontinued if ALT levels increase to greater than or equal to 3 x ULN in patients with normal liver function, or greater or equal to 3 x baseline in patients with pretreatment transaminase elevations that are progressively increasing, persist for 4 weeks or more, also have an increase in bilirubin, or also have clinical symptoms of liver injury or hepatic decompensation. Hepatic impairment influences the exposure to eltrombopag. The initial dose should be reduced in patients with chronic ITP or severe aplastic anemia who have hepatic impairment. No dose adjustment is required on patients with chronic hepatitis C and hepatic impairment.

  1 source

  1. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):

• Hepatitis C

  Major

  Eltrombopag has shown to increase the risk of hepatic decompensation in patients with chronic hepatitis C in treatment with interferon and ribavirin. Clinical trials reported that ascites and encephalopathy occurred more frequently on these patients than in the placebo arm. Patients with chronic hepatitis and receiving antiviral treatment should be closely monitored. The manufacturers also recommend to discontinue eltrombopag if the antiviral therapy is discontinued.

  1 source

  1. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):

• Cataract

  Moderate

  In clinical trials, eltrombopag developed or worsened cataracts in 7% of the patients receiving treatment. A baseline ocular examination prior to administration of eltrombopag is recommended, and regular monitoring for signs and symptoms of cataracts should be performed regularly during treatment.

  1 source

  1. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):

• Thromboembolism

  Moderate

  Thromboembolic complications may result from increases in platelet counts with TPO receptor agonists such as avatrombopag, lusutrombopag, and eltrombopag. Consider the potential for increased risk of thromboembolism when administering these medications to patients with known risk factors for thromboembolism, including genetic prothrombotic conditions (Factor V Leiden, Prothrombin 20210 A, Antithrombin deficiency or Protein C or S deficiency).

  3 sources

  1. "Product Information. Promacta (eltrombopag)." GlaxoSmithKline (2008):
  2. "Product Information. Doptelet (avatrombopag)." Dova Pharmaceuticals (2018):
  3. "Product Information. Mulpleta (lusutrombopag)." Shionogi USA Inc (2018):