What is the usage and dosage of eltrombopag
The usage and dosage of eltrombopag should be adjusted according to the indications, individual patient conditions, and dynamic platelet count. Emphasis should be placed on fasting administration, regular monitoring, and dose titration to ensure efficacy while avoiding the risk of thrombosis.
1. Patients with chronic immune thrombocytopenia (ITP)
(1) Initial dose: 25mg orally once daily, starting from 25mg every other day for East Asian patients or those with liver dysfunction.
(2) Dose adjustment: Monitor platelet count weekly. If platelet count is less than 50 × 10 ⁹/L after 2 weeks of treatment, it can be increased to 50mg once daily (maximum 75mg/day).
(3) Timing of administration: It should be taken on an empty stomach (1 hour before or 2 hours after meals), avoiding co administration with foods/drugs containing multivalent cations.
2. Chronic hepatitis C-related thrombocytopenia
(1) Initial dose: 25mg once daily, synchronized with antiviral therapy, to maintain platelet count ≥ 50 × 10 ⁹/L to reduce bleeding risk.
(2) Adjustment rule: When the platelet count exceeds 200 × 10 ⁹/L, it should be reduced or paused, and treatment should be resumed from the lowest dose.
3. Severe aplastic anemia (SAA)
(1) Combination therapy: When used in combination with immunosuppressive therapy, the initial dose is 50mg once daily for 6 months.
(2) Single drug maintenance: Effective patients can continue with single drug maintenance, with the dosage adjusted according to platelet response (range 25-150mg/day).
4. Dose adjustment for special populations
(1) Liver dysfunction: ITP indications for Child Pugh B/C patients should be reduced by 50%, and indications for hepatitis C should be avoided.
(2) Pediatric patients: The initial dose for ITP children over 1 year old is 25mg/day (body weight ≥ 6kg), which needs to be accurately calculated based on body weight.
5. Principles of discontinuation and restart of medication
(1) Discontinuation indication: When the platelet count is greater than 250 × 10 ⁹/L, the dosage should be reduced. If it is greater than 400 × 10 ⁹/L, the medication should be stopped immediately and monitored to a safe range.
(2) Restart dose: If the interruption exceeds 3 days, titration should be restarted from the initial dose.
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