Elopag Tablet

Introduction

Elopag Tablet 50 mg (promoted under the brand name Promacta, among others) is an oral chemotherapy drug prescribed for the treatment of thrombocytopenia—a condition associated with low platelet counts in the blood.

Uses For

Elopag Tablet 50 mg is primarily prescribed for people suffering from thrombocytopenia who do not respond to other standard treatments. It is also used for enhancing platelet counts in people suffering from hepatitis C, aplastic anemia, and hereditary thrombocytopenia.

Brand Name	Elopag
Type	Tablet
Weight	50 mg
Generic	Eltrombopag Olamine
Manufacturer	Everest Pharmaceuticals Ltd.
Available in	English বাংলা

Mechanism of Action

Elopag Tablet 50 mg binds to and activates the thrombopoietin receptor site on megakaryocyte progenitor cells, which helps in stimulating the proliferation and maturation of megakaryocytes to release more platelets in the blood. This ultimately increases platelet counts.

How Long Does It Take To Work

Elopag Tablet 50 mg typically takes about 7 to 14 days to work. Patients may begin to see platelet count increase within 4-5 days but it is better to consult a doctor to check platelet count at 7 to14 days at its maximum effectiveness.

Absorption

Elopag Tablet 50 mg is rapidly and completely absorbed from the gastrointestinal tract. Peak plasma concentrations are reached about 1-3 hours after oral administration.

Route of Elimination

Elopag Tablet 50 mg is mainly excreted in feces as metabolites and about 3 to 5 percent is excreted in the urine unchanged.

Dosage

Route of administration: Eltrombopag tablet should be taken in oral route and it can be taken without a meal or with a meal low in calcium (<50 mg).

Persistent or chronic immune thrombocytopenia: Use the lowest dose of Eltrombopag to achieve and maintain a platelet count greater than or equal to 50x10⁹/L as necessary to reduce the risk for bleeding. Do not exceed a dose of 75 mg daily.

Adult and pediatric patients 6 years and older with ITP: Initiate Eltrombopag at a dose of 50 mg once daily, except in patients who are of Asian ancestry or who have mild to severe hepatic impairment. For patients of Asian ancestry with ITP, initiate Eltrombopag at a reduced dose of 25 mg once daily. For patients with ITP
and mild, moderate or severe hepatic impairment, initiate Eltrombopag at a reduced dose of 25 mg once daily. For patients of Asian ancestry with ITP and hepatic impairment, consider initiating Eltrombopag at a reduced dose of 12.5 mg once daily.

Pediatric patients with ITP aged 1 to 5 years: Initiate Eltrombopag at a dose of 25 mg once daily.

Chronic hepatitis C associated thrombocytopenia: Initiate Eltrombopag at a dose of 25 mg once daily. Adjust the dose of Eltrombopag in 25 mg increments every 2 weeks as necessary to achieve the target platelet count required to initiate antiviral therapy. Do not exceed a dose of 100 mg daily.

First line severe aplastic anemia: Initiate Eltrombopag once daily at 2.5 mg/kg (in pediatric patients aged 2 to 5 years old), 75 mg (pediatric patients aged 6 to 11 years old) or 150 mg for patients aged 12 years and older for 6 months concurrently with standard immunosuppressive therapy. For patients of Asian ancestry or those with mild, moderate or severe hepatic impairment, decrease the initial dose by 50%. Modify the dose regimen of Eltrombopag based on platelet counts, ALT or AST elevations and thromboembolic events.

Refractory severe aplastic anemia: Initiate Eltrombopag at 50 mg once daily. Hematologic response requires dose titration, generally up to 150 mg and may take up to 16 weeks after starting Eltrombopag. For patients of Asian ancestry or those with mild, moderate, or severe hepatic impairment, initiate Eltrombopag at a reduced dose of 25 mg once daily. Adjust the dose of Eltrombopag in 50 mg increments every 2 weeks as necessary to achieve the target platelet count greater than or equal to 50 x 109/L as necessary. Do not exceed a dose of 150 mg per day.

The recommended starting dose of eltrombopag olamine is 50 mg once per day orally.

Administration

Elopag Tablet 50 mg should be taken with or without food, not to exceed 50 mg once per day. It should be taken at least one hour before or two hours after a meal.

Side Effects

Some common side effects associated with Elopag Tablet 50 mg include nausea, fatigue, headache, abdominal pain, influenza-like symptoms, and constipation.

Toxicity

In case of an overdose of Elopag Tablet 50 mg, it can cause severe hepatic toxicity, leading to liver damage. If overdose is confirmed, the patient should seek immediate medical treatment.

Precautions

Elopag Tablet 50 mg should not be administered to patients with hypersensitivity to the drug and its components, or severe hepatic impairment.

Interactions

Elopag Tablet 50 mg should not be combined with drugs that inhibit CYP3A4 and P-glycoprotein transporter, as well as drugs that induce CYP3A4 and P-glycoprotein transporter.

Disease Interaction

Elopag Tablet 50 mg should not be administered to patients with severe hepatic impairment since it can lead to serious health complications such as liver failure or death.

Drug Interaction

Elopag Tablet 50 mg may interact with several drugs such as simvastatin, teriflunomide, procainamide, quinidine, methotrexate and mifepristone.

Food Interactions

Elopag Tablet 50 mg is not known to interact with food. However, it should be taken on an empty stomach or at least one hour before or two hours after a meal for better absorption.

Pregnancy Use

Elopag Tablet 50 mg should not be used during pregnancy unless the potential benefit justifies the risk to the foetus.

Lactation Use

Elopag Tablet 50 mg has not been tested in lactating women, and therefore its use is not recommended.

Acute Overdose

In case of an acute overdose of Elopag Tablet 50 mg, it can cause severe hepatic toxicity, leading to liver damage. If overdose is confirmed, the patient should seek immediate medical treatment.

Contraindication

Elopag Tablet 50 mg is contraindicated in patients with hypersensitivity to the drug and its components, as well as in patients with severe hepatic impairment.

Use Direction

Elopag Tablet 50 mg should be taken as directed by the health care provider. It should be taken once daily with or without food, not to exceed 50 mg per day. It should be taken at least one hour before or two hours after a meal, for better absorption.