Elopag 50 mg contains Eltrombopag, an orally active thrombopoietin (TPO) receptor agonist used to treat conditions characterized by low platelet counts. It is specifically indicated for:

• Chronic Immune (Idiopathic) Thrombocytopenia (ITP)

• Chronic Hepatitis C-associated Thrombocytopenia

• Severe Aplastic Anemia

Eltrombopag works by stimulating the TPO receptor, promoting platelet production, and in certain cases, enhancing other hematopoietic lineages, improving overall blood cell counts.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Haemostatic drugs

Pharmacology

Eltrombopag is a small-molecule TPO-receptor agonist that binds to the transmembrane domain of the human TPO receptor. Its action stimulates JAK-STAT signaling pathways, increasing platelet production. Unlike recombinant TPO, Eltrombopag does not activate the AKT pathway. In patients with aplastic anemia, its effects may extend beyond platelets, potentially improving other blood cell lineages, though the exact mechanism remains under study.

Indications

Elopag 50 mg is indicated for:

• Chronic Immune Thrombocytopenia (ITP): To increase platelet counts in adults and pediatric patients aged 1 year and older when conventional therapies are insufficient.

• Chronic Hepatitis C-associated Thrombocytopenia: To allow initiation or continuation of antiviral therapy.

• Severe Aplastic Anemia: As part of therapy to improve platelet counts in refractory or relapsed cases.

Dosage and Administration

Chronic ITP (Adults and Children ≥6 years):

• Start at 50 mg once daily.

• For East Asian patients or those with hepatic impairment, initiate at 25 mg daily; if both factors are present, start at 12.5 mg daily.

Pediatric Patients 1–5 years:

• Start at 25 mg once daily

Chronic Hepatitis C-associated Thrombocytopenia:

• Start at 25 mg once daily.

• Adjust in 25 mg increments every 2 weeks to reach the target platelet count.

Severe Aplastic Anemia:

• Start at 50 mg once daily.

• Dose adjustments apply for East Asian ancestry or hepatic impairment.

Administration Note:

• Take at least 2 hours before or 4 hours after medications or foods containing polyvalent cations (e.g., antacids, calcium, iron, magnesium supplements).

Drug Interactions

• Polyvalent cations: Reduce absorption; separate administration by at least 2–4 hours.

• Monitor co-administration with other hepatotoxic or hematologic agents.

Contraindications

There are no absolute contraindications, but caution is advised in patients with liver disease or a predisposition to thrombotic events.

Side Effects

Common adverse reactions include:

• Adults with ITP: Nausea, diarrhea, upper respiratory tract infection, vomiting, increased ALT, myalgia, urinary tract infection.

• Pediatrics (≥1 year) with ITP: Upper respiratory tract infection, nasopharyngitis.

• Chronic Hepatitis C: Anemia, fatigue, headache, nausea, diarrhea, influenza-like illness, peripheral edema.

• Severe Aplastic Anemia: Nausea, fatigue, headache, cough, diarrhea.

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions and Warnings

• Hepatotoxicity: Monitor liver function regularly.

• Thrombotic Risk: Monitor platelet counts; portal vein thrombosis has been reported in liver disease patients.

• Use cautiously in older adults and those with renal impairment.

Pregnancy and Lactation

• Pregnancy Category C: Use only if benefits outweigh risks. Animal studies showed embryotoxicity at high doses.

• Nursing mothers: Unknown if excreted in human milk; discontinue nursing or therapy based on clinical need.

Overdose

Excessive platelet counts and thrombotic complications may occur. Management includes:

• Discontinue Elopag

• Supportive care, possible chelation with metal cation-containing preparations

• Close monitoring of platelet counts and liver function

Storage Conditions

Store in a cool, dry place below 30°C, away from light and moisture. Keep out of reach of children.