Eltrombopag
Eltrombopag Polpharma 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 components that help reduce the risk of bleeding or prevent it. Eltrombopag Polpharma is used to treat a blood clotting 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 under the skin), bruising, nosebleeds, bleeding from the gums, and difficulty stopping bleeding in case of injury or trauma. Eltrombopag Polpharma may also be used to treat a low platelet count (thrombocytopenia) in adults with hepatitis C virus (HCV) infection who have had difficulties 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 some antiviral drugs used in its treatment. Taking Eltrombopag Polpharma may help patients complete full treatment with antiviral drugs (peginterferon and ribavirin).
Before starting treatment with Eltrombopag Polpharma, the patient should discuss the following with their doctor:
The patient should inform 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 patient may also be examined for any bleeding in the retina (the light-sensitive layer at the back of the eye) or near it.
Before starting treatment with Eltrombopag Polpharma, the doctor will perform blood tests to assess the patient's blood cells, including platelets. During treatment, these tests will be repeated at regular intervals.
Eltrombopag Polpharma may cause changes in blood test results that may indicate liver damage - increased activity of certain liver enzymes, in particular bilirubin and alanine and aspartate transaminases. If the patient is taking interferon-based treatment and Eltrombopag Polpharma 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 Polpharma and at regular intervals during treatment. It may be necessary to stop taking Eltrombopag Polpharma 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 Polpharma, it is likely that their platelet count will decrease to pre-treatment levels within a few days. A low platelet count may increase the risk of bleeding or bruising. The patient's platelet count will be monitored, and their doctor will discuss appropriate precautions with them. 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 Polpharma to prevent the platelet count from becoming too high. The patient should seek immediate medical attentionif they experience any of the following symptoms of a blood clot:
In patients with bone marrow disorders, medicines like Eltrombopag Polpharma 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 Polpharma.
If the patient is taking interferon-based treatment and Eltrombopag Polpharma for low platelet count associated with hepatitis C, they will be monitored for signs of bleeding from the stomach or intestines after stopping treatment with Eltrombopag Polpharma.
The doctor may decide to perform a heart test on the patient during treatment with Eltrombopag Polpharma and perform an electrocardiogram (ECG).
There is limited data on the use of Eltrombopag Polpharma in patients aged 65 and older. Caution should be exercised when using Eltrombopag Polpharma in patients aged 65 and older.
Eltrombopag Polpharma 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, including those available without a prescription and vitamins. Some commonly used medicines interact with Eltrombopag Polpharma- including both prescription and non-prescription medicines and products containing minerals. These include:
The patient should consult their doctor if they are taking any of the above medicines. Some of them should not be taken during treatment with Eltrombopag Polpharma, while others may require dose adjustment or appropriate timing of administration. 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, the doses of these medicines may be reduced or their use stopped during treatment with Eltrombopag Polpharma.
Eltrombopag Polpharma should not be taken with dairy products or drinks, as the calcium in these products affects the absorption of the medicine. For more information, see "When to take the medicine" in section 3.
Eltrombopag Polpharma should not be taken during pregnancy, unless the doctor recommends it. The effect of Eltrombopag Polpharma when taken during pregnancy is unknown.
The patient should not breastfeed while taking Eltrombopag Polpharma. It is not known whether Eltrombopag Polpharma passes into breast milk. The patient should tell their doctor if they are breastfeedingor plan to breastfeed.
Eltrombopag Polpharma may cause dizzinessand other side effects that reduce attention. The patient should not drive or operate machineryunless they are sure that these symptoms do not occur.
If the patient has 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 tablet, which means it is considered "sodium-free".
This medicine should always be taken exactly as prescribed by the doctor. In case of doubt, the patient should consult their doctor or pharmacist. The patient should not change the dose or dosing schedule of Eltrombopag Polpharma unless their doctor or pharmacist tells them to do so. During treatment with Eltrombopag Polpharma, the patient will remain under the care of a doctor with experience in treating the condition they have.
In the case of primary immune thrombocytopenia
Adults and children(aged 6 to 17 years) - the usual starting dose for primary immune thrombocytopenia is one 50 mg tabletof Eltrombopag Polpharma per day. Patients of East Asian/Southeast Asian descent may require a lower starting dose of 25 mg. Children (aged 1 to 5 years) - the usual starting dose for primary immune thrombocytopenia is one 25 mg tabletof Eltrombopag Polpharma per day. In the case of hepatitis C
Adults- the usual starting dose for hepatitis C is one 25 mg tabletof Eltrombopag Polpharma per day. In patients of East Asian/Southeast Asian descent, treatment should be started with the same dose of 25 mg. The onset of action of Eltrombopag Polpharma may occur within 1 to 2 weeks. Depending on the patient's response to treatment with Eltrombopag Polpharma, the doctor may recommend a change in the daily dose.
The tablets should be swallowed whole with water.
The patient should make sure that:
If the patient does not follow these recommendations, Eltrombopag Polpharma will not be properly absorbed by the body.
The patient should consult their doctor for more information about the foods and drinks they can consume.
The patient should contact their doctor or pharmacist immediately. If possible, they should show them the packaging of the medicine or this leaflet. The patient's condition will be monitored for any side effects and appropriate treatment will be given promptly.
The patient should take the next dose at the usual time. They should not take more than one dose of Eltrombopag Polpharma per day.
The patient should not stop taking Eltrombopag Polpharma 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 Polpharma can cause side effects, although not everybody gets them.
In patients taking Eltrombopag Polpharma for primary immune thrombocytopenia or low platelet count associated with hepatitis C, severe 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 Polpharma may worsen this condition. Sudden blockage of a blood vessel by a blood clot is an uncommon side effect and may affect up to 1 in 100 patients.
Liver disordersEltrombopag Polpharma 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 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 tell their doctor immediately.
Bleeding or bruising after stopping treatmentUsually, within two weeks of stopping Eltrombopag Polpharma, the patient's platelet count decreases to pre-treatment levels. 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 Eltrombopag Polpharma. The patient should tell their doctorif they experience bruising or bleeding after stopping Eltrombopag Polpharma. In some patients, gastrointestinal bleedingmay occur after stopping peginterferon, ribavirin, and Eltrombopag Polpharma. Symptoms include:
The patient should tell their doctor immediatelyif they experience any of these symptoms.
Very commonside effects (may affect more than 1 in 10 patients):
Very commonside effects that may be detected in blood tests:
Commonside effects (may affect up to 1 in 10 patients):
Commonside effects that may be detected in blood tests:
increased bilirubin in the blood (a substance produced by the liver)
Uncommonside effects (may affect up to 1 in 100 patients):
Uncommonside effects that may be detected in laboratory tests:
The following side effects have been reported in children (aged 1 to 17 years) with primary immune thrombocytopenia taking eltrombopag:
Very commonside effects (may affect more than 1 in 10 children):
Commonside effects (may affect up to 1 in 10 children):
The following side effects have been reported in patients with hepatitis C taking eltrombopag in combination with peginterferon and ribavirin:
Very commonside effects (may affect more than 1 in 10 patients):
Very commonside effects that may be detected in blood tests:
Commonside effects (may affect up to 1 in 10 patients):
Commonside effects that may be detected in blood tests:
Uncommonside effects (may affect up to 1 in 100 patients):
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, 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, more information can be gathered 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. The inscription on the packaging after the abbreviation EXP indicates the expiry date, and after the abbreviation Lot indicates the batch number. There are no special storage instructions for the medicine. 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 use. This will help protect the environment.
Eltrombopag Polpharma 12.5 mg is orange to brown, round, biconvex, film-coated tablets with "I" embossed on one side and a diameter of about 5.5 mm. Eltrombopag Polpharma 25 mg is dark pink, round, biconvex, film-coated tablets with "II" embossed on one side and a diameter of about 8 mm. Eltrombopag Polpharma 50 mg is pink, round, biconvex, film-coated tablets with "III" embossed on one side and a diameter of about 10 mm. Eltrombopag Polpharma 75 mg is red to brown, round, biconvex, film-coated tablets with "IV" embossed on one side and a diameter of about 12 mm. Eltrombopag Polpharma 12.5 mg is available in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets in blisters or in cardboard boxes containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets in single-dose perforated blisters. Eltrombopag Polpharma 25 mg is available in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets in blisters or in cardboard boxes containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets in single-dose perforated blisters. Eltrombopag Polpharma 50 mg is available in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets in blisters or in cardboard boxes containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets in single-dose perforated blisters. Eltrombopag Polpharma 75 mg is available in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets in blisters or in cardboard boxes containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets in single-dose perforated blisters. Not all pack sizes may be marketed.
Polpharma S.A., ul. Pelplińska 19, 83-200 Starogard Gdański, tel. +48 22 364 61 01
Synthon Hispania S.L., Calle De Castello 1, 08330 Sant Boi De Llobregat, Spain; Synthon B.V., Microweg 22, 6545 CM Nijmegen, Netherlands
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