Package Leaflet: Information for the User
Eltrombopag Zentiva 25 mg film-coated tablets EFG
Eltrombopag Zentiva 50 mg film-coated tablets EFG
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Contents of the pack
Eltrombopag Zentiva contains eltrombopag, which belongs to a group of medicines called thrombopoietin receptor agonists. It is used to help increase the number of platelets in the blood. Platelets are blood cells that help to stop or prevent bleeding.
Eltrombopag is used to treat a blood disorder called primary immune thrombocytopenia (ITP) in patients aged 1 year and older who have already taken other medicines (corticosteroids or immunoglobulins) that have not worked.
ITP is caused by a low platelet count in the blood (thrombocytopenia). People with ITP have a higher risk of bleeding. Symptoms that patients with ITP may notice include petechiae (small, round, flat red spots under the skin), bruising, nosebleeds, bleeding gums, and an inability to stop bleeding if they cut or injure themselves.
Eltrombopag may also be used to treat low platelet counts (thrombocytopenia) in adults with hepatitis C virus (HCV) infection, if they have had problems with side effects during treatment with interferon. Many people with hepatitis C have low platelet counts, not only as a result of the disease but also due to some of the antiviral medicines used to treat it. Taking eltrombopag may help you complete a full course of antiviral medicine (peginterferon and ribavirin).
Do not takeEltrombopag Zentiva
Talk to your doctor if you think this may apply to you.
Warnings and precautions
Talk to your doctor or pharmacist before you start taking eltrombopag:
The risk of getting a blood clot may be higher in the following situations:
If any of these apply to you, tell your doctor before you start treatment. You must not take eltrombopag unless your doctor thinks that the expected benefit is greater than the risk of blood clots.
Tell your doctor if any of these situations apply to you.
Eye examinations
Your doctor will recommend that you have an eye examination to check for cataracts. If you do not have regular eye checks, your doctor may arrange for you to have regular checks. You may also be checked for any bleeding in or around the retina (the layer of light-sensitive cells at the back of the eye).
You will need to have regular blood tests
Before you start taking eltrombopag, your doctor will do blood tests to check your blood cells, including your platelets. These tests will be repeated frequently while you are taking the medicine.
Blood tests to check your liver
Eltrombopag may cause changes in your blood test results that can be signs of liver damage: an increase in some liver enzymes, especially bilirubin and alanine/aspartate transaminases. If you are taking interferon-based treatments with eltrombopag to treat low platelet counts due to hepatitis C, some of your liver problems may get worse.
You will have blood tests to check your liver before you start taking eltrombopag and frequently while you are taking it. You may need to stop taking eltrombopag if the levels of these markers increase too much or if you get other signs of liver damage.
Read the information on “Liver problems” in section 4 of this leaflet.
Blood tests to check your platelet count
If you stop taking eltrombopag, it is likely that your platelet count will fall back to its previous level within a few days. Your platelet levels will be checked and your doctor will tell you what precautions to take.
Very high platelet counts can increase the risk of blood clots. However, blood clots can also occur with normal or even low platelet counts. Your doctor will adjust your dose of eltrombopag to make sure that your platelet count does not get too high.
Seek medical help immediately if you get any of the following signs of a blood clot:
Tests to examine your bone marrow
In people who have problems with their bone marrow, medicines like eltrombopag may make these problems worse. Signs of changes in the bone marrow may appear as abnormal blood test results. Your doctor may also do tests to directly check your bone marrow while you are taking eltrombopag.
Checking for bleeding in the gut
If you are taking interferon-based treatments with eltrombopag, you will be monitored for any signs of bleeding in the stomach or intestines after you stop taking this medicine.
Heart monitoring
Your doctor may consider it necessary to monitor your heart while you are taking eltrombopag and may do an electrocardiogram (ECG) test.
Elderly (65 years and over)
There is limited information on the use of eltrombopag in patients aged 65 years and over. Caution should be used when taking eltrombopag if you are 65 years or older.
Children and adolescents
Eltrombopag is not recommended for children under 1 year of age with ITP. It is also not recommended for children under 18 years of age with low platelet counts due to hepatitis C.
Other medicines and Eltrombopag Zentiva
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines.
Some common medicines may interact with eltrombopag, including prescription and non-prescription medicines and minerals. These include:
Talk to your doctor if you are taking any of these medicines. Some of them must not be taken with eltrombopag, or it may be necessary to adjust the dose or the time at which you take them. Your doctor will review the medicines that you are taking and suggest alternative medicines if necessary.
If you are also taking medicines to prevent blood clots, there is a higher risk of bleeding. Your doctor will discuss this with you.
If you are taking corticosteroids, danazol, and/or azathioprine, you may need to take a lower dose or stop taking them while you are taking eltrombopag.
Taking Eltrombopag Zentiva with food and drink
Do not take eltrombopag with dairy foods or drinks, as the calcium in these foods affects the absorption of the medicine. For more information, see “When to take it” in section 3.
Pregnancy and breastfeeding
Do not take eltrombopag if you are pregnant unless your doctor specifically recommends it. The effects of eltrombopag during pregnancy are not known.
Do not breastfeed while you are taking eltrombopag. It is not known if eltrombopag passes into breast milk.
If you are breastfeeding or plan to breastfeed, talk to your doctor.
Driving and using machines
Eltrombopag may cause dizziness and have other effects that may make you less alert.
Do not drive or use machines unless you are sure that eltrombopag does not affect you.
Eltrombopag Zentiva contains isomalt and sodium
If your doctor has told you that you have an intolerance to some sugars, talk to your doctor before taking this medicine.
This medicine contains less than 1 mmol sodium (23 mg) per tablet, which is essentially “sodium-free”.
Take this medicine exactly as your doctor has told you. If you are not sure, ask your doctor or pharmacist. Do not change the dose or stop taking eltrombopag unless your doctor or pharmacist tells you to. While you are taking eltrombopag, you will be under the care of a specialist doctor who is experienced in treating your condition.
How much to take
For ITP
Adults and children (6 to 17 years): the usual starting dose for ITP is one 50 mg tablet of eltrombopag per day.
If you are of East or South-East Asian origin, you may need to start with a lower dose of 25 mg.
Children (1 to 5 years): the usual starting dose for ITP is one 25 mg tablet of eltrombopag per day.
For hepatitis C
Adults: the usual starting dose for hepatitis C is one 25 mg tablet of eltrombopag per day.
If you are of East or South-East Asian origin, you will start with the same dose of 25 mg.
Eltrombopag may take 1 to 2 weeks to start working. Depending on your response to eltrombopag, your doctor may recommend that you change your daily dose.
How to take the tablets
Swallow the tablet whole with a little water.
When to take it
Make sure that
you do not eat or drink any of the following:
If you do, the medicine will not be absorbed properly into your body.
For more information about suitable foods and drinks, talk to your doctor.
If you take more Eltrombopag Zentiva than you should
Talk to your doctor or pharmacist immediately. If possible, show them the pack or this leaflet. You will be monitored for any signs or symptoms of side effects and will be given the appropriate treatment as soon as possible.
In case of overdose or accidental ingestion, talk to a doctor or pharmacist immediately or call the Toxicology Information Service, telephone 91 562 04 20, stating the medicine and the amount taken.
If you forget to take Eltrombopag Zentiva
Take your next dose at the usual time. Do not take more than one dose of eltrombopag in a day.
If you stop taking Eltrombopag Zentiva
Do not stop taking eltrombopag without talking to your doctor. If your doctor advises you to stop treatment, your platelet levels will be checked every week for four weeks. See also “Bleeding or bruising after stopping treatment” in section 4.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.
Symptoms that require attention: consult a doctor
People taking eltrombopag for ITP or for a low platelet count due to hepatitis C may develop signs related to potentially serious adverse effects. It is essential to inform a doctor if these symptoms occur.
Increased risk of thrombosis
Some people may have an increased risk of suffering from thrombosis, and medications like eltrombopag could worsen this problem. The sudden blockage of a blood vessel by a thrombus is a rare adverse effect and can affect up to 1 in 100 people.
Seek immediate medical attention if you experience signs and symptoms of a thrombus, such as:
Liver problems
Eltrombopag may cause changes that appear in blood tests and can be signs of liver damage. Liver problems (elevated enzymes in blood tests) are common and can affect up to 1 in 10 people.
Other liver problems are rare and can affect up to 1 in 100 people.
If you have any of these signs of liver problems:
Inform your doctor immediately.
Bleeding or bruising after treatment interruption
Within two weeks after stopping eltrombopag, your platelet count in the blood will generally return to the level it was before starting eltrombopag. A decrease in platelet levels can increase the risk of bleeding or bruising. Your doctor will monitor your platelet levels for at least 4 weeks after stopping this medication.
Inform your doctor if you experience bleeding or bruising after stopping treatment with eltrombopag.
Some people experience bleeding in the digestive system after stopping peginterferon, ribavirin, and eltrombopag. The symptoms include:
Inform your doctor immediately if you experience any of these symptoms.
The following adverse effects have been reported in association with eltrombopag treatment in adult patients with ITP:
Very common adverse effects(can affect more than 1 in 10 people)
Very common adverse effectsthat may appear in blood tests:
Common adverse effects(can affect up to 1 in 10 people)
Common adverse effectsthat may appear in blood tests:
Uncommon adverse effects(can affect up to 1 in 100 people)
Uncommon adverse effectsthat may appear in laboratory tests:
The following additional adverse effects have been reported in association with eltrombopag treatment in children (1 to 17 years) with ITP:
If these adverse effects become severe, inform your doctor, pharmacist, or nurse.
Very common adverse effects(can affect more than 1 in 10 children)
Common adverse effects(can affect up to 1 in 10 children)
The following adverse effects have been reported in association with eltrombopag treatment in combination with peginterferon and ribavirin in patients with HCV:
Very common adverse effects(can affect more than 1 in 10 people)
Very common adverse effectsthat may appear in blood tests:
Common adverse effects(can affect up to 1 in 10 people)
Common adverse effectsthat may appear in blood tests:
Uncommon adverse effects(can affect up to 1 in 100 people)
The following adverse effects have been reported in association with eltrombopag treatment in patients with severe aplastic anemia (SAA):
If these adverse effects become severe, inform your doctor, pharmacist, or nurse.
Very common adverse effects(can affect more than 1 in 10 people)
Very common adverse effectsthat may appear in blood tests:
Common adverse effects(can affect up to 1 in 10 people)
Common adverse effectsthat may appear in blood tests:
Adverse effects of unknown frequency(frequency cannot be estimated from available data)
Reporting adverse effects
If you experience any adverse effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister and on the carton after "EXP". The expiry date refers to the last day of the month shown.
This medicine does not require any special storage conditions.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help to protect the environment.
Composition ofEltrombopag Zentiva
Eltrombopag Zentiva 25 mg: Each film-coated tablet contains eltrombopag olamine equivalent to 25 mg of eltrombopag.
Eltrombopag Zentiva 50 mg: Each film-coated tablet contains eltrombopag olamine equivalent to 50 mg of eltrombopag.
Appearance and package contents
Eltrombopag Zentiva 25 mg are film-coated tablets (tablets) biconvex, round, dark pink, with "II" engraved on one side and with a diameter of approximately 8 mm.
Eltrombopag Zentiva 50 mg are film-coated tablets (tablets) biconvex, round, pink, with "III" engraved on one side and with a diameter of approximately 10 mm.
Eltrombopag Zentiva 25 mg and 50 mg is available in boxes containing 14, 28 or 84 film-coated tablets in blisters, or in boxes containing 14x1, 28x1 or 84x1 film-coated tablets in unit-dose blisters.
Only certain pack sizes may be marketed.
Marketing authorisation holder and manufacturer
Marketing authorisation holder
Zentiva, k.s.
U Kabelovny 130
Dolní Mecholupy,
102 37 Prague 10
Czech Republic
Manufacturer
Synthon B.V.
Microweg 22
6545 CM Nijmegen
Netherlands
Or
Synthon Hispania S.L.
c/ Castelló, 1
08830 Sant Boi de Llobregat
Barcelona
Spain
You can request more information about this medicine from the local representative of the marketing authorisation holder:
Zentiva Spain S.L.U.
Avenida de Europa, 19, Edificio 3, Planta 1.
28224 Pozuelo de Alarcón, Madrid
Spain
This medicine is authorised in the Member States of the European Economic Area under the following names:
Germany | Eltrombopag Zentiva 25 mg film-coated tablets Eltrombopag Zentiva 50 mg film-coated tablets |
Denmark | Eltrombopag Zentiva |
Spain | Eltrombopag Zentiva 25 mg film-coated tablets EFG Eltrombopag Zentiva 50 mg film-coated tablets EFG |
Estonia | Eltrombopag Zentiva |
France | Eltrombopag Zentiva 25 mg, film-coated tablets Eltrombopag Zentiva 50 mg, film-coated tablets |
Italy | Eltrombopag Zentiva |
Lithuania | Eltrombopag Zentiva 25mg film-coated tablets |
Norway | Eltrombopag Zentiva |
Netherlands | Eltrombopag Zentiva 25 mg, film-coated tablets Eltrombopag Zentiva 50 mg, film-coated tablets |
Poland | Eltrombopag Zentiva |
Portugal | Eltrombopag Zentiva |
Sweden | Eltrombopag Zentiva |
Date of last revision of this leaflet: May 2024
Detailed information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/