Medication precautions for eltrombopag
As a thrombopoietin receptor agonist, eltrombopag requires strict adherence to dosage adjustment, monitoring, and special population management requirements, with a focus on thrombus risk, liver function monitoring, and drug interactions, to ensure the safety and effectiveness of clinical use.
1. Dosage and administration method
(1) The initial dose needs to be adjusted according to the indications: patients with chronic immune thrombocytopenia (ITP) usually start at 25mg once daily, while those with chronic hepatitis C-related thrombocytopenia start at 25mg once daily and need to take on an empty stomach (1 hour before or 2 hours after meals).
(2) Dose adjustment based on platelet count: Monitor platelet count weekly. If it is below 50 × 10 ⁹/L, increase by 25mg per week (maximum 75mg/day). If it exceeds 200 × 10 ⁹/L, reduce or pause.
2. Thrombosis risk monitoring
(1) Be alert to thrombotic events: Especially for existing thrombotic risk factors (such as genetic thrombophilia and bedridden patients), monitoring should be strengthened, and medication should be stopped immediately if thrombotic symptoms occur.
(2) Platelet control goal: Maintain platelets within the range of 50-150 × 10 ⁹/L to avoid excessive elevation and the risk of thrombosis.
3. Liver function management
(1) Regular monitoring of transaminases: ALT/AST should be tested every 2 weeks before and during treatment, and any abnormalities should be evaluated for continued medication.
(2) Reduced dose for patients with liver dysfunction: Children Pugh grades B/C patients need to adjust the dose (such as halving the initial dose for ITP patients).
4. Medication for special populations
(1) Prohibited during pregnancy: May cause fetal malformation, confirm negative pregnancy test before medication, and take contraceptive measures during treatment.
(2) Suspension of breastfeeding: Medications may be secreted through breast milk. Avoid breastfeeding during treatment and for 3 days after the last dose.
5. Drug interactions
(1) Avoid co administration with multivalent cations: preparations containing aluminum/calcium/magnesium (such as antacids) should be taken every 4 hours to avoid affecting absorption.
(2) Be alert to the effects of liver enzymes: CYP1A2/CYP2C8 inhibitors may increase the blood concentration of ezetimibe, and adverse reactions need to be closely monitored.
6. Omission and Overtreatment
(1) Remedial measures for missed doses: Take it immediately when remembered, skip if it is close to the next administration time, and prohibit double dose compensation.
(2) Overdose response plan: There may be high platelet count, and medication should be suspended and platelet count monitored to a safe range.
Disclaimer：《Medication precautions for eltrombopag》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！