Eltrombopag Olamine – Uses, Dosage, Side Effects, Interaction

Eltrombopag Olamine is the orally active ethanolamine salt of eltrombopag, a small-molecule, nonpeptide thrombopoietin receptor agonist with megakaryopoiesis-stimulating activity. Eltrombopag binds to and stimulates the transmembrane domain of the platelet thrombopoietin receptor (TPO-R or CD110), a member of the hematopoietic receptor superfamily. Activation of TPO-R leads to the proliferation and differentiation of cells in the megakaryocytic lineage and an increase in platelet production.

Use in Cancer.

Eltrombopag olamine is approved to treat:

• Thrombocytopenia (low platelet levels). It is used in adults and in children aged 1 year or older with chronic immune thrombocytopenia (ITP). ITP is a condition in which platelets are destroyed by the immune system. Eltrombopag olamine is used in certain patients with ITP who have not gotten better with other treatments.

Eltrombopag olamine is also being studied in the treatment of other conditions and types of cancer.

Contraindications

• increase in the number of platelets in the blood
• clouding of the lens of the eye called cataracts
• obstruction of a blood vessel by a blood clot
• a blood clot in a vein of the liver
• at risk for formation of blood clots
• acute liver failure
• damage to the liver and inflammation
• decreased kidney function
• high amount of bilirubin in the blood
• abnormal liver function tests
• a patient who is producing milk and breastfeeding
• antiphospholipid antibody syndrome
• abnormal blood clotting due to factor V leiden mutation
• hereditary antithrombin III deficiency
• Child-Pugh class A liver impairment
• Child-Pugh class B liver impairment
• Child-Pugh class C liver impairment

Dosage

Strengths: 25 mg; 50 mg; 75 mg; 12.5 mg

Aplastic Anemia

FIRST-LINE SEVERE APLASTIC ANEMIA:

• Initial dose: 150 mg orally once a day

Patients of Asian Ancestry (such as Chinese, Japanese, Taiwanese, Korean, or Thai):

• Initial dose: 75 mg orally once a day
• Duration of therapy: 6 months
• If baseline ALT or AST levels are greater than 6 times the upper limit of normal (ULN), do not initiate this drug until transaminase levels are less than 5 x ULN.
• Initiate this drug concurrently with standard immunosuppressive therapy.
• Do not exceed the initial dose.

REFRACTORY SEVERE APLASTIC ANEMIA:

• Initial dose: 50 mg orally once a day; may adjust the dose in 50 mg increments every 2 weeks as needed to achieve a platelet count between 50 and 200 x 10(9)/L.
• Initial dose: 25 mg orally once a day; may adjust the dose in 50 mg increments every 2 weeks as needed to achieve a platelet count between 50 and 200 x 10(9)/L.
• Maintenance dose: The lowest dose needed to achieve and maintain a platelet count between 50 and 200 x 10(9)/L.
• Maximum dose: 150 mg orally once a day
• Duration of therapy: If no hematologic response has occurred after 16 weeks of therapy with this drug, discontinue therapy.
• For patients who achieve trilineage response, including transfusion independence, lasting at least 8 weeks, the dose of this drug may be reduced by 50%. If counts remain stable after 8 weeks at the reduced dose, then this drug may be discontinued. If platelet counts drop to less than 30 x 10(9)/L, hemoglobin to less than 9 g/dL, or absolute neutrophil count (ANC) to less than 0.5 x 10(9)/L, this drug may be reinitiated at the previous effective dose
• If new cytogenetic abnormalities are observed, consider discontinuation of this drug.

Idiopathic (Immune) Thrombocytopenic Purpura

• Initial dose: 50 mg orally once a day
• Initial dose: 25 mg orally once a day
• Maintenance dose: The lowest dose to achieve and maintain a platelet count between 50 to 200 x 10(9)/L as necessary to reduce the risk of bleeding.
• Maximum dose: 75 mg orally once a day
• Duration: Treatment should be discontinued if the platelet count does not increase to a level sufficient to avoid clinically important bleeding after 4 weeks of therapy at the maximum daily dose.
• Monitor CBC with differentials, including platelet counts, every week until the platelet count is stable, followed by monthly thereafter. Monitoring should continue every week for at least 4 weeks following treatment discontinuation.
• Platelet counts generally increase within 1 to 2 weeks after starting therapy and decrease within 1 to 2 weeks after treatment discontinuation.

Thrombocytopenia

• Initial dose: 25 mg orally once a day
• Maintenance dose: The lowest dose to achieve and maintain a platelet count necessary to initiate and maintain antiviral therapy with pegylated interferon and ribavirin.
• Maximum dose: 100 mg orally once a day
• Duration: Treatment should be discontinued when concomitant antiviral therapy is discontinued
• Adjust the daily dose by increments of 25 mg every two weeks as necessary according to platelet count response.
• Monitor platelet counts every week prior to starting antiviral therapy.
• During antiviral therapy, monitor CBC with differentials, including platelet counts, every week until the platelet count is stable. Monitor platelet counts monthly thereafter.
• Platelet counts generally begin to rise within the first week of treatment with eltrombopag.
• Treatment of thrombocytopenia in patients with chronic hepatitis C to allow the initiation and maintenance of interferon-based therapy.

Pediatric Dose

Idiopathic (Immune) Thrombocytopenic Purpura

1 TO 5 YEARS:

• Initial dose: 25 mg orally once a day

6 YEARS OR OLDER:

• Initial dose: 50 mg orally once a day
• Initial dose: 25 mg orally once a day
• Maintenance dose: The lowest dose to achieve and maintain a platelet count between 50 to 200 x 10(9)/L as necessary to reduce the risk of bleeding.
• Maximum dose: 75 mg orally once a day
• Duration: Treatment should be discontinued if the platelet count does not increase to a level sufficient to avoid clinically important bleeding after 4 weeks of therapy at the maximum daily dose.
• Monitor CBC with differentials, including platelet counts, every week until the platelet count is stable, followed by monthly thereafter. Monitoring should continue every week for at least 4 weeks following treatment discontinuation.
• Platelet counts generally increase within 1 to 2 weeks after starting therapy and decrease within 1 to 2 weeks after treatment discontinuation.

Aplastic Anemia

FIRST-LINE SEVERE APLASTIC ANEMIA:
Initial dose:

• 2 to 5 years: 2.5 mg/kg orally once a day
• 6 to 11 years: 75 mg orally once a day
• 12 years or older: 150 mg orally once a day

Patients of Asian ancestry (such as Chinese, Japanese, Taiwanese, Korean, or Thai):
Initial dose:

• 2 to 5 years: 1.25 mg/kg orally once a day
• 6 to 11 years: 37.5 mg orally once a day
• 12 years or older: 75 mg orally once a day
• Duration of therapy: 6 months
• If baseline ALT or AST levels are greater than 6 times the upper limit of normal (ULN), do not initiate this drug until transaminase levels are less than 5 x ULN.
• Initiate this drug concurrently with standard immunosuppressive therapy.
• Do not exceed the initial dose.

Liver Dose Adjustments

CHRONIC IMMUNE THROMBOCYTOPENIA:

• Mild to severe liver dysfunction (Child-Pugh A, B, or C): Initiate dose at 25 mg orally once a day
• Mild to severe liver dysfunction with East Asian ancestry: Initiate dose at 12.5 mg orally once a day
• In patients with liver dysfunction (Child-Pugh Class A, B, C), after initiating eltrombopag or after any subsequent dosing increase, wait 3 weeks before increasing the dose.

CHRONIC HEPATITIS C-ASSOCIATED THROMBOCYTOPENIA:

• Liver dysfunction: No dosage adjustment is recommended

FIRST-LINE SEVERE APLASTIC ANEMIA:

• If baseline ALT or AST levels are greater than 6 times the upper limit of normal (ULN), do not initiate this drug until transaminase levels are less than 5 x ULN.

Mild to Severe Liver Dysfunction (Child-Pugh A, B, or C):
Initial dose:

• 2 to 5 years: 1.25 mg/kg orally once a day for 6 months
• 6 to 11 years: 37.5 mg orally once a day for 6 months
• 12 years or older: 75 mg orally once a day for 6 months
• Increase in ALT or AST greater than 6 x ULN: Discontinue this drug. Once ALT or AST is less than 5 x ULN, reinitiate this drug at the same dose.
• Increase in ALT or AST greater than 6 x ULN after reinitiating this drug: Discontinue this drug and monitor ALT or AST at least every 3 to 4 days. Once ALT or AST is less than 5 x ULN, reinitiate this drug at a daily dose reduced by 25 mg compared to the previous dose.
• If ALT or AST returns to greater than 6 x ULN on the reduced dose: Reduce the daily dose of this drug by 25 mg until ALT or AST is less than 5 x ULN. In pediatric patients, less than 12 years of age, reduce the daily dose by at least 15% to the nearest dose that can be administered.

REFRACTORY SEVERE APLASTIC ANEMIA:
Mild to Severe Liver Dysfunction (Child-Pugh A, B, or C):

• Initial dose: 25 mg orally once a day

GENERAL:
Discontinue eltrombopag if ALT levels increase by at least 3 x ULN in patients with normal liver function or transaminases increase by at least 3 x baseline levels in patients with elevated transaminases pretreatment and where transaminases are:

• Progressively increasing,
• Persistent for at least 4 weeks,
• Accompanied by increased direct bilirubin, or
• Accompanied by clinical symptoms of liver injury or evidence of hepatic decompensation
• Treatment may be cautiously restarted if the benefits outweigh the risks, with weekly LFT monitoring during the dose adjustment phase; however, it should be permanently discontinued if LFT abnormalities remain, worsen, or reoccur.

Dose Adjustments

General:

• A period of at least 2 weeks is recommended between dose adjustments in order to see the effect on the platelet count.
• Excessive platelet count responses necessitate eltrombopag treatment discontinuation.

Thrombocytopenia in Patients with Chronic ITP:

• General: Modify the dosage regimen of concomitant ITP medications, as medically appropriate, to avoid
  excessive increases in platelet counts during eltrombopag therapy.

Platelet count:

• Less than 50 x 10(9)/L following at least 2 weeks of eltrombopag therapy: Increase daily dose by 25 mg to a maximum of 75 mg per day. For patients taking 12.5 mg once a day, increase the dose to 25 mg once a day before increasing the dose amount by 25 mg.
• Greater than or equal to 200 x 10(9)/L to less than or equal to 400 x 10(9)/L at any time: Decrease the daily dose by 25 mg. For patients taking 25 mg once a day, decrease the dose to 12.5 mg once a day.
• Greater than 400 x 10(9)/L: Stop eltrombopag; increase platelet monitoring to twice weekly. Once the platelet count is less than 150 x 10(9)/L, restart eltrombopag at a daily dose reduced by 25 mg. For patients taking 25 mg once a day, restart therapy at 12.5 mg once a day.
• Greater than 400 x 10(9)/L after 2 weeks of therapy at the lowest dose of eltrombopag: Discontinue eltrombopag

Thrombocytopenia in Patients with Chronic Hepatitis C:
General:

• During antiviral therapy, the dose of eltrombopag should be adjusted to avoid dose reductions of peginterferon.
• Eltrombopag should be discontinued when antiviral therapy is discontinued.

Platelet count:

• Less than 50 x 10(9)/L following at least 2 weeks of eltrombopag therapy: Increase daily dose by 25 mg to a maximum of 100 mg per day
• Greater than or equal to 200 x 10(9)/L to less than or equal to 400 x 10(9)/L at any time: Decrease the daily dose by 25 mg
• Greater than 400 x 10(9)/L: Stop eltrombopag; increase platelet monitoring to twice weekly. Once the platelet count is less than 150 x 10(9)/L, restart eltrombopag at a daily dose reduced by 25 mg. For patients taking 25 mg once a day, restart therapy at 12.5 mg once a day.
• Greater than 400 x 10(9)/L after 2 weeks of therapy at the lowest dose of eltrombopag: Discontinue eltrombopag

First-line Severe Aplastic Anemia:
Platelet count:

• Greater than 200 x 10(9)/L to less than or equal to 400 x 10(9)/L: Decrease the daily dose by 25 mg every 2 weeks to the lowest dose that maintains a platelet count of at least 50 x 10(9)/L. In pediatric patients less than 12 years of age, decrease the dose by 12.5 mg.
• Greater than 400 x 10(9)/L: Discontinue this drug for 1 week. Once the platelet count is less than 200 x 10(9)/L, reinitiate this drug at a daily dose reduced by 25 mg (or 12.5 mg in pediatric patients less than 12 years of age).

Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolus, stroke, myocardial infarction): Discontinue this drug but remain on horse anti-thymocyte globulin (h-ATG) and cyclosporine.

Refractory Severe Aplastic Anemia:

Platelet count:

• Less than 50 x 10(9)/L following at least 2 weeks of this drug: Increase daily dose by 50 mg to a maximum of 150 mg/day. For patients taking 25 mg once a day, increase the dose to 50 mg once a day before increasing the dose amount by 50 mg.
• Greater than or equal to 200 x 10(9)/L to less than or equal to 400 x 10(9)/L at any time: Decrease the daily dose by 50 mg.
• Greater than 400 x 10(9)/L: Stop this drug for 1 week. Once the platelet count is less than 150 x 10(9)/L, reinitiate therapy at a dose reduced by 50 mg.
• Greater than 400 x 10(9)/L after 2 weeks of therapy at the lowest dose of this drug: Discontinue this drug.

Administration advice:

• This drug should be taken without a meal or with a meal low in calcium (50 mg or less) and at least 2 hours before or 4 hours after other medications (e.g., antacids), calcium-rich foods, or supplements containing polyvalent cations such as iron, calcium, aluminum, magnesium, selenium, and zinc.
• Do not administer more than one dose of eltrombopag within any 24-hour period.
• Do not split, chew, or crush tablets and mix them with food or liquids.

Side Effects

The Most Common

• back pain
• muscle aches or spasms
• headache
• flu symptoms such as fever, headache, sore throat, cough, tiredness, chills, and body aches
• weakness
• extreme tiredness
• decreased appetite
• pain or swelling in the mouth or throat
• hair loss
• rash
• skin color changes
• skin tingling, itching, or burning
• swelling of the ankles, feet, or lower legs
• toothache (in children)
• swelling, pain, tenderness, warmth or redness in one leg
• shortness of breath, coughing up blood, fast heartbeat, fast breathing, pain when breathing deeply
• pain in the chest, arms, back, neck, jaw, or stomach, breaking out in cold sweat, lightheadedness
• slow or difficult speech, sudden weakness or numbness of the face, arm or leg, sudden headache, sudden vision problems, sudden difficulty walking
• stomach pain, nausea, vomiting, diarrhea
• cloudy, blurry vision, or other vision changes

More common

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• body aches or pain
• chills
• cough
• difficulty with breathing
• fever
• headache
• loss of voice
• pain in the chest, groin, or legs, especially the calves
• pale skin
• rapid weight gain
• runny nose
• severe, sudden headache
• slurred speech
• sore throat
• sudden loss of coordination
• sudden, severe weakness or numbness in the arm or leg
• tingling of the hands or feet
• troubled breathing with exertion
• unusual tiredness or weakness
• unusual weight gain or loss
• yellow eyes or skin
• Decreased appetite
• difficulty with moving
• hair loss or thinning of the hair
• itching skin
• lack or loss of strength
• muscle cramps or stiffness
• swollen joints

Rare

• Bladder pain
• blindness
• blurred or decreased vision
• bruising
• burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
• diarrhea
• a general feeling of discomfort or illness
• hoarseness
• joint pain
• lower back or side pain
• muscle aches and pains
• nausea
• pinpoint red spots on the skin
• redness of the eye
• shivering
• sweating
• tender, swollen glands in the neck
• trouble sleeping
• trouble swallowing
• voice changes
• vomiting
• Back pain
• belching
• bone pain
• darkening of the skin
• dry mouth
• heartburn
• indigestion
• rash
• stomach discomfort, upset, or pain

Drug Interactions

DRUG	INTERACTION
Abacavir	The metabolism of Abacavir can be decreased when combined with Eltrombopag.
Abametapir	The serum concentration of Eltrombopag can be increased when it is combined with Abametapir.
Abatacept	The metabolism of Eltrombopag can be increased when combined with Abatacept.
Abemaciclib	Eltrombopag may decrease the excretion rate of Abemaciclib which could result in a higher serum level.
Abiraterone	The serum concentration of Eltrombopag can be increased when it is combined with Abiraterone.
Acemetacin	The metabolism of Acemetacin can be decreased when combined with Eltrombopag.
Acenocoumarol	The metabolism of Eltrombopag can be decreased when combined with Acenocoumarol.
Acetaminophen	The metabolism of Acetaminophen can be decreased when combined with Eltrombopag.
Acetylsalicylic acid	The metabolism of Acetylsalicylic acid can be decreased when combined with Eltrombopag.
Acyclovir	The metabolism of Eltrombopag can be decreased when combined with Acyclovir.
Adalimumab	The metabolism of Eltrombopag can be increased when combined with Adalimumab.
Adenine	The metabolism of Eltrombopag can be decreased when combined with Adenine.
Afatinib	Eltrombopag may decrease the excretion rate of Afatinib which could result in a higher serum level.
Agomelatine	The metabolism of Agomelatine can be decreased when combined with Eltrombopag.
Albendazole	The metabolism of Eltrombopag can be increased when combined with Albendazole.
Allopurinol	Eltrombopag may decrease the excretion rate of Allopurinol which could result in a higher serum level.
Almotriptan	The metabolism of Almotriptan can be decreased when combined with Eltrombopag.
Alosetron	The metabolism of Eltrombopag can be decreased when combined with Alosetron.
Alpelisib	The serum concentration of Alpelisib can be increased when it is combined with Eltrombopag.
Aluminium	Aluminium can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminium	Aluminium phosphate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminum chloride	Aluminum chloride can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminum hydroxide	Aluminum hydroxide can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminum oxide	Aluminum oxide can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Aluminum sulfate	Aluminum sulfate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ambrisentan	The metabolism of Ambrisentan can be decreased when combined with Eltrombopag.
Aminophenazone	The metabolism of Aminophenazone can be decreased when combined with Eltrombopag.
Aminophylline	The metabolism of Eltrombopag can be decreased when combined with Aminophylline.
Amiodarone	The metabolism of Amiodarone can be decreased when combined with Eltrombopag.
Amitriptyline	The metabolism of Amitriptyline can be decreased when combined with Eltrombopag.
Amodiaquine	The metabolism of Amodiaquine can be decreased when combined with Eltrombopag.
Anagrelide	The metabolism of Eltrombopag can be decreased when combined with Anagrelide.
Anakinra	The metabolism of Eltrombopag can be increased when combined with Anakinra.
Anastrozole	The metabolism of Anastrozole can be decreased when combined with Eltrombopag.
Antipyrine	The metabolism of Antipyrine can be decreased when combined with Eltrombopag.
Apalutamide	The metabolism of Apalutamide can be decreased when combined with Eltrombopag.
Apixaban	The metabolism of Apixaban can be decreased when combined with Eltrombopag.
Apomorphine	The metabolism of Apomorphine can be decreased when combined with Eltrombopag.
Apremilast	The metabolism of Eltrombopag can be increased when combined with Apremilast.
Armodafinil	The metabolism of Eltrombopag can be increased when combined with Armodafinil.
Artenimol	The metabolism of Artenimol can be decreased when combined with Eltrombopag.
Artesunate	The metabolism of Artesunate can be decreased when combined with Eltrombopag.
Asciminib	The metabolism of Eltrombopag can be decreased when combined with Asciminib.
Asenapine	The metabolism of Asenapine can be decreased when combined with Eltrombopag.
Asunaprevir	The excretion of Asunaprevir can be decreased when combined with Eltrombopag.
Atazanavir	The metabolism of Eltrombopag can be decreased when combined with Atazanavir.
Atogepant	The serum concentration of Atogepant can be increased when it is combined with Eltrombopag.
Atorvastatin	The metabolism of Atorvastatin can be decreased when combined with Eltrombopag.
Avatrombopag	The metabolism of Eltrombopag can be increased when combined with Avatrombopag.
Axitinib	The metabolism of Axitinib can be decreased when combined with Eltrombopag.
Azathioprine	The metabolism of Eltrombopag can be decreased when combined with Azathioprine.
Azelastine	The metabolism of Azelastine can be decreased when combined with Eltrombopag.
Bazedoxifene	The metabolism of Bazedoxifene can be decreased when combined with Eltrombopag.
Belantamab mafodotin	The excretion of Belantamab mafodotin can be decreased when combined with Eltrombopag.
Belinostat	The metabolism of Belinostat can be decreased when combined with Eltrombopag.
Bempedoic acid	The metabolism of Bempedoic acid can be decreased when combined with Eltrombopag.
Bendamustine	The metabolism of Bendamustine can be decreased when combined with Eltrombopag.
Bentonite	Bentonite can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Bentoquatam	Bentoquatam can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Benzocaine	The metabolism of Eltrombopag can be decreased when combined with Benzocaine.
Benzyl alcohol	The metabolism of Benzyl alcohol can be decreased when combined with Eltrombopag.
Benzylpenicillin	The excretion of Benzylpenicillin can be decreased when combined with Eltrombopag.
Berotralstat	The serum concentration of Berotralstat can be increased when it is combined with Eltrombopag.
Betamethasone	The metabolism of Eltrombopag can be increased when combined with Betamethasone.
Betaxolol	The metabolism of Eltrombopag can be decreased when combined with Betaxolol.
Bexarotene	The metabolism of Eltrombopag can be decreased when combined with Bexarotene.
Bezafibrate	The metabolism of Eltrombopag can be decreased when combined with Bezafibrate.
Bictegravir	The metabolism of Bictegravir can be decreased when combined with Eltrombopag.
Bimekizumab	The metabolism of Eltrombopag can be increased when combined with Bimekizumab.
Binimetinib	The metabolism of Binimetinib can be decreased when combined with Eltrombopag.
Bortezomib	The metabolism of Eltrombopag can be decreased when combined with Bortezomib.
Bosentan	The excretion of Bosentan can be decreased when combined with Eltrombopag.
Bosutinib	The metabolism of Eltrombopag can be decreased when combined with Bosutinib.
Brigatinib	The metabolism of Brigatinib can be decreased when combined with Eltrombopag.
Brincidofovir	The serum concentration of Brincidofovir can be increased when it is combined with Eltrombopag.
Bromazepam	The metabolism of Eltrombopag can be decreased when combined with Bromazepam.
Bromotheophylline	The metabolism of Bromotheophylline can be decreased when combined with Eltrombopag.
Buprenorphine	The metabolism of Buprenorphine can be decreased when combined with Eltrombopag.
Cabazitaxel	The metabolism of Cabazitaxel can be decreased when combined with Eltrombopag.
Cabotegravir	The metabolism of Cabotegravir can be decreased when combined with Eltrombopag.
Cabozantinib	The metabolism of Eltrombopag can be decreased when combined with Cabozantinib.
Caffeine	The metabolism of Eltrombopag can be decreased when combined with Caffeine.
Calcium acetate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium acetate.
Calcium carbonate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium carbonate.
Calcium chloride	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium chloride.
Calcium citrate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium citrate.
Calcium glucoh	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium glucoheptonate.
Calcium gluconate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium gluconate.
Calcium lactate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium lactate.
Calcium Phosphate	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium Phosphate.
Calcium polycarbophil	The serum concentration of Eltrombopag can be decreased when it is combined with Calcium polycarbophil.
Canagliflozin	The metabolism of Canagliflozin can be decreased when combined with Eltrombopag.
Canakinumab	The metabolism of Eltrombopag can be increased when combined with Canakinumab.
Candesartan cilexetil	The metabolism of Eltrombopag can be decreased when combined with Candesartan cilexetil.
Cannabidiol	The metabolism of Eltrombopag can be decreased when combined with Cannabidiol.
Capmatinib	The metabolism of Eltrombopag can be decreased when combined with Capmatinib.
Capsaicin	The metabolism of Eltrombopag can be increased when combined with Capsaicin.
Carbamazepine	The metabolism of Eltrombopag can be increased when combined with Carbamazepine.
Carmustine	The metabolism of Eltrombopag can be decreased when combined with Carmustine.
Carvedilol	The metabolism of Carvedilol can be decreased when combined with Eltrombopag.

Caspofungin	The excretion of Caspofungin can be decreased when combined with Eltrombopag.
Celecoxib	The metabolism of Celecoxib can be decreased when combined with Eltrombopag.
Cenobamate	The metabolism of Eltrombopag can be increased when combined with Cenobamate.
Cerivastatin	The metabolism of Cerivastatin can be decreased when combined with Eltrombopag.
Certolizumab pegol	The metabolism of Eltrombopag can be increased when combined with Certolizumab pegol.
Chloroquine	The metabolism of Chloroquine can be decreased when combined with Eltrombopag.
Chlorpromazine	The metabolism of Eltrombopag can be decreased when combined with Chlorpromazine.
Chlorzoxazone	The metabolism of Eltrombopag can be decreased when combined with Chlorzoxazone.
Cholecystokinin	The excretion of Cholecystokinin can be decreased when combined with Eltrombopag.
Cholic Acid	The excretion of Cholic Acid can be decreased when combined with Eltrombopag.
Cilostazol	The metabolism of Eltrombopag can be decreased when combined with Cilostazol.
Cimetidine	The metabolism of Eltrombopag can be decreased when combined with Cimetidine.
Cinacalcet	The metabolism of Eltrombopag can be decreased when combined with Cinacalcet.
Cinnarizine	The metabolism of Eltrombopag can be decreased when combined with Cinnarizine.
Cinoxacin	The metabolism of Eltrombopag can be decreased when combined with Cinoxacin.
Ciprofloxacin	The metabolism of Eltrombopag can be decreased when combined with Ciprofloxacin.
Cisapride	The metabolism of Cisapride can be decreased when combined with Eltrombopag.
Citalopram	The metabolism of Eltrombopag can be decreased when combined with Citalopram.
Cladribine	Eltrombopag may decrease the excretion rate of Cladribine which could result in a higher serum level.
Clofarabine	Eltrombopag may decrease the excretion rate of Clofarabine which could result in a higher serum level.
Clomipramine	The metabolism of Eltrombopag can be decreased when combined with Clomipramine.
Clonidine	The metabolism of Eltrombopag can be decreased when combined with Clonidine.
Clopidogrel	The metabolism of Eltrombopag can be decreased when combined with Clopidogrel.
Clozapine	The metabolism of Eltrombopag can be decreased when combined with Clozapine.
Codeine	The metabolism of Codeine can be decreased when combined with Eltrombopag.
Conjugated estrogens	Eltrombopag may decrease the excretion rate of Conjugated estrogens which could result in a higher serum level.
Copanlisib	Eltrombopag may decrease the excretion rate of Copanlisib which could result in a higher serum level.
Curcumin	The metabolism of Eltrombopag can be decreased when combined with Curcumin.
Cyclobenzaprine	The metabolism of Eltrombopag can be decreased when combined with Cyclobenzaprine.
Cyclophosphamide	The metabolism of Cyclophosphamide can be decreased when combined with Eltrombopag.
Cyproheptadine	The metabolism of Cyproheptadine can be decreased when combined with Eltrombopag.
Cyproterone acetate	The metabolism of Eltrombopag can be increased when combined with Cyproterone acetate.
Dabigatran etexilate	The metabolism of Dabigatran etexilate can be decreased when combined with Eltrombopag.
Dabrafenib	The serum concentration of Eltrombopag can be decreased when it is combined with Dabrafenib.
Dacarbazine	The metabolism of Eltrombopag can be decreased when combined with Dacarbazine.
Dacomitinib	Eltrombopag may decrease the excretion rate of Dacomitinib which could result in a higher serum level.
Dactinomycin	Eltrombopag may decrease the excretion rate of Dactinomycin which could result in a higher serum level.
Dapagliflozin	The metabolism of Eltrombopag can be decreased when combined with Dapagliflozin.
Dapsone	The metabolism of Dapsone can be decreased when combined with Eltrombopag.
Darolutamide	Eltrombopag may decrease the excretion rate of Darolutamide which could result in a higher serum level.
Dasabuvir	The metabolism of Dasabuvir can be decreased when combined with Eltrombopag.
Dasatinib	Eltrombopag may decrease the excretion rate of Dasatinib which could result in a higher serum level.
Daunorubicin	Eltrombopag may decrease the excretion rate of Daunorubicin which could result in a higher serum level.
Deferasirox	The serum concentration of Eltrombopag can be increased when it is combined with Deferasirox.
Deferiprone	The serum concentration of Deferiprone can be increased when it is combined with Eltrombopag.
Delafloxacin	Eltrombopag may decrease the excretion rate of Delafloxacin which could result in a higher serum level.
Desogestrel	The metabolism of Eltrombopag can be increased when combined with Desogestrel.
Dexamethasone	The metabolism of Eltrombopag can be increased when combined with Dexamethasone.
Dexfenfluramine	The metabolism of Eltrombopag can be decreased when combined with Dexfenfluramine.
Dexibuprofen	The metabolism of Dexibuprofen can be decreased when combined with Eltrombopag.
Dexmedetomidine	The metabolism of Eltrombopag can be decreased when combined with Dexmedetomidine.
Dextromethorphan	The metabolism of Dextromethorphan can be decreased when combined with Eltrombopag.
Diacerein	The metabolism of Eltrombopag can be decreased when combined with Diacerein.
Diclofenac	The metabolism of Diclofenac can be decreased when combined with Eltrombopag.
Diethylstilbestrol	The metabolism of Diethylstilbestrol can be decreased when combined with Eltrombopag.
Digoxin	The excretion of Digoxin can be decreased when combined with Eltrombopag.
Dihydralazine	The metabolism of Eltrombopag can be decreased when combined with Dihydralazine.
Diltiazem	The metabolism of Eltrombopag can be decreased when combined with Diltiazem.
Dinoprostone	The excretion of Dinoprostone can be decreased when combined with Eltrombopag.
Disopyramide	The metabolism of Eltrombopag can be decreased when combined with Disopyramide.
Dolutegravir	Eltrombopag may decrease the excretion rate of Dolutegravir which could result in a higher serum level.
Domperidone	The metabolism of Domperidone can be decreased when combined with Eltrombopag.
Donepezil	Eltrombopag may decrease the excretion rate of Donepezil which could result in a higher serum level.
Dosulepin	The metabolism of Eltrombopag can be decreased when combined with Dosulepin.
Doxepin	The metabolism of Eltrombopag can be decreased when combined with Doxepin.
Doxorubicin	Eltrombopag may decrease the excretion rate of Doxorubicin which could result in a higher serum level.
Dronabinol	The metabolism of Eltrombopag can be decreased when combined with Dronabinol.
Duvelisib	Eltrombopag may decrease the excretion rate of Duvelisib which could result in a higher serum level.
Efavirenz	The metabolism of Eltrombopag can be increased when combined with Efavirenz.
Elagolix	The metabolism of Elagolix can be decreased when combined with Eltrombopag.
Eluxadoline	The serum concentration of Eluxadoline can be increased when it is combined with Eltrombopag.
Elvitegravir	The metabolism of Elvitegravir can be decreased when combined with Eltrombopag.
Emapalumab	The metabolism of Eltrombopag can be increased when combined with Emapalumab.
Enalapril	The excretion of Enalapril can be decreased when combined with Eltrombopag.
Enasidenib	The metabolism of Enasidenib can be decreased when combined with Eltrombopag.
Enoxacin	The metabolism of Eltrombopag can be decreased when combined with Enoxacin.
Entacapone	The metabolism of Entacapone can be decreased when combined with Eltrombopag.
Entecavir	The metabolism of Eltrombopag can be decreased when combined with Entecavir.
Enzalutamide	The metabolism of Enzalutamide can be decreased when combined with Eltrombopag.
Epirubicin	The metabolism of Epirubicin can be decreased when combined with Eltrombopag.
Erlotinib	The metabolism of Erlotinib can be decreased when combined with Eltrombopag.
Ertugliflozin	Eltrombopag may decrease the excretion rate of Ertugliflozin which could result in a higher serum level.
Erythromycin	The excretion of Erythromycin can be decreased when combined with Eltrombopag.
Eslicarbazepine	The metabolism of Eslicarbazepine can be decreased when combined with Eltrombopag.
Eslicarbazepine acetate	The metabolism of Eslicarbazepine acetate can be decreased when combined with Eltrombopag.
Estradiol	The metabolism of Estradiol can be decreased when combined with Eltrombopag.
Estradiol acetate	The metabolism of Estradiol acetate can be decreased when combined with Eltrombopag.
Estradiol benzoate	The metabolism of Estradiol benzoate can be decreased when combined with Eltrombopag.
Estradiol cypionate	The metabolism of Estradiol cypionate can be decreased when combined with Eltrombopag.
Estradiol dienanthate	The metabolism of Estradiol dienanthate can be decreased when combined with Eltrombopag.
Estradiol valerate	The metabolism of Estradiol valerate can be decreased when combined with Eltrombopag.
Estrone sulfate	The metabolism of Eltrombopag can be decreased when combined with Estrone sulfate.
Eszopiclone	The metabolism of Eszopiclone can be decreased when combined with Eltrombopag.
Etanercept	The metabolism of Eltrombopag can be increased when combined with Etanercept.
Ethambutol	The metabolism of Eltrombopag can be decreased when combined with Ethambutol.
Ethanol	The metabolism of Eltrombopag can be decreased when combined with Ethanol.
Ethinylestradiol	The metabolism of Eltrombopag can be increased when combined with Ethinylestradiol.
Etodolac	The metabolism of Etodolac can be decreased when combined with Eltrombopag.
Etoposide	The metabolism of Etoposide can be decreased when combined with Eltrombopag.
Etoricoxib	The metabolism of Eltrombopag can be decreased when combined with Etoricoxib.

Ezetimibe	Eltrombopag may decrease the excretion rate of Ezetimibe which could result in a higher serum level.
Ezogabine	The metabolism of Ezogabine can be decreased when combined with Eltrombopag.
Famotidine	The metabolism of Eltrombopag can be decreased when combined with Famotidine.
Favipiravir	The metabolism of Eltrombopag can be decreased when combined with Favipiravir.
Febuxostat	The metabolism of Febuxostat can be decreased when combined with Eltrombopag.
Felodipine	The metabolism of Eltrombopag can be decreased when combined with Felodipine.
Fenfluramine	The metabolism of Eltrombopag can be decreased when combined with Fenfluramine.
Fenofibrate	The metabolism of Fenofibrate can be decreased when combined with Eltrombopag.
Ferric ammonium	Ferric ammonium citrate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferric cation	Ferric cation can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferric maltol	Ferric maltol can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferric sulfate	Ferric sulfate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferrous bisglycinate	Ferrous bisglycinate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferrous fumarate	Ferrous fumarate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferrous gluconate	Ferrous gluconate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferrous succinate	Ferrous succinate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferrous sulfate	Ferrous sulfate anhydrous can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferumoxides	Ferumoxides can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ferumoxsil	Ferumoxsil can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Fexinidazole	The metabolism of Eltrombopag can be decreased when combined with Fexinidazole.
Fexofenadine	The excretion of Fexofenadine can be decreased when combined with Eltrombopag.
Finerenone	The metabolism of Finerenone can be decreased when combined with Eltrombopag.
Flecainide	The metabolism of Eltrombopag can be decreased when combined with Flecainide.
Flunarizine	The metabolism of Eltrombopag can be decreased when combined with Flunarizine.
Flunitrazepam	The metabolism of Eltrombopag can be decreased when combined with Flunitrazepam.
Fluorouracil	The metabolism of Fluorouracil can be decreased when combined with Eltrombopag.
Fluoxetine	The metabolism of Eltrombopag can be decreased when combined with Fluoxetine.
Flurbiprofen	The metabolism of Eltrombopag can be decreased when combined with Flurbiprofen.
Flutamide	The metabolism of Eltrombopag can be decreased when combined with Flutamide.
Fluticasone	The metabolism of Eltrombopag can be decreased when combined with Fluticasone.
Fluticasone furoate	The metabolism of Eltrombopag can be decreased when combined with Fluticasone furoate.
Fluticasone propionate	The metabolism of Eltrombopag can be decreased when combined with Fluticasone propionate.
Fluvastatin	The metabolism of Eltrombopag can be decreased when combined with Fluvastatin.
Fluvoxamine	The metabolism of Eltrombopag can be decreased when combined with Fluvoxamine.
Folic acid	Eltrombopag may decrease the excretion rate of Folic acid which could result in a higher serum level.
Formoterol	The metabolism of Formoterol can be decreased when combined with Eltrombopag.
Fosphenytoin	The metabolism of Fosphenytoin can be decreased when combined with Eltrombopag.
Fostamatinib	The metabolism of Eltrombopag can be decreased when combined with Fostamatinib.
Fostemsavir	Eltrombopag may decrease the excretion rate of Fostemsavir which could result in a higher serum level.
Frovatriptan	The metabolism of Eltrombopag can be decreased when combined with Frovatriptan.
Fulvestrant	The metabolism of Fulvestrant can be decreased when combined with Eltrombopag.
Furosemide	The metabolism of Furosemide can be decreased when combined with Eltrombopag.
Fusidic acid	The metabolism of Fusidic acid can be decreased when combined with Eltrombopag.
Gadoxetic acid	The excretion of Gadoxetic acid can be decreased when combined with Eltrombopag.
Gatifloxacin	The metabolism of Eltrombopag can be decreased when combined with Gatifloxacin.
Gefitinib	Eltrombopag may decrease the excretion rate of Gefitinib which could result in a higher serum level.
Gemfibrozil	The metabolism of Eltrombopag can be decreased when combined with Gemfibrozil.
Gemifloxacin	The metabolism of Eltrombopag can be decreased when combined with Gemifloxacin.
Givosiran	The serum concentration of Eltrombopag can be increased when it is combined with Givosiran.
Glasdegib	The metabolism of Glasdegib can be decreased when combined with Eltrombopag.
Glecaprevir	Eltrombopag may decrease the excretion rate of Glecaprevir which could result in a higher serum level.
Glipizide	The metabolism of Glipizide can be decreased when combined with Eltrombopag.
Glyburide	Eltrombopag may decrease the excretion rate of Glyburide which could result in a higher serum level.
Golimumab	The metabolism of Eltrombopag can be increased when combined with Golimumab.
Grazoprevir	The excretion of Grazoprevir can be decreased when combined with Eltrombopag.
Grepafloxacin	The metabolism of Eltrombopag can be decreased when combined with Grepafloxacin.
Guanabenz	The metabolism of Eltrombopag can be decreased when combined with Guanabenz.
Halofantrine	The metabolism of Halofantrine can be decreased when combined with Eltrombopag.
Haloperidol	The metabolism of Eltrombopag can be decreased when combined with Haloperidol.
Hydrocortisone	The metabolism of Eltrombopag can be increased when combined with Hydrocortisone.
Hydromorphone	The metabolism of Hydromorphone can be decreased when combined with Eltrombopag.
Hydrotalcite	Hydrotalcite can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Hydroxychloroquine	The metabolism of Hydroxychloroquine can be decreased when combined with Eltrombopag.
Ibuprofen	The metabolism of Ibuprofen can be decreased when combined with Eltrombopag.
Idelalisib	Eltrombopag may decrease the excretion rate of Idelalisib which could result in a higher serum level.
Ifosfamide	The metabolism of Ifosfamide can be decreased when combined with Eltrombopag.
Imatinib	The metabolism of Imatinib can be decreased when combined with Eltrombopag.
Imipramine	The metabolism of Eltrombopag can be decreased when combined with Imipramine.
Indacaterol	The metabolism of Indacaterol can be decreased when combined with Eltrombopag.
Indinavir	The metabolism of Eltrombopag can be decreased when combined with Indinavir.
Indomethacin	The metabolism of Eltrombopag can be decreased when combined with Indomethacin.
Infliximab	The metabolism of Eltrombopag can be increased when combined with Infliximab.
Insulin beef	The metabolism of Eltrombopag can be increased when combined with Insulin beef.
Insulin pork	The metabolism of Eltrombopag can be increased when combined with Insulin pork.
Interferon alfa-2a	The metabolism of Eltrombopag can be decreased when combined with Interferon alfa-2a.
Interferon alfa-2b	The metabolism of Eltrombopag can be decreased when combined with Interferon alfa-2b.
Interferon alfa-n1	The metabolism of Eltrombopag can be decreased when combined with Interferon alfa-n1.
Interferon alfa-n3	The metabolism of Eltrombopag can be decreased when combined with Interferon alfa-n3.
Interferon alfacon-1	The metabolism of Eltrombopag can be decreased when combined with Interferon alfacon-1.
Interferon beta-1a	The metabolism of Eltrombopag can be decreased when combined with Interferon beta-1a.
Interferon beta-1b	The metabolism of Eltrombopag can be decreased when combined with Interferon beta-1b.
Interferon gamma-1b	The metabolism of Eltrombopag can be decreased when combined with Interferon gamma-1b.
Irbesartan	The metabolism of Eltrombopag can be decreased when combined with Irbesartan.
Irinotecan	The risk or severity of neutropenia can be increased when Eltrombopag is combined with Irinotecan.
Iron	Iron can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Iron Dextran	Iron Dextran can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Iron sucrose	Iron sucrose can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Isavuconazole	The metabolism of Eltrombopag can be decreased when combined with Isavuconazole.
Isoniazid	The metabolism of Eltrombopag can be decreased when combined with Isoniazid.
Istradefylline	The metabolism of Istradefylline can be decreased when combined with Eltrombopag.
Ivermectin	Eltrombopag may decrease the excretion rate of Ivermectin which could result in a higher serum level.
Kaolin	Kaolin can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Ketamine	The metabolism of Ketamine can be decreased when combined with Eltrombopag.
Ketoconazole	The metabolism of Eltrombopag can be decreased when combined with Ketoconazole.
Ketoprofen	The metabolism of Ketoprofen can be decreased when combined with Eltrombopag.
Ketorolac	The metabolism of Ketorolac can be decreased when combined with Eltrombopag.
Labetalol	The metabolism of Labetalol can be decreased when combined with Eltrombopag.
Lamivudine	Eltrombopag may decrease the excretion rate of Lamivudine which could result in a higher serum level.
Lamotrigine	The metabolism of Eltrombopag can be increased when combined with Lamotrigine.
Lansoprazole	The metabolism of Lansoprazole can be decreased when combined with Eltrombopag.

Lapatinib	The metabolism of Lapatinib can be decreased when combined with Eltrombopag.
Leflunomide	The serum concentration of Eltrombopag can be decreased when it is combined with Leflunomide.
Lenvatinib	Eltrombopag may decrease the excretion rate of Lenvatinib which could result in a higher serum level.
Letermovir	The metabolism of Letermovir can be decreased when combined with Eltrombopag.
Levobupivacaine	The metabolism of Eltrombopag can be decreased when combined with Levobupivacaine.
Levoketoconazole	The metabolism of Eltrombopag can be decreased when combined with Levoketoconazole.
Levomilnacipran	The metabolism of Levomilnacipran can be decreased when combined with Eltrombopag.
Levosalbutamol	The excretion of Levosalbutamol can be decreased when combined with Eltrombopag.
Levothyroxine	The metabolism of Levothyroxine can be decreased when combined with Eltrombopag.
Lidocaine	The metabolism of Eltrombopag can be decreased when combined with Lidocaine.
Linzagolix	The serum concentration of Eltrombopag can be increased when it is combined with Linzagolix.
Liothyronine	The metabolism of Liothyronine can be decreased when combined with Eltrombopag.
Liotrix	The metabolism of Eltrombopag can be decreased when combined with Liotrix.
Lofexidine	The metabolism of Eltrombopag can be decreased when combined with Lofexidine.
Lomefloxacin	The metabolism of Eltrombopag can be decreased when combined with Lomefloxacin.
Lonapegsomatropin	The metabolism of Eltrombopag can be increased when combined with Lonapegsomatropin.
Loperamide	The metabolism of Loperamide can be decreased when combined with Eltrombopag.
Loratadine	The metabolism of Eltrombopag can be decreased when combined with Loratadine.
Lorcaserin	The metabolism of Eltrombopag can be decreased when combined with Lorcaserin.
Lorlatinib	The metabolism of Lorlatinib can be decreased when combined with Eltrombopag.
Losartan	The metabolism of Losartan can be decreased when combined with Eltrombopag.
Lovastatin	The metabolism of Eltrombopag can be decreased when combined with Lovastatin.
Lumacaftor	The metabolism of Eltrombopag can be decreased when combined with Lumacaftor.
Lumateperone	The serum concentration of Lumateperone can be increased when it is combined with Eltrombopag.
Lumiracoxib	The metabolism of Lumiracoxib can be decreased when combined with Eltrombopag.
Lusutrombopag	Eltrombopag may decrease the excretion rate of Lusutrombopag which could result in a higher serum level.
Magaldrate	Magaldrate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium	Magnesium can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium carbonate	Magnesium carbonate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium chloride	Magnesium chloride can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium citrate	Magnesium citrate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium gluconate	Magnesium gluconate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium hydroxide	Magnesium hydroxide can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium oxide	Magnesium oxide can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium silicate	Magnesium silicate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium sulfate	Magnesium sulfate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Magnesium trisilicate	Magnesium trisilicate can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Maprotiline	The metabolism of Eltrombopag can be decreased when combined with Maprotiline.
Medroxyprogesterone	The metabolism of Eltrombopag can be decreased when combined with Medroxyprogesterone acetate.
Mefenamic acid	The metabolism of Eltrombopag can be decreased when combined with Mefenamic acid.
Melatonin	The metabolism of Eltrombopag can be decreased when combined with Melatonin.
Mephenytoin	The metabolism of Mephenytoin can be decreased when combined with Eltrombopag.
Mestranol	The metabolism of Mestranol can be decreased when combined with Eltrombopag.
Methimazole	The metabolism of Eltrombopag can be decreased when combined with Methimazole.
Methotrexate	Eltrombopag may decrease the excretion rate of Methotrexate which could result in a higher serum level.
Methoxsalen	The metabolism of Eltrombopag can be decreased when combined with Methoxsalen.
Methylene blue	The metabolism of Eltrombopag can be decreased when combined with Methylene blue.
Metoclopramide	The metabolism of Eltrombopag can be decreased when combined with Metoclopramide.
Metronidazole	The metabolism of Metronidazole can be decreased when combined with Eltrombopag.
Mexiletine	The metabolism of Eltrombopag can be decreased when combined with Mexiletine.
Mianserin	The metabolism of Eltrombopag can be decreased when combined with Mianserin.
Miconazole	The metabolism of Eltrombopag can be decreased when combined with Miconazole.
Midazolam	The metabolism of Midazolam can be decreased when combined with Eltrombopag.
Mifepristone	The serum concentration of Eltrombopag can be increased when it is combined with Mifepristone.
Migalastat	The metabolism of Migalastat can be decreased when combined with Eltrombopag.
Minoxidil	The metabolism of Minoxidil can be decreased when combined with Eltrombopag.
Mirtazapine	The metabolism of Eltrombopag can be decreased when combined with Mirtazapine.
Mitapivat	The metabolism of Eltrombopag can be increased when combined with Mitapivat.
Mitoxantrone	Eltrombopag may decrease the excretion rate of Mitoxantrone which could result in a higher serum level.
Mometasone furoate	The metabolism of Eltrombopag can be decreased when combined with Mometasone furoate.
Montelukast	The metabolism of Montelukast can be decreased when combined with Eltrombopag.
Morphine	The metabolism of Morphine can be decreased when combined with Eltrombopag.
Moxifloxacin	The metabolism of Eltrombopag can be decreased when combined with Moxifloxacin.
Mycophenolate mofetil	The metabolism of Mycophenolate mofetil can be decreased when combined with Eltrombopag.
Mycophenolic acid	The metabolism of Mycophenolic acid can be decreased when combined with Eltrombopag.
Nabumetone	The metabolism of Eltrombopag can be decreased when combined with Nabumetone.
Nafcillin	The metabolism of Eltrombopag can be increased when combined with Nafcillin.
Naldemedine	The metabolism of Naldemedine can be decreased when combined with Eltrombopag.
Nalidixic acid	The metabolism of Eltrombopag can be decreased when combined with Nalidixic acid.
Nalmefene	The metabolism of Nalmefene can be decreased when combined with Eltrombopag.
Naloxone	The metabolism of Naloxone can be decreased when combined with Eltrombopag.
Naltrexone	The metabolism of Naltrexone can be decreased when combined with Eltrombopag.
Naproxen	The metabolism of Naproxen can be decreased when combined with Eltrombopag.
Nateglinide	The metabolism of Nateglinide can be decreased when combined with Eltrombopag.
Nelfinavir	The metabolism of Eltrombopag can be increased when combined with Nelfinavir.
Nevirapine	The metabolism of Eltrombopag can be decreased when combined with Nevirapine.
Nicardipine	The metabolism of Eltrombopag can be decreased when combined with Nicardipine.
Niclosamide	The metabolism of Eltrombopag can be decreased when combined with Niclosamide.
Nifedipine	The metabolism of Eltrombopag can be decreased when combined with Nifedipine.
Nilotinib	Eltrombopag may decrease the excretion rate of Nilotinib which could result in a higher serum level.
Nilutamide	The metabolism of Eltrombopag can be decreased when combined with Nilutamide.
Nilvadipine	The metabolism of Eltrombopag can be decreased when combined with Nilvadipine.
Nintedanib	The metabolism of Nintedanib can be decreased when combined with Eltrombopag.
Nitrofurantoin	Eltrombopag may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
Norfloxacin	The metabolism of Eltrombopag can be decreased when combined with Norfloxacin.
Norgestimate	The metabolism of Norgestimate can be decreased when combined with Eltrombopag.
Obeticholic acid	The metabolism of Eltrombopag can be decreased when combined with Obeticholic acid.
Olanzapine	The metabolism of Eltrombopag can be decreased when combined with Olanzapine.
Olodaterol	The metabolism of Olodaterol can be decreased when combined with Eltrombopag.
Ombitasvir	The metabolism of Ombitasvir can be decreased when combined with Eltrombopag.
Omeprazole	The metabolism of Omeprazole can be decreased when combined with Eltrombopag.
Ondansetron	The metabolism of Eltrombopag can be decreased when combined with Ondansetron.
Orphenadrine	The metabolism of Eltrombopag can be decreased when combined with Orphenadrine.
Osilodrostat	The metabolism of Eltrombopag can be decreased when combined with Osilodrostat.
Osimertinib	The serum concentration of Eltrombopag can be decreased when it is combined with Osimertinib.
Ouabain	The excretion of Ouabain can be decreased when combined with Eltrombopag.
Oxaliplatin	Eltrombopag may decrease the excretion rate of Oxaliplatin which could result in a higher serum level.
Oxazepam	The metabolism of Oxazepam can be decreased when combined with Eltrombopag.
Oxtriphylline	The metabolism of Eltrombopag can be decreased when combined with Oxtriphylline.
Oxybutynin	The metabolism of Eltrombopag can be decreased when combined with Oxybutynin.

Ozanimod	Eltrombopag may decrease the excretion rate of Ozanimod which could result in a higher serum level.
Paclitaxel	The metabolism of Paclitaxel can be decreased when combined with Eltrombopag.
Pacritinib	The metabolism of Eltrombopag can be decreased when combined with Pacritinib.
Palbociclib	Eltrombopag may decrease the excretion rate of Palbociclib which could result in a higher serum level.
Paramethadione	The metabolism of Paramethadione can be decreased when combined with Eltrombopag.
Paricalcitol	The metabolism of Paricalcitol can be decreased when combined with Eltrombopag.
Paritaprevir	The metabolism of Eltrombopag can be decreased when combined with Paritaprevir.
Paroxetine	The metabolism of Eltrombopag can be decreased when combined with Paroxetine.
Pazopanib	The metabolism of Pazopanib can be decreased when combined with Eltrombopag.
Pefloxacin	The metabolism of Eltrombopag can be decreased when combined with Pefloxacin.
Peginterferon alfa-2a	The metabolism of Eltrombopag can be decreased when combined with Peginterferon alfa-2a.
Peginterferon alfa-2b	The serum concentration of Eltrombopag can be increased when it is combined with Peginterferon alfa-2b.
Pemetrexed	The metabolism of Eltrombopag can be decreased when combined with Pemetrexed.
Penciclovir	The metabolism of Eltrombopag can be decreased when combined with Penciclovir.
Penicillamine	The excretion of Penicillamine can be decreased when combined with Eltrombopag.
Pentoxifylline	The metabolism of Eltrombopag can be decreased when combined with Pentoxifylline.
Perampanel	The metabolism of Perampanel can be decreased when combined with Eltrombopag.
Perflubutane	Perflubutane can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Perphenazine	The metabolism of Eltrombopag can be decreased when combined with Perphenazine.
Pexidartinib	The metabolism of Pexidartinib can be decreased when combined with Eltrombopag.
Phenobarbital	The metabolism of Eltrombopag can be increased when combined with Phenobarbital.
Phenprocoumon	The metabolism of Phenprocoumon can be decreased when combined with Eltrombopag.
Phenylephrine	The metabolism of Eltrombopag can be increased when combined with Phenylephrine.
Phenytoin	The metabolism of Phenytoin can be decreased when combined with Eltrombopag.
Pibrentasvir	Eltrombopag may decrease the excretion rate of Pibrentasvir which could result in a higher serum level.
Pimozide	The metabolism of Eltrombopag can be decreased when combined with Pimozide.
Pioglitazone	The metabolism of Eltrombopag can be decreased when combined with Pioglitazone.
Pirfenidone	The metabolism of Eltrombopag can be decreased when combined with Pirfenidone.
Piroxicam	The metabolism of Piroxicam can be decreased when combined with Eltrombopag.
Pitavastatin	The metabolism of Pitavastatin can be decreased when combined with Eltrombopag.
Pitolisant	The metabolism of Eltrombopag can be increased when combined with Pitolisant.
Pomalidomide	The metabolism of Pomalidomide can be decreased when combined with Eltrombopag.
Ponatinib	The metabolism of Ponatinib can be decreased when combined with Eltrombopag.
Ponesimod	The metabolism of Ponesimod can be decreased when combined with Eltrombopag.
Potassium alum	Potassium alum can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Pralatrexate	Eltrombopag may decrease the excretion rate of Pralatrexate which could result in a higher serum level.
Pralsetinib	Eltrombopag may decrease the excretion rate of Pralsetinib which could result in a higher serum level.
Pravastatin	Eltrombopag may decrease the excretion rate of Pravastatin which could result in a higher serum level.
Praziquantel	The metabolism of Eltrombopag can be decreased when combined with Praziquantel.
Prazosin	Eltrombopag may decrease the excretion rate of Prazosin which could result in a higher serum level.
Prednisolone phosphate	The metabolism of Eltrombopag can be increased when combined with Prednisolone phosphate.
Primaquine	The metabolism of Eltrombopag can be increased when combined with Primaquine.
Primidone	The metabolism of Eltrombopag can be increased when combined with Primidone.
Probenecid	The metabolism of Eltrombopag can be decreased when combined with Probenecid.
Promazine	The metabolism of Eltrombopag can be decreased when combined with Promazine.
Propafenone	The metabolism of Eltrombopag can be decreased when combined with Propafenone.
Propofol	The metabolism of Propofol can be decreased when combined with Eltrombopag.
Propranolol	The metabolism of Eltrombopag can be decreased when combined with Propranolol.
Prussian blue	Prussian blue can cause a decrease in the absorption of Eltrombopag resulting in a reduced serum concentration and potentially a decrease in efficacy.
Pyrimethamine	The metabolism of Eltrombopag can be decreased when combined with Pyrimethamine.
Quinidine	The metabolism of Eltrombopag can be decreased when combined with Quinidine.
Quinine	The metabolism of Eltrombopag can be decreased when combined with Quinine.
Raloxifene	Eltrombopag may decrease the excretion rate of Raloxifene which could result in a higher serum level.
Raltegravir	The metabolism of Raltegravir can be decreased when combined with Eltrombopag.
Ramelteon	The metabolism of Eltrombopag can be decreased when combined with Ramelteon.
Ranitidine	The metabolism of Eltrombopag can be decreased when combined with Ranitidine.
Rasagiline	The metabolism of Eltrombopag can be decreased when combined with Rasagiline.
Regorafenib	The metabolism of Regorafenib can be decreased when combined with Eltrombopag.
Repaglinide	The metabolism of Repaglinide can be decreased when combined with Eltrombopag.
Revefenacin	Eltrombopag may decrease the excretion rate of Revefenacin which could result in a higher serum level.
Rifabutin	The metabolism of Eltrombopag can be increased when combined with Rifabutin.
Rifampicin	The metabolism of Eltrombopag can be increased when combined with Rifampicin.
Rifamycin	The metabolism of Eltrombopag can be decreased when combined with Rifamycin.
Rifapentine	The metabolism of Eltrombopag can be increased when combined with Rifapentine.
Rilonacept	The metabolism of Eltrombopag can be increased when combined with Rilonacept.
Rilpivirine	The metabolism of Eltrombopag can be decreased when combined with Rilpivirine.
Riluzole	Eltrombopag may decrease the excretion rate of Riluzole which could result in a higher serum level.
Rimegepant	The serum concentration of Rimegepant can be increased when it is combined with Eltrombopag.
Riociguat	The metabolism of Riociguat can be decreased when combined with Eltrombopag.
Ripretinib	Eltrombopag may decrease the excretion rate of Ripretinib which could result in a higher serum level.
Ritonavir	The metabolism of Eltrombopag can be decreased when combined with Ritonavir.
Rivaroxaban	Eltrombopag may decrease the excretion rate of Rivaroxaban which could result in a higher serum level.
Rofecoxib	The metabolism of Eltrombopag can be decreased when combined with Rofecoxib.
Roflumilast	The metabolism of Eltrombopag can be decreased when combined with Roflumilast.
Ropeginterferon	The metabolism of Eltrombopag can be decreased when combined with Ropeginterferon alfa-2b.
Ropivacaine	The metabolism of Eltrombopag can be decreased when combined with Ropivacaine.
Rosiglitazone	The metabolism of Rosiglitazone can be decreased when combined with Eltrombopag.
Rosoxacin	The metabolism of Eltrombopag can be decreased when combined with Rosoxacin.
Rosuvastatin	The serum concentration of Rosuvastatin can be increased when it is combined with Eltrombopag.
Roxadustat	The metabolism of Roxadustat can be decreased when combined with Eltrombopag.
Rucaparib	Eltrombopag may decrease the excretion rate of Rucaparib which could result in a higher serum level.
Sacituzumab govitecan	The serum concentration of Sacituzumab govitecan can be increased when it is combined with Eltrombopag.
Salmeterol	The metabolism of Eltrombopag can be decreased when combined with Salmeterol.
Saquinavir	The metabolism of Eltrombopag can be decreased when combined with Saquinavir.
Satralizumab	The serum concentration of Eltrombopag can be decreased when it is combined with Satralizumab.
Secobarbital	The metabolism of Eltrombopag can be increased when combined with Secobarbital.
Secukinumab	The metabolism of Eltrombopag can be increased when combined with Secukinumab.
Selegiline	The metabolism of Selegiline can be decreased when combined with Eltrombopag.
Selenic acid	The bioavailability of Selenic acid can be decreased when combined with Eltrombopag.
Selenious acid	The bioavailability of Selenious acid can be decreased when combined with Eltrombopag.
Selenium	The bioavailability of Selenium can be decreased when combined with Eltrombopag.
Selenomethionine	The bioavailability of Selenomethionine can be decreased when combined with Eltrombopag.
Selenomethionine	The bioavailability of Selenomethionine Se-75 can be decreased when combined with Eltrombopag.
Selexipag	The metabolism of Selexipag can be decreased when combined with Eltrombopag.
Selpercatinib	The serum concentration of Eltrombopag can be increased when it is combined with Selpercatinib.
Selumetinib	The metabolism of Selumetinib can be decreased when combined with Eltrombopag.
Silodosin	The metabolism of Silodosin can be decreased when combined with Eltrombopag.
Siltuximab	The metabolism of Eltrombopag can be increased when combined with Siltuximab.
Simeprevir	The metabolism of Eltrombopag can be decreased when combined with Simeprevir.
Simvastatin	The metabolism of Simvastatin can be decreased when combined with Eltrombopag.

Pregnancy and Lactation

FDA Pregnancy Category C

Pregnancy

There are no adequate and well-controlled studies of eltrombopag use in pregnancy. In animal reproduction and developmental toxicity studies, there was evidence of embryolethality and reduced fetal weights at maternally toxic doses. PROMACTA should be us

Lactation

It is not known whether eltrombopag is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from PROMACTA, a decision should be made whether to discontinue nursing or to
discontinue PROMACTA taking into account the importance of PROMACTA to the mother and the known benefits of nursing.

How should this medicine be used?

Eltrombopag comes as a tablet and as a powder for oral suspension (liquid) to take by mouth. It is usually taken once a day on an empty stomach, at least 1 hour before or 2 hours after eating. Take eltrombopag at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take eltrombopag exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Take eltrombopag at least 2 hours before or 4 hours after you eat or drink foods that contain a lot of calcium, such as dairy products, calcium-fortified juices, cereals, oatmeal, and bread; trout; clams; leafy green vegetables such as spinach and collard greens; and tofu and other soy products. Ask your doctor if you are not sure if a food contains a lot of calcium. You may find it helpful to take eltrombopag close to the beginning or end of your day so that you will be able to eat these foods during most of your waking hours.

Swallow the tablets whole. Do not split, chew, or crush them and mix them into food or liquids.

If you are taking the powder for oral suspension, carefully read the manufacturer’s instructions for use that comes with the medication. These instructions describe how to prepare and measure your dose. Mix the powder with cool or cold water before use. Do not mix the powder with hot water. Immediately after preparation, swallow the dose. If it is not taken within 30 minutes or if there is remaining liquid, dispose of the mixture in the trash (do not pour it down the sink).

Do not allow the powder to touch your skin. If you spill the powder on your skin, wash it off immediately with soap and water. Call your doctor if you have a skin reaction or if you have any questions.

Your doctor will probably start you on a low dose of eltrombopag and adjust your dose depending on your response to the medication. At the beginning of your treatment, your doctor will order a blood test to check your platelet level once every week. Your doctor may increase your dose if your platelet level is too low. If your platelet level is too high, your doctor may decrease your dose or may not give you eltrombopag for a time. After your treatment has continued for some time and your doctor has found the dose of eltrombopag that works for you, your platelet level will be checked less often. Your platelet level will also be checked weekly for at least 4 weeks after you stop taking eltrombopag.

If you have chronic ITP, you may receive other medications to treat your condition along with eltrombopag. Your doctor may decrease your dose of these medications if eltrombopag works well for you.

Eltrombopag does not work for everyone. If your platelet level does not increase enough after you have taken eltrombopag for some time, your doctor may tell you to stop taking eltrombopag.

Eltrombopag may help to control your condition but will not cure it. Continue to take eltrombopag even if you feel well. Do not stop taking eltrombopag without talking to your doctor.

What special precautions should I follow?

Before taking eltrombopag,

• tell your doctor and pharmacist if you are allergic to eltrombopag, any other medications, or any of the ingredients in eltrombopag tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven); bosentan (Tracleer); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor, in Caduet), fluvastatin (Lescol), pitavastatin (Livalo, Zypitamag), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor, Flolopid, in Vytorin); ezetimibe (Zetia, in Vytorin); glyburide (Diabeta, Glynase); imatinib (Gleevec); irinotecan (Camptosar, Onivyde); olmesartan (Benicar, in Azor, in Tribenzor); lapatinib (Tykerb); methotrexate (Rasuvo, Trexall, others); mitoxantrone; repaglinide (Prandin): rifampin (Rimactane, Rifadin, in Rifamate, Rifater); sulfasalazine (Azulfidine); topotecan (Hycamtin), and valsartan (Diovan, in Byvalson, in Entresto, in Exforge). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with eltrombopag, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• if you are taking antacids containing calcium, aluminum, or magnesium (Maalox, Mylanta, Tums) or vitamin or mineral supplements containing calcium, iron, zinc or selenium, take eltrombopag 2 hours before or 4 hours after you take them.
• tell your doctor if you are of East Asian (Chinese, Japanese, Taiwanese, or Korean) descent and if you have or have ever had a cataract (clouding of the lens of the eye that may cause vision problems), blood clots, any condition that increases the risk that you will develop a blood clot, bleeding problems, myelodysplastic syndrome (MDS; a blood disorder that can lead to cancer), or liver disease. Also tell your doctor if you have had surgery to remove your spleen.
• tell your doctor if you are pregnant, or plan to become pregnant. You should not become pregnant during your treatment with eltrombopag. Use effective birth control while you are receiving treatment and for 7 days after your last dose. If you become pregnant while taking eltrombopag, call your doctor.
• tell your doctor if you are breastfeeding. You should not breastfeed while you are taking eltrombopag.
• continue to avoid activities that may cause injury and bleeding during your treatment with eltrombopag. Eltrombopag is given to decrease the risk that you will experience severe bleeding, but there is still a risk that bleeding may occur.

References

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