Elopag 25 mg contains Eltrombopag, an orally active thrombopoietin (TPO) receptor agonist designed to increase platelet production. It is used to treat conditions characterized by low platelet counts, helping reduce the risk of bleeding and improve patient outcomes.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Haemostatic Drugs

• TPO-Receptor Agonist

Indications

Elopag 25 mg is indicated for:

• Chronic Immune (Idiopathic) Thrombocytopenia (ITP): In adults and children 1 year and older to increase platelet counts and reduce bleeding risk.

• Chronic Hepatitis C-associated Thrombocytopenia: To allow initiation and maintenance of antiviral therapy.

• Severe Aplastic Anemia: As part of treatment to stimulate platelet production.

Pharmacology / Mode of Action

Eltrombopag is a small-molecule TPO-receptor agonist that binds to the transmembrane domain of the human TPO receptor. It stimulates STAT and JAK phosphorylation, promoting megakaryocyte proliferation and differentiation, which leads to increased platelet production. Unlike recombinant TPO or romiplostim, it does not activate the AKT pathway. In patients with aplastic anemia, eltrombopag may also increase other blood cell lineages, suggesting additional mechanisms of action.

Dosage and Administration

Chronic Immune Thrombocytopenia (ITP)

• Adults & Children ≥6 years: Start 50 mg once daily; reduce to 25 mg for East Asian patients or those with hepatic impairment.

• Children 1–5 years: 25 mg once daily.

• Dose Adjustment: Adjust in 25 mg increments every 2 weeks to maintain target platelet counts. Maximum dose: 100 mg/day.

Chronic Hepatitis C-associated Thrombocytopenia

• Start at 25 mg once daily. Adjust to maintain platelet counts sufficient for antiviral therapy.

Severe Aplastic Anemia

• Start at 50 mg once daily; reduce to 25 mg in East Asian patients or in cases of hepatic impairment.

Administration Notes:

• Take 2 hours before or 4 hours after products containing polyvalent cations (e.g., antacids, calcium, iron, mineral supplements).

• Monitor platelet counts, liver function, and CBC regularly during therapy.

Side Effects

Common adverse reactions:

• Nausea, diarrhea, vomiting

• Upper respiratory tract infection, nasopharyngitis

• Fatigue, headache, myalgia

• Increased liver enzymes (ALT/AST)

• Anemia, peripheral edema, alopecia

Severe reactions:

• Thrombotic or thromboembolic complications, particularly with elevated platelet counts

• Hepatotoxicity; monitor liver function regularly

Contraindications

• No absolute contraindications, but use cautiously in patients with hepatic impairment or history of thrombotic events.

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Pregnancy and Lactation

• Pregnancy Category C: Use only if benefits outweigh risks. Animal studies indicate potential embryolethality and reduced fetal weights at high, toxic doses.

• Nursing: Unknown if excreted in human milk; weigh maternal benefits against potential risks to infants.

Precautions and Warnings

• Hepatotoxicity: Monitor liver function before and during therapy.

• Thrombotic Risk: Monitor platelet counts to avoid excessive increases.

• Special Populations: Adjust dose in East Asian patients and those with hepatic impairment. Elderly and renal impairment patients require close monitoring.

Overdose Management

• Excessive doses may lead to high platelet counts and thrombotic events.

• Management includes stopping therapy, supportive care, chelation with metal cation-containing preparations, and close monitoring of platelet counts.

Storage Conditions

• Store in a cool, dry place, away from light and moisture.

• Keep out of the reach of children.