eltrombopag
Eltrombopag Olpha 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 blood cells that help reduce the risk of bleeding or prevent it. Eltrombopag Olpha is used to treat a blood clotting disorder called primary immune thrombocytopenia (ITP) in patients over 1 year of age who have already been treated with other medicines (corticosteroids or immunoglobulins) and have not responded to them. Primary immune thrombocytopenia is caused by a low number of platelets in the blood (thrombocytopenia). People with primary immune thrombocytopenia are more likely to bleed. Symptoms that patients with primary immune thrombocytopenia may notice include petechiae (small, flat, red spots under the skin), purpura, nosebleeds, gum bleeding, and difficulty stopping bleeding in case of injury or trauma. Eltrombopag Olpha 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 drugs used to treat it. Taking Eltrombopag Olpha may help patients complete full treatment with antiviral drugs (peginterferon and ribavirin).
Before starting treatment with Eltrombopag Olpha, the patient should discuss the following with their doctor:
The patient should tell their doctor if any of the above situations apply to them.
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 layer of light-sensitive cells at the back of the eye) or near it may also be examined.
Before starting treatment with Eltrombopag Olpha, the doctor will perform blood tests to assess the patient's blood cells, including platelets. During treatment with the medicine, these tests will be repeated at regular intervals.
Taking eltrombopag may cause changes in blood test results that indicate liver damage - increased activity of certain liver enzymes, in particular alanine aminotransferase and aspartate aminotransferase, and increased bilirubin. If the patient is taking interferon-based treatment with Eltrombopag Olpha for low platelet count associated with hepatitis C, some liver diseases may worsen. Blood tests to assess liver function will be performed in the patient before starting treatment with Eltrombopag Olpha and at regular intervals during treatment. It may be necessary to stop taking Eltrombopag Olpha if the levels of these substances increase too much or if other symptoms of liver damage occur. The patient should read the information in section 4 of this leaflet "Liver disorders".
If the patient stops taking Eltrombopag Olpha, there is a risk of the platelet count decreasing 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 Olpha for the patient to prevent excessive increase in platelet count. The patient should seek immediate medical attention if they experience any of the following symptoms of a blood clot:
In patients with bone marrow disorders, medicines like Eltrombopag Olpha 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 Olpha.
If the patient is taking interferon-based treatment with Eltrombopag Olpha, they will be monitored for symptoms of gastrointestinal bleeding after completing treatment with this medicine.
The doctor may consider it necessary to examine the patient's heart during treatment with Eltrombopag Olpha and perform an electrocardiogram (ECG).
There is limited data on the use of eltrombopag in patients aged 65 and older. Caution should be exercised when taking Eltrombopag Olpha in patients aged 65 and older.
Eltrombopag is not recommended in children under 1 year of age with primary immune thrombocytopenia. The medicine is also not recommended in 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 obtained without a prescription and vitamins. Some commonly used medicines interact with eltrombopag - including prescription and non-prescription medicines and mineral supplements. These include:
The patient should consult their doctor if they are taking any of the above medicines. Some of them should not be taken while taking Eltrombopag Olpha, while others may require dose adjustment or appropriate timing of administration. The doctor will review the patient's medicines and recommend changes to treatment 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, the doses of these medicines may be reduced or their use discontinued during concurrent use of Eltrombopag Olpha.
Eltrombopag Olpha should not be taken with dairy products or drinks, as the calcium in dairy products affects the absorption of the medicine. For more information, see "When to take Eltrombopag Olpha" in section 3.
Eltrombopag Olpha should not be taken during pregnancy unless the doctor recommends it. The effect of eltrombopag during pregnancy is unknown.
Eltrombopag Olpha may cause dizziness and other side effects that reduce concentration. The patient should not drive or operate machinery unless they are sure that these symptoms do not occur in them.
If the patient has previously been diagnosed with intolerance to some sugars, they should contact their doctor before taking the medicine. This medicine contains less than 1 mmol (23 mg) of sodium per coated tablet, which means that the medicine is considered "sodium-free".
This medicine should always be taken as directed by the doctor. If the patient has any doubts, they should consult their doctor or pharmacist. The patient should not change the dose or dosing schedule of Eltrombopag Olpha unless their doctor or pharmacist recommends it. While taking Eltrombopag Olpha, the patient will remain under the care of a doctor experienced in treating the disease they have.
In the case of primary immune thrombocytopenia
In the case of hepatitis C
The onset of action of Eltrombopag Olpha may occur within 1 to 2 weeks. Depending on the patient's response to treatment with Eltrombopag Olpha, the doctor may recommend a change in the daily dose.
The tablets should be swallowed whole, with a glass of water. When to take the medicine The patient should make sure that -
The patient should consult their doctor for more information about suitable foods and drinks.
The patient should contact their doctor or pharmacist immediately. If possible, they should show them the medicine packaging or this leaflet. The patient's condition will be monitored for any side effects and appropriate treatment will be administered promptly.
The patient should take the next dose at the usual time. The patient should not take more than one dose of Eltrombopag Olpha per day.
The patient should not stop taking Eltrombopag Olpha without consulting their doctor. If the doctor recommends stopping treatment, the patient's platelet count will be monitored weekly for four weeks. See also "Bleeding or bruising after stopping treatment" in section 4. If the patient has any further doubts about taking this medicine, they should consult their doctor or pharmacist.
Like all medicines, Eltrombopag Olpha can cause side effects, although not everybody gets them. Symptoms to watch out for: the patient should see a doctor. In patients taking eltrombopag for primary immune thrombocytopenia or low platelet count associated with hepatitis C, symptoms of serious side effects may occur. It is essential to inform the doctor about these symptoms. Increased risk of blood clotsSome patients may have an increased risk of blood clots, and medicines like Eltrombopag Olpha may worsen this. Sudden blockage of a blood vessel by a blood clot is an uncommon side effect and may affect up to 1 in 100 patients. The patient should seek immediate medical attention if they experience any symptoms of a blood clot, such as:
Liver disordersEltrombopag Olpha may cause changes in blood test results that indicate liver damage. Liver disorders (increased enzyme activity in blood test results) are common and may affect up to 1 in 10 patients. Other liver problems are uncommon and may affect up to 1 in 100 patients. If the patient experiences any of the following symptoms of liver disorders:
the patient should see a doctor immediately.
Bleeding or bruising after stopping treatmentUsually, within two weeks of stopping Eltrombopag Olpha, the patient's platelet count decreases to the level before starting treatment with Eltrombopag Olpha. 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 Eltrombopag Olpha. The patient should tell their doctor if they experience bruising or bleeding after stopping treatment with this medicine. In some patients, gastrointestinal bleeding may occur after stopping treatment with peginterferon, ribavirin, and eltrombopag. Symptoms include:
If these side effects worsen, the patient should tell their doctor, pharmacist, or nurse. Very common side effects(may affect more than 1 in 10 patients):
Very common side effectsthat may be seen in blood tests:
Common side effects(may affect up to 1 in 10 patients):
Common side effectsthat may be seen in blood tests:
Uncommon side effects(may affect up to 1 in 100 patients):
Uncommon side effectsthat may be seen in laboratory tests:
If these side effects worsen, the patient should tell their doctor, pharmacist, or nurse. Very common side effects(may affect more than 1 in 10 children):
Common side effects(may affect up to 1 in 10 children):
Very common side effects(may affect more than 1 in 10 patients):
Very common side effectsthat may be seen in blood tests:
Common side effects(may affect up to 1 in 10 patients):
Common side effectsthat may be seen in blood tests:
Uncommon side effects(may affect up to 1 in 100 patients):
If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices, and Biocides of the Office for Registration of Medicinal Products, Medical Devices, and Biocides: Al. Jerozolimskie 181C, 02-222 Warsaw, Tel.: +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, it is possible to gather more information on the safety of the medicine.
The medicine should be stored out of sight and reach of children. The patient should not take this medicine after the expiry date stated on the carton and blister after "EXP". The expiry date refers to the last day of the month. No special precautions. Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
The active substance is eltrombopag olamine. Eltrombopag Olpha, 12.5 mg, coated tabletsEach coated tablet contains eltrombopag olamine equivalent to 12.5 mg of eltrombopag. Eltrombopag Olpha, 25 mg, coated tabletsEach coated tablet contains eltrombopag olamine equivalent to 25 mg of eltrombopag. Eltrombopag Olpha, 50 mg, coated tabletsEach coated tablet contains eltrombopag olamine equivalent to 50 mg of eltrombopag. Eltrombopag Olpha, 75 mg, coated tabletsEach coated tablet contains eltrombopag olamine equivalent to 75 mg of eltrombopag. The other ingredients are: Tablet core: microcrystalline cellulose, mannitol, povidone, isomalt (E 953), calcium silicate, sodium carboxymethyl cellulose, magnesium stearate. Tablet coating: Eltrombopag Olpha, 12.5 mg, coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin. Eltrombopag Olpha, 25 mg, coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin. Eltrombopag Olpha, 50 mg, coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin. Eltrombopag Olpha, 75 mg, coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), triacetin.
Eltrombopag Olpha, 12.5 mg, coated tabletsOrange to brown, round, biconvex coated tablets with "I" embossed on one side and a diameter of about 5.5 mm. Eltrombopag Olpha, 25 mg, coated tabletsDark pink, round, biconvex coated tablets with "II" embossed on one side and a diameter of about 8 mm. Eltrombopag Olpha, 50 mg, coated tabletsPink, round, biconvex coated tablets with "III" embossed on one side and a diameter of about 10 mm. Eltrombopag Olpha, 75 mg, coated tabletsRed to brown, round, biconvex coated tablets with "IV" embossed on one side and a diameter of about 12 mm. Blisters of OPA/Aluminum/PVC/Aluminum foil packaged in a cardboard box containing 10, 14, 28, 30, or 84 coated tablets, and single-dose blisters packaged in a cardboard box containing 10x1, 14x1, 28x1, 30x1, or 84x1 coated tablets. Not all pack sizes may be marketed.
Olpha AS, Rupnicu iela 5, Olaine, Olaines novads, LV-2114, Latvia E-mail: olpha.poland.pv@insuvia.com
Synthon B.V., Microweg 22, 6545 CM Nijmegen, Netherlands Synthon Hispania S.L., c/ Castelló, 1, 08830 Sant Boi de Llobregat, Barcelona, Spain
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