Eltrombopag
Eltrombopag Glenmark contains eltrombopag, which belongs to a group of medicines called thrombopoietin receptor agonists. The medicine is used to increase the number of platelets in the patient's blood. Platelets are components of blood that help reduce or prevent the risk of bleeding.
Eltrombopag Glenmark is used to treat a bleeding disorder called primary immune thrombocytopenia (ITP) in patients over 1 year of age who have been previously treated with other medicines (corticosteroids or immunoglobulins) and have not responded to them.
Primary immune thrombocytopenia is caused by a low platelet count (thrombocytopenia). People with primary immune thrombocytopenia are more prone to bleeding. Symptoms that patients with primary immune thrombocytopenia may notice include petechiae (small, flat, red spots on the skin), purpura (bleeding under the skin), nosebleeds, gum bleeding, and difficulty stopping bleeding in case of injury or trauma.
Eltrombopag Glenmark may also be used to treat low platelet count (thrombocytopenia) in adults with hepatitis C virus (HCV) infection who have had difficulty due to side effects during treatment with interferon. Many people with hepatitis C have a low platelet count, not only due to the disease but also as a result of the action of certain antiviral medicines used to treat it.
Taking Eltrombopag Glenmark may help patients complete their full antiviral treatment (peginterferon and ribavirin).
Before starting treatment with Eltrombopag Glenmark, the patient should discuss the following with their doctor:
The doctor will recommend an eye examination to detect cataracts. If the patient does not undergo regular eye examinations, the doctor should recommend regular examinations. The occurrence of any bleeding in the retina (the light-sensitive layer at the back of the eye) or near it may also be examined.
Before starting treatment with Eltrombopag Glenmark, the doctor will perform blood tests to assess the patient's blood cells, including platelets. During treatment with Eltrombopag Glenmark, these tests will be repeated at regular intervals.
Eltrombopag Glenmark may cause changes in blood test results that may indicate liver damage, such as increased activity of certain liver enzymes, particularly bilirubin, and alanine or aspartate transaminase. If the patient is taking interferon-based treatment with Eltrombopag Glenmark for low platelet count associated with hepatitis C, some liver diseases may worsen.
Blood tests to assess liver function will be performed before starting treatment with Eltrombopag Glenmark and at regular intervals during treatment. It may be necessary to stop taking Eltrombopag Glenmark if the levels of these substances increase significantly or if other symptoms of liver damage occur.
The patient should read the information in section 4 "Liver disorders" of this leaflet.
If the patient stops taking Eltrombopag Glenmark, it is likely that the platelet count will decrease again within a few days. The platelet count will be monitored, and the doctor will discuss appropriate precautions with the patient.
A very high platelet count may increase the risk of blood clots. However, blood clots can also occur when the platelet count is normal or too low. The doctor will adjust the dose of Eltrombopag Glenmark to ensure that the platelet count is not too high.
The patient should seek medical help immediately if they experience any of the following symptoms of a blood clot:
In people with bone marrow disorders, medicines like Eltrombopag Glenmark may worsen these disorders. Changes in the bone marrow may be indicated by abnormal blood test results. The doctor may order direct bone marrow tests during treatment with Eltrombopag Glenmark.
If the patient is taking interferon-based treatment with Eltrombopag Glenmark for low platelet count associated with hepatitis C, they will be monitored for signs of gastrointestinal bleeding after stopping Eltrombopag Glenmark.
The doctor may consider performing heart tests on the patient during treatment with Eltrombopag Glenmark and may perform an electrocardiogram (ECG).
There is limited data on the use of Eltrombopag Glenmark in patients aged 65 and older.
Care should be taken when using Eltrombopag Glenmark in patients aged 65 and older.
Eltrombopag Glenmark is not recommended for children under 1 year of age with primary immune thrombocytopenia.
The medicine is also not recommended for patients under 18 years of age with low platelet count associated with hepatitis C virus infection.
The patient should tell their doctor or pharmacist about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take. This includes medicines available without a prescription and vitamins.
Certain commonly used medicines interact with eltrombopag, including prescription and non-prescription medicines and mineral products. These include:
The patient should tell their doctor if they are taking any of these medicines. Some of them should not be taken while taking Eltrombopag Glenmark, or the dose or timing of the medicines may need to be adjusted. The doctor will review the patient's medicines and recommend changes if necessary.
If the patient is taking medicines to prevent blood clots, there is an increased risk of bleeding. The doctor will discuss this with the patient.
If the patient is taking corticosteroids, danazol, and/or azathioprine, it may be necessary to reduce the dose of these medicines or stop taking them while taking Eltrombopag Glenmark.
Eltrombopag Glenmark should not be taken with dairy products or drinks, as the calcium in these products affects the absorption of the medicine. For more information, the patient should read "When to take the medicine" in section 3.
Eltrombopag Glenmark should not be taken during pregnancy unless the doctor recommends it. The effect of taking eltrombopag during pregnancy is unknown.
The patient should not breastfeed while taking Eltrombopag Glenmark. It is not known whether eltrombopag passes into breast milk.
The patient should inform their doctor if they are breastfeeding or plan to breastfeed.
Eltrombopag Glenmark may cause dizziness and other side effects that reduce attention.
The patient should not drive or operate machinery unless they are sure that these symptoms do not occur.
If the patient has previously been diagnosed with intolerance to some sugars, they should contact their doctor before taking the medicine.
The medicine contains less than 1 mmol (23 mg) of sodium per film-coated tablet, which means it is essentially "sodium-free".
This medicine should always be taken exactly as the doctor has instructed. If the patient is unsure, they should consult their doctor or pharmacist. The patient should not change the dose or dosing schedule of Eltrombopag Glenmark unless their doctor or pharmacist tells them to.
While taking Eltrombopag Glenmark, the patient will remain under the care of a doctor experienced in treating the patient's condition.
Primary immune thrombocytopenia
Adults and children (aged 6 to 17 years): the usual starting dose for primary immune thrombocytopenia is one 50 mg tablet of Eltrombopag Glenmark per day. In patients of East Asian/South-East Asian origin, it may be necessary to start treatment with a lower dose of 25 mg.
Children (aged 1 to 5 years): the usual starting dose for primary immune thrombocytopenia is one 25 mg tablet of Eltrombopag Glenmark per day.
Hepatitis C
Adults: the usual starting dose for hepatitis C is one 25 mg tablet of Eltrombopag Glenmark per day. In patients of East Asian/South-East Asian origin, treatment should be started with the same dose of 25 mg.
The tablets should be swallowed whole with water.
The patient should make sure that:
they do not eat the following foods:
If the patient does not follow these instructions, Eltrombopag Glenmark may not be properly absorbed by the body.
The patient should talk to their doctor to get more information about the foods and drinks to avoid.
If the patient takes more Eltrombopag Glenmark than they should, they should contact their doctor immediately.
The patient should take the next dose at the usual time. They should not take more than one dose of Eltrombopag Glenmark per day.
The patient should not stop taking Eltrombopag Glenmark without first consulting their doctor. If the doctor recommends stopping treatment, the patient's platelet count will be monitored.
…and for 2 hours after taking this medicine
or take them once a week for four weeks.See also "Bleeding or bruising after stopping treatment" in section 4.
If the patient has any further questions about taking this medicine, they should ask their doctor or pharmacist.
Like all medicines, Eltrombopag Glenmark can cause side effects, although not everybody gets them.
In patients taking Eltrombopag Glenmark for primary immune thrombocytopenia or low platelet count associated with hepatitis C, the following symptoms of serious side effects may occur. It is essential to inform the doctor about these symptoms.
Increased risk of blood clots
In some people, the risk of blood clots may increase, and medicines like Eltrombopag Glenmark may worsen this condition. Sudden blockage of a blood vessel by a blood clot is an uncommon side effect and may occur in less than 1 in 100 people.
The patient should seek medical help immediately if they experience any symptoms of a blood clot, such as:
Liver disorders
Eltrombopag Glenmark may cause changes in blood test results that may indicate liver damage. Liver disorders (increased activity of enzymes in blood test results) are common and may occur in less than 1 in 10 people. Other liver problems are uncommon and may occur in less than 1 in 100 people.
If the patient experiences any of the following symptoms of liver disorders:
they should tell their doctor immediately.
Bleeding or bruising after stopping treatment
Usually, within two weeks after stopping Eltrombopag Glenmark, the patient's platelet count will decrease to the level before starting treatment with Eltrombopag Glenmark. A low platelet count may increase the risk of bleeding or bruising. The doctor will monitor the patient's platelet count for at least 4 weeks after stopping treatment with this medicine.
The patient should inform their doctor if they experience any bleeding or bruising after stopping Eltrombopag Glenmark.
In some patients, gastrointestinal bleeding may occur after stopping peginterferon, ribavirin, and eltrombopag. Symptoms include:
The patient should tell their doctor immediately if they experience any of these symptoms.
If these side effects worsen, the patient should tell their doctor, pharmacist, or nurse.
Very commonside effects (may affect more than 1 in 10 people):
Very commonside effects that may be seen in blood tests:
Commonside effects (may affect up to 1 in 10 people):
Commonside effects that may be seen in blood tests:
Uncommonside effects (may affect up to 1 in 100 people):
Uncommonside effects that may be seen in laboratory tests:
Rareside effects (may affect up to 1 in 1,000 people):
Additional side effects have been reported in children (aged 1 to 17 years) with ITP:
If these side effects worsen, the patient should tell their doctor, pharmacist, or nurse.
Very commonside effects (may affect more than 1 in 10 children):
Commonside effects (may affect up to 1 in 10 children):
Side effects have been reported in patients with HCV taking eltrombopag in combination with peginterferon and ribavirin:
Very commonside effects (may affect more than 1 in 10 people):
Very commonside effects that may be seen in blood tests:
Commonside effects (may affect up to 1 in 10 people):
Commonside effects that may be seen in blood tests:
Uncommonside effects (may affect up to 1 in 100 people):
If the patient experiences any side effects, including any not listed in this leaflet, they should tell their doctor, pharmacist, or nurse.
Side effects can be reported directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products:
Al. Jerozolimskie 181C, 02-222 Warsaw
Phone: +48 22 49 21 301, fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
By reporting side effects, more information can be collected on the safety of the medicine.
The medicine should be stored out of sight and reach of children.
The patient should not take Eltrombopag Glenmark after the expiry date stated on the carton and blister after the abbreviation EXP. The expiry date refers to the last day of the month stated.
There are no special storage requirements.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines they no longer need. This will help protect the environment.
Eltrombopag Glenmark 50 mg: each film-coated tablet contains eltrombopag olamine equivalent to 50 mg of eltrombopag.
Eltrombopag Glenmark 25 mg is a dark pink, round, biconvex film-coated tablet with a diameter of about 8 mm, with the symbol "II" embossed on one side.
Eltrombopag Glenmark 50 mg is a pink, round, biconvex film-coated tablet with a diameter of about 10 mm, with the symbol "III" embossed on one side.
Available pack sizes:
Blisters in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets, single-dose blisters in cardboard boxes containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets.
Not all pack sizes may be marketed.
Glenmark Pharmaceuticals s.r.o.
Hvězdova 1716/2b
140 78 Prague 4
Czech Republic
Synthon Hispania S.L.
Calle De Castelló 1
Sant Boi De Llobregat
08830 Barcelona
Spain
Synthon B.V.
Microweg 22
6545 CM, Nijmegen
Netherlands
Glenmark Pharmaceuticals Sp. z o.o.
ul. Dziekońskiego 3
00-728 Warsaw
Phone: +48 22 35 12 500
Email: poland.receptionist@glenmarkpharma.com
Member State | Proposed name |
Netherlands | Eltrombopag Glenmark 12.5 mg tabletten Eltrombopag Glenmark 25 mg tabletten |
Eltrombopag Glenmark 50 mg tabletten Eltrombopag Glenmark 75 mg tabletten | |
Denmark | Eltrombopag Glenmark |
Spain | Eltrombopag Glenmark 12.5 mg comprimidos recubiertos con película EFG Eltrombopag Glenmark 25 mg comprimidos recubiertos con película EFG Eltrombopag Glenmark 50 mg comprimidos recubiertos con película EFG Eltrombopag Glenmark 75 mg comprimidos recubiertos con película EFG |
Norway | Eltrombopag Glenmark |
Poland | Eltrombopag Glenmark |
Sweden | Eltrombopag Glenmark |
Slovakia | Eltrombopag Glenmark 12.5 mg Eltrombopag Glenmark 25 mg Eltrombopag Glenmark 50 mg Eltrombopag Glenmark 75 mg |
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