Eltrombopag Olamine: Brands, Price & Uses in Bangladesh

Established / FDA-approved uses

• Chronic immune thrombocytopenia (ITP): Eltrombopag Olamine is indicated for the treatment of thrombocytopenia in adult and pediatric patients (1 year of age and older) with chronic ITP who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.
• Severe aplastic anemia (SAA): Eltrombopag Olamine is indicated, in combination with standard immunosuppressive therapy, for the first-line treatment of severe aplastic anemia in adult and pediatric patients 2 years and older, and alone for the treatment of patients with severe aplastic anemia who have had an insufficient response to prior immunosuppressive therapy or are heavily pretreated.
• Chronic hepatitis C-associated thrombocytopenia: Eltrombopag Olamine is indicated in combination with interferon-based antiviral therapy to treat thrombocytopenia in patients with chronic hepatitis C, to allow initiation and maintenance of interferon-based therapy. This is a combination-therapy indication; Eltrombopag Olamine is not used alone for this purpose.

Important limitation

Eltrombopag Olamine should be used only in patients whose degree of thrombocytopenia and clinical condition increase the risk of bleeding. It is not indicated to normalize platelet counts.

Chronic ITP

Dose is titrated in increments to achieve and maintain a platelet count of ≥50 x 10⁹/L as needed to reduce bleeding risk; do not exceed 75 mg/day.

Severe aplastic anemia

Starting dose is 50 mg once daily (25 mg once daily in patients of East/Southeast Asian ancestry or with hepatic impairment), titrated every 2 weeks in increments up to a maximum of 150 mg/day based on platelet response, when used in combination with immunosuppressive therapy or as monotherapy.

Chronic hepatitis C-associated thrombocytopenia

Starting dose is 25 mg once daily, titrated in increments to the lowest dose required to achieve a platelet count that allows initiation of interferon-based therapy, up to a maximum of 100 mg/day. Given together with interferon-based antiviral therapy.

Administration instructions

• Take once daily, at least 4 hours before or after any polyvalent cation-containing products (antacids, dairy products, calcium-fortified juices, mineral/vitamin supplements containing iron, calcium, magnesium, aluminum, selenium, or zinc).
• Not recommended to be taken with a high-fat meal, which reduces absorption; a low-fat/low-calcium meal is preferred if taken with food.
• Do not crush tablets to mix with liquid for administration unless a specific formulation (oral suspension) is used as directed by a physician.

Common side effects

• Headache
• Nausea and vomiting
• Diarrhea
• Upper respiratory tract infection
• Muscle aches (myalgia) and pain in extremities
• Elevated liver enzymes (ALT, AST, bilirubin)

Serious side effects

• Hepatotoxicity: Eltrombopag Olamine can cause serious, sometimes fatal, liver injury; requires baseline and periodic liver function testing (see Precautions and Warnings).
• Thrombotic/thromboembolic events: increased risk of blood clots, including portal vein thrombosis, especially in patients with chronic liver disease.
• Cataracts: reported with long-term use, particularly in patients with severe aplastic anemia; periodic eye examinations are recommended.
• New malignancies and worsening of pre-existing malignancies have been reported, particularly in patients with myelodysplastic syndrome.
• Bone marrow reticulin fibrosis with long-term use.