Eltrombopag
Eltrombopag Sandoz 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.
Primary immune thrombocytopenia is caused by a low number of platelets (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), purpura, nosebleeds, gum bleeding, and difficulty stopping bleeding in case of injury or trauma.
Before starting treatment with Eltrombopag Sandoz, 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 routine 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 will also be examined.
Before starting treatment with Eltrombopag Sandoz, 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.
Taking eltrombopag may cause changes in blood test results that may indicate liver damage - increased activity of certain liver enzymes, particularly alanine aminotransferase and aspartate aminotransferase, and bilirubin levels. If the patient is taking interferon-based treatment and Eltrombopag Sandoz for low platelet count associated with hepatitis C, some liver diseases may worsen.
Before starting treatment with Eltrombopag Sandoz and at regular intervals during treatment, the patient will undergo blood tests to assess liver function. It may be necessary to stop taking Eltrombopag Sandoz 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 disease".
If the patient stops taking Eltrombopag Sandoz, there is a risk 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 occur even if the platelet count is normal or too low. The doctor will adjust the dose of Eltrombopag Sandoz for the patient to avoid 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 Sandoz may worsen these conditions. 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 Sandoz.
If the patient is taking interferon-based treatment and Eltrombopag Sandoz for low platelet count associated with hepatitis C, they will be monitored for symptoms of gastrointestinal bleeding after stopping treatment with Eltrombopag Sandoz.
The doctor may consider it necessary to examine the patient's heart during treatment with Eltrombopag Sandoz 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 Sandoz 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.
Certain commonly used medicines interact with eltrombopag Sandoz - including prescription and non-prescription medicines and mineral supplements. These include:
vitamin and mineral supplements (see also "When to take the medicine" in section 3)
The patient should consult their doctorif they are taking any of the above medicines. Some of them should not be taken during treatment with Eltrombopag Sandoz, 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 may be stopped during treatment with Eltrombopag Sandoz.
Eltrombopag Sandoz 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 the medicine" in section 3.
Eltrombopag Sandoz should not be taken during pregnancyunless the doctor has explicitly recommended it. The effect of Eltrombopag Sandoz when taken during pregnancy is unknown.
The patient should not breastfeed while taking Eltrombopag Sandoz. It is not known whether Eltrombopag Sandoz passes into breast milk.
The patient should inform their doctor if they are breastfeeding or plan to breastfeed.
Eltrombopag Sandoz 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 certain 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 considered "sodium-free".
This medicine should always be taken exactly as prescribed by the doctor. In case of doubts, the patient should consult their doctor or pharmacist. The patient should not change the dose or dosing schedule of Eltrombopag Sandoz unless their doctor or pharmacist recommends it. During treatment with Eltrombopag Sandoz, the patient will remain under the care of a doctor experienced in treating the patient's condition.
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 tablet of Eltrombopag Sandoz per day.
Patients of East Asian/Southeast Asian origin 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 tablet of Eltrombopag Sandoz per day.
In the case of hepatitis C
Adults - the usual starting dose for hepatitis C is one 25 mg tablet of Eltrombopag Sandoz per day. In patients of East Asian/Southeast Asian origin, treatment should be started with the same dose of 25 mg.
The onset of action of Eltrombopag Sandoz may occur within 1 to 2 weeks.
Depending on the patient's response to treatment with Eltrombopag Sandoz, the doctor may recommend changing the daily dose.
The tablets should be swallowed whole with water.
The patient should make sure that -
If these recommendations are not followed, Eltrombopag Sandoz may not be properly absorbed by the body.
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 as soon as possible.
The patient should take the next dose at the usual time. They should not take more than one dose of Eltrombopag Sandoz per day.
The patient should not stop taking Eltrombopag Sandoz 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 Sandoz can cause side effects, although not everybody gets them.
In patients taking Eltrombopag Sandoz 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 clots
Some patients may be at increased risk of blood clots, and medicines like Eltrombopag Sandoz 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.
The patient should seek immediate medical attention if they experience any symptoms of a blood clot, such as:
Liver disorders
Eltrombopag Sandoz may cause changes in blood test results that may indicate liver damage. Liver function 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:
they should see their doctor immediately.
Bleeding or bruising after stopping treatment
Usually, within two weeks of stopping Eltrombopag Sandoz, the patient's platelet count will decrease 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 Sandoz.
The patient should inform their doctor if they experience bruising or bleeding after stopping treatment with Eltrombopag Sandoz.
In some patients, gastrointestinal bleedingmay occur after stopping peginterferon, ribavirin, and eltrombopag. Symptoms include:
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):
Uncommonside effects that may be detected in laboratory tests:
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):
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:
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 Adverse Reaction Monitoring 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.
Reporting side effects will help 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 blister and carton after "EXP". The expiry date refers to the last day of the month stated.
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 Sandoz, 12.5 mg: each film-coated tablet contains eltrombopag olamine equivalent to 12.5 mg of eltrombopag.
Eltrombopag Sandoz, 25 mg: each film-coated tablet contains eltrombopag olamine equivalent to 25 mg of eltrombopag.
Eltrombopag Sandoz, 50 mg: each film-coated tablet contains eltrombopag olamine equivalent to 50 mg of eltrombopag.
Eltrombopag Sandoz, 75 mg: each film-coated tablet contains eltrombopag olamine equivalent to 75 mg of eltrombopag.The other ingredients are: microcrystalline cellulose, mannitol, povidone (K29/32), isomalt, calcium silicate, sodium starch glycolate (type A), magnesium stearate (tablet core); hypromellose 2910 (5 mPas), titanium dioxide (E 171), iron oxide red (E 172), triacetin (tablet coating).
Eltrombopag Sandoz, 12.5 mg, 25 mg, and 50 mg film-coated tablets also contain iron oxide yellow (E 172).
Eltrombopag Sandoz, 12.5 mg, are orange to brown, round, biconvex film-coated tablets (tablets) with "I" embossed on one side, approximately 5.5 mm in diameter.
Eltrombopag Sandoz, 25 mg, are dark pink, round, biconvex film-coated tablets (tablets) with "II" embossed on one side, approximately 8 mm in diameter.
Eltrombopag Sandoz, 50 mg, are pink, round, biconvex film-coated tablets (tablets) with "III" embossed on one side, approximately 10 mm in diameter.
Eltrombopag Sandoz, 75 mg, are red to brown, round, biconvex film-coated tablets (tablets) with "IV" embossed on one side, approximately 12 mm in diameter.
Eltrombopag Sandoz, 12.5 mg, 25 mg, 50 mg, 75 mg, is packaged in cardboard boxes containing 10, 14, 28, 30, or 84 film-coated tablets in blisters or cardboard boxes containing 10 x 1, 14 x 1, 28 x 1, 30 x 1, or 84 x 1 film-coated tablets in single-dose blisters or bulk packages containing 84 film-coated tablets (3 packages of 28 film-coated tablets).
Not all pack sizes may be marketed.
Sandoz Polska Sp. z o.o.
ul. Domaniewska 50 C
02-672 Warsaw
Phone: 22 209 70 00
Synthon B.V.
Microweg 22
6545 CM Nijmegen
Netherlands
Synthon Hispania S.L.
c/ Castelló, 1
Sant Boi de Llobregat
08830 Barcelona
Spain
Eltrombopag Sandoz, 12.5 mg
Austria
Eltrombopag Sandoz 12.5 mg – Film-coated tablets
Croatia
Eltrombopag Sandoz 12.5 mg film-coated tablets
Cyprus
Eltrombopag Sandoz
Estonia
Eltrombopag Sandoz
Germany
Eltrombopag - 1 A Pharma 12.5 mg Film-coated tablets
Greece
Eltrombopag/Sandoz
Hungary
Eltrombopag Sandoz 12.5 mg film-coated tablet
Ireland
Eltrombopag Rowex 12.5 mg film-coated tablets
Latvia
Eltrombopag Sandoz 12.5 mg film-coated tablets
Lithuania
Eltrombopag Sandoz 12.5 mg film-coated tablets
Poland
Eltrombopag Sandoz
Romania
Eltrombopag Sandoz 12.5 mg film-coated tablets
Slovenia
Eltrombopag Sandoz 12.5 mg film-coated tablets
Eltrombopag Sandoz, 25 mg
Austria
Eltrombopag Sandoz 25 mg – Film-coated tablets
Bulgaria
Eltrombopag Sandoz/Елтромбопаг Сандоз
Croatia
Eltrombopag Sandoz 25 mg film-coated tablets
Cyprus
Eltrombopag Sandoz
Czech Republic
Eltrombopag Sandoz
Estonia
Eltrombopag Sandoz
Finland
Eltrombopag Sandoz 25 mg tablet, film-coated
France
ELTROMBOPAG SANDOZ 25 mg, film-coated tablet
Germany
Eltrombopag - 1 A Pharma 25 mg Film-coated tablets
Greece
Eltrombopag/Sandoz
Hungary
Eltrombopag Sandoz 25 mg film-coated tablet
Ireland
Eltrombopag Rowex 25 mg film-coated tablets
Italy
Eltrombopag Sandoz
Latvia
Eltrombopag Sandoz 25 mg film-coated tablets
Lithuania
Eltrombopag Sandoz 25 mg film-coated tablets
Norway
Eltrombopag Sandoz
Poland
Eltrombopag Sandoz
Romania
Eltrombopag Sandoz 25 mg film-coated tablets
Slovakia
Eltrombopag Sandoz
Slovenia
Eltrombopag Sandoz 25 mg film-coated tablets
Spain
Eltrombopag Sandoz 25 mg film-coated tablets EFG
Sweden
Eltrombopag Sandoz
Eltrombopag Sandoz, 50 mg
Austria
Eltrombopag Sandoz 50 mg – Film-coated tablets
Bulgaria
Eltrombopag Sandoz/Елтромбопаг Сандоз
Croatia
Eltrombopag Sandoz 50 mg film-coated tablets
Cyprus
Eltrombopag Sandoz
Czech Republic
Eltrombopag Sandoz
Denmark
Eltrombopag Sandoz
Estonia
Eltrombopag Sandoz
Finland
Eltrombopag Sandoz 50 mg tablet, film-coated
France
ELTROMBOPAG SANDOZ 50 mg, film-coated tablet
Germany
Eltrombopag - 1 A Pharma 50 mg Film-coated tablets
Greece
Eltrombopag/Sandoz
Hungary
Eltrombopag Sandoz 50 mg film-coated tablet
Ireland
Eltrombopag Rowex 50 mg film-coated tablets
Italy
Eltrombopag Sandoz
Latvia
Eltrombopag Sandoz 50 mg film-coated tablets
Lithuania
Eltrombopag Sandoz 50 mg film-coated tablets
Norway
Eltrombopag Sandoz
Poland
Eltrombopag Sandoz
Romania
Eltrombopag Sandoz 50 mg film-coated tablets
Slovakia
Eltrombopag Sandoz
Slovenia
Eltrombopag Sandoz 50 mg film-coated tablets
Spain
Eltrombopag Sandoz 50 mg film-coated tablets EFG
Sweden
Eltrombopag Sandoz
Eltrombopag Sandoz, 75 mg
Austria
Eltrombopag Sandoz 75 mg – Film-coated tablets
Croatia
Eltrombopag Sandoz 75 mg film-coated tablets
Cyprus
Eltrombopag Sandoz
Denmark
Eltrombopag Sandoz
Estonia
Eltrombopag Sandoz
Finland
Eltrombopag Sandoz 75 mg tablet, film-coated
France
ELTROMBOPAG SANDOZ 75 mg, film-coated tablet
Germany
Eltrombopag - 1 A Pharma 75 mg Film-coated tablets
Greece
Eltrombopag/Sandoz
Hungary
Eltrombopag Sandoz 75 mg film-coated tablet
Ireland
Eltrombopag Rowex 75 mg film-coated tablets
Italy
Eltrombopag Sandoz
Latvia
Eltrombopag Sandoz 75 mg film-coated tablets
Lithuania
Eltrombopag Sandoz 75 mg film-coated tablets
Norway
Eltrombopag Sandoz
Poland
Eltrombopag Sandoz
Romania
Eltrombopag Sandoz 75 mg film-coated tablets
Slovakia
Eltrombopag Sandoz
Slovenia
Eltrombopag Sandoz 75 mg film-coated tablets
Sweden
Eltrombopag Sandoz
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