Patient Information Leaflet
Revolade 25mg Oral Powder for Suspension
eltrombopag
Read this leaflet carefully before you start taking this medicine, as it contains important information for you.
1.What Revolade is and what it is used for
2.What you need to know before you start taking Revolade
3.How to take Revolade
4.Possible side effects
5.Storage of Revolade
6.Contents of the pack and additional information
Instructions for use
Revolade contains eltrombopag, which belongs to a group of medications calledthrombopoietin receptor agonists,used to help increase the number of platelets in the blood. Platelets are cells present in the blood that help reduce or prevent bleeding.
PTI is caused by a low platelet count (thrombocytopenia). People with PTI have a higher risk of bleeding. Symptoms that patients with PTI may notice are petechiae (small, round, flat red spots under the skin), ecchymoses, nosebleeds, bleeding gums, and inability to control bleeding if they cut or injure themselves.
Do not take Revolade
Consult your doctorif you think this may affect you.
Warnings and precautions
Consult your doctor before starting to take Revolade:
The risk of suffering a blood clot may be higherin the following circumstances:
If you find yourself in any of these situations,inform your doctorbefore starting treatment.You should not take Revolade unless your doctor considers that the expected benefits outweigh the risk of blood clots.
Inform your doctorif you find yourself in any of these situations.
Eye examinations
Your doctor will recommend that you undergo a check-up to see if you have cataracts. If you do not have regular eye check-ups, your doctor will ask you to have them done. They will also examine your retina (the layer of light-sensitive cells at the back of the eye) to see if there is bleeding in the retina or around it.
You will need to have regular blood tests
Before starting to take Revolade, your doctor will perform a blood test to see how your blood cells, including platelets, are doing. These blood tests will be repeated frequently while you are taking the medicine.
Blood tests to check liver function
Revolade may cause abnormal results on your blood tests that indicate liver damage - an increase in certain liver enzymes, especially bilirubin and alanine/aspartate transaminase. If you are taking interferon, a treatment used in combination with Revolade to treat low platelet counts caused by hepatitis C, it may worsen some liver problems.
You will have blood tests before starting to take Revolade and frequently while you are taking it to check your liver function. You may need to stop taking Revolade if your liver enzyme levels become too high or if you have any other signs of liver damage.
See the information “Liver problems” in section 4 of this leaflet
Blood tests for platelet count
If you stop taking Revolade, it is likely that your platelet count will drop again a few days later (thrombocytopenia). Your doctor will monitor your platelet count and advise you on the precautions you need to take.
Very high platelet counts may increase the risk of blood clots. However, blood clots can also form with normal or low platelet counts. Your doctor will adjust your Revolade dose to ensure that your platelet count does not become too high.
Seek medical help immediatelyif you experience any of the following signs of ablood clot:
Blood tests to examine your bone marrow
In people with bone marrow disorders, medicines like Revolade can worsen the disorders. Signs of changes in the bone marrow may appear as abnormal results on your blood tests. Your doctor may also perform tests to directly examine your bone marrow during treatment with Revolade.
Review of gastrointestinal bleeding
If you are taking interferon, a treatment used in combination with Revolade, you will be monitored for any signs of bleeding in your stomach or intestines after you stop taking Revolade.
Cardiac monitoring
Your doctor may consider, if necessary, monitoring your heart while you are taking Revolade using an electrocardiogram.
People over 65 years old
There is little data on the use of Revolade in patients aged 65 years or older. If you are 65 years or older, you should be careful when using Revolade.
Children and adolescents
Revolade is not recommended for use in children under 1 year old with PTI. It is also not recommended for children under 18 years old with low platelet counts caused by hepatitis C or severe aplastic anemia.
Other medicines and Revolade
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine. This includes medicines obtained without a prescription and vitamins.
Some common medicines may interact with Revolade(including prescription medicines, non-prescription medicines, and minerals). These include:
Consult your doctorif you are taking any of these medicines. Some should not be taken with Revolade, you may need to adjust your dose or take them at different times. Your doctor will review the medicines you are taking and recommend alternatives 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 takingcorticosteroids, danazol, and/orazathioprinewith Revolade, you may need to reduce your dose or stop taking these medicines.
Taking Revolade with food and drinks
Do not take Revolade with milk or milk products, as the calcium in these products affects the absorption of the medicine. For more information, see section3, “When to take it”.
Pregnancy and breastfeeding
Do not take Revolade if you are pregnantunless your doctor specifically recommends it. The effect of Revolade during pregnancy is unknown.
Do not breastfeed while taking Revolade. It is unknown whether Revolade passes into breast milk.
If you are breastfeeding or plan to breastfeed, inform your doctor.
Driving and operating machines
Revolade may cause dizzinessand other side effects that make you less alert.
Do not drive or operate machinesunless you are sure that Revolade does not affect you.
Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again. Do not change the dose or treatment schedule with Revolade unless your doctor or pharmacist advises you to. While taking Revolade, you will be under the supervision of a specialist doctor with experience in treating your disease.
How much to take
For PTI
Adults and children(6 to 17years old) - the usual initial dose for PTI is two packets of 25mgof Revolade per day. If you are of East or Southeast Asian descent, you may need to start treatment with a lower dose of 25mg.
Children(1 to 5years old) - the usual initial dose for PTI is one packet of 25mgof Revolade per day.
For Hepatitis C
Adults- the usual initial dose for hepatitis C is one packet of 25mgof Revolade per day. If you are of East or Southeast Asian descent, start treatment with the same dose of 25mg.
For AAG
Adults– the usual initial dose for AAG is two packets of 25mgof Revolade per day. If you are of East or Southeast Asian descent, you may need to start treatment with a lower dose of 25mg.
Revolade may take 1 to 2 weeks to take effect. Depending on your response to Revolade, your doctor may recommend changing your daily dose.
How to take a dose of the medication
The oral suspension powder is found in the packets, whose contents you will need to mix before you can take the medication. After section6 of the leaflet are theInstructions for Usethat explain how to mix and administer the medication. If you have doubts or do not understand the Instructions for Use, consult your doctor, nurse or pharmacist.
IMPORTANT – Use the medication immediatelyafter mixing it with water. If you do not useit within 30minutesfrom mixing, you will need to prepare a new dose. Do not reuse the oral dosing syringe. Use a new oral dosing syringe each time you prepare a new dose of Revolade oral suspension.
When to take it
Make sure that –
do notconsume:
If you do, your body will not absorb the medication properly.
For more information on suitable foods and drinks, consult your doctor.
If you take more Revolade than you should
Consult your doctor or pharmacist immediately. If possible, show them the packaging or this leaflet. You will be monitored for signs or symptoms of adverse effects and will be given immediate treatment.
If you forget to take Revolade
Take the next dose at the usual time. Do not take more than one dose of Revolade per day.
If you interrupt treatment with Revolade
Do not stop taking Revolade without first consulting your doctor. If your doctor advises you to stop treatment, you will be monitored for platelet levels every week for four weeks. See also “Bleeding or bruising after stopping treatment” in section4.
If you have any other questions about using this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
Symptoms to watch for: consult your doctor
People taking Revolade for both PTI and low platelet counts associated with hepatitis C may experience signs related to possible severe side effects.It is essential to inform your doctor if you develop symptoms.
Increased risk of thrombosis
Some people may be at a higher risk of developing a blood clot, and medicines like Revolade may worsen this problem. The sudden blockage of a blood vessel by a clot is a rare side effect that can affect up to 1 in 100 people.
Seek immediate medical help if you experience signs or symptoms of thrombosis, such as:
Liver problems
Revolade may cause changes that appear in blood tests, which may be signs of liver damage. Liver problems (elevated liver 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 the signs of liver problems:
Bleeding or hematomas after treatment interruption
Two weeks after stopping treatment with Revolade, your platelet levels will usually return to similar levels to those before starting Revolade. A decrease in platelet levels may increase the risk of bleeding or hematomas. Your doctor will check your platelet levels for at least 4 weeks after stopping treatment with Revolade.
Contact your doctorif you experience bleeding or hematomas after stopping Revolade.
Some peopleexperience bleeding in thedigestive systemafter stopping peginterferon, ribavirin, and Revolade.The symptoms include:
Contact your doctor immediatelyif you experience any of these symptoms.
The following side effects have been reported in patients with adult PTI treated with Revolade
Very common side effects
Can affect more than 1 in 10 people
Very common side effects that may appear in blood tests
Common side effects
Can affect up to 1 in 10 people
Common side effects that may appear in blood tests:
Rare side effects
Can affect up to 1 in 100 people:
Rare side effects that may appear in blood tests:
The following side effects have been reported in children (1 to 17 years old) with PTI treated with Revolade
If these side effects worsen, please inform your doctor, pharmacist, or nurse.
Very common side effects
Can affect more than 1 in 10 children
Common side effects
Can affect up to 1 in 10 children
The following side effects have been reported in patients with chronic hepatitis C treated with Revolade in combination with peginterferon and ribavirin
Very common side effects
Can affect more than 1 in 10 people:
Very common side effects that may appear in blood tests:
Common side effects
Can affect up to 1 in 10 people:
Common side effects that may appear in blood tests:
Rare side effects
Can affect up to 1 in 100 people:
The following side effects have been observed in patients with severe aplastic anemia (SAA) treated with Revolade
If these side effects worsen, please inform your doctor, pharmacist, or nurse.
Very common side effects
Can affect more than 1 in 10 people:
Very common side effects that may appear in a blood test:
Common side effects
Can affect up to 1 in 10 people:
Common side effects that may appear in a blood test:
Side effects of unknown frequency
Cannot be estimated from available data:
Reporting side effects
If you experienceany type of side effect, consult your doctor or pharmacist, even if it is a possible side effect not listed in this leaflet.You can also report them directly through the Spanish System for Pharmacovigilance of Medicinal Products for Human Use: www.notificaRAM.es.By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the packaging and on the overwrap.
This medication does not require special storage conditions.
Do not open the overwrap until you are ready to use it. Once mixed, Revolade should be administered immediately, but it may be stored for no more than 30minutes at room temperature.
Medications should not be disposed of through drains or in the trash. Ask your pharmacist how to dispose of the packaging and medications that you no longer need. This will help protect the environment.
Composition of Revolade
25 mg powder for oral suspension
The active ingredient of Revolade is eltrombopag. Each pack contains a powder to reconstitute that releases 32 mg of eltrombopag olamine, equivalent to 25 mg of eltrombopag free acid.
The other components are: mannitol (E421), sucralose, and xanthan gum.
Appearance of the product and contents of the pack
Revolade 25 mg powder for oral suspension is available in a kit that contains 30 sachets; each sachet contains a brownish-red to yellow powder. The kit also includes a reusable mixing vial with a cap and plug and 30 oral dosing syringes for single use.
Marketing Authorization Holder
Novartis Europharm Limited
Vista Building
Elm Park, Merrion Road
Dublin 4
Ireland
Responsible for manufacturing
Lek d.d
Verovskova Ulica 57
Ljubljana 1526
Slovenia
Novartis Pharmaceutical Manufacturing LLC
Verovskova Ulica 57
Ljubljana 1000
Slovenia
Novartis Pharma GmbH
Roonstraße 25
D-90429 Nuremberg
Germany
Novartis Pharma GmbH
Sophie-Germain-Strasse 10
90443 Nürnberg
Germany
You can request more information about this medicine by contacting the local representative of the marketing authorization holder:
België/Belgique/Belgien Novartis Pharma N.V. Tél/Tel: +32 2 246 16 11 | Lietuva SIA Novartis Baltics Lietuvos filialas Tel: +370 5 269 16 50 |
Luxembourg/Luxemburg Novartis Pharma N.V. Tél/Tel: +32 2 246 16 11 | |
Ceská republika Novartis s.r.o. Tel: +420 225 775 111 | Magyarország Novartis Hungária Kft. Tel.: +36 1 457 65 00 |
Danmark Novartis Healthcare A/S Tlf: +45 39 16 84 00 | Malta Novartis Pharma Services Inc. Tel: +356 2122 2872 |
Deutschland Novartis Pharma GmbH Tel: +49 911 273 0 | Nederland Novartis Pharma B.V. Tel: +31 88 04 52 555 |
Eesti SIA Novartis Baltics Eesti filiaal Tel: +372 66 30 810 | Norge Novartis Norge AS Tlf: +47 23 05 20 00 |
Ελλάδα Novartis (Hellas) A.E.B.E. Τηλ: +30 210 281 17 12 | Österreich Novartis Pharma GmbH Tel: +43 1 86 6570 |
España Novartis Farmacéutica, S.A. Tel: +34 93 306 42 00 | Polska Novartis Poland Sp. z o.o. Tel.: +48 22 375 4888 |
France Novartis Pharma S.A.S. Tél: +33 1 55 47 66 00 | Portugal Novartis Farma - Produtos Farmacêuticos, S.A. Tel: +351 21 000 8600 |
Hrvatska Novartis Hrvatska d.o.o. Tel. +385 1 6274 220 | România Novartis Pharma Services Romania SRL Tel: +40 21 31299 01 |
Ireland Novartis Ireland Limited Tel: +353 1 260 12 55 | Slovenija Novartis Pharma Services Inc. Tel: +386 1 300 75 50 |
Ísland Vistor hf. Sími: +354 535 7000 | Slovenská republika Novartis Slovakia s.r.o. Tel: +421 2 5542 5439 |
Italia Novartis Farma S.p.A. Tel: +39 02 96 54 1 | Suomi/Finland Novartis Finland Oy Puh/Tel: +358 (0)10 6133 200 |
Κύπρος Novartis Pharma Services Inc. Τηλ: +357 22 690 690 | Sverige Novartis Sverige AB Tel: +46 8 732 32 00 |
Latvija SIA Novartis Baltics Tel: +371 67 887 070 |
Last update of the leaflet:
The detailed information about this medicine is available on the website of the European Medicines Agencyhttp://www.ema.europa.eu.
INSTRUCTIONS FOR USE
Revolade®25 mg powder for oral suspension
(eltrombopag)
Read and follow the instructions below to prepare a dose of Revolade and administer it to the patient. If you have any questions, or if you are damaged or lost any component of the kit, consult your doctor, nurse or pharmacist.
Before starting
Read these messages first
Administer the medicine to the patient immediately after mixing the powder with water. If you do not use the medicinewithin 30 minutes, you will need to prepare a new dose.
Dispose of the unwanted mixture in the trash,do not pour it down the drain.
What you need
Each kit of Revolade powder for oral suspension contains:
30 sachets of powder | |
1 reusable mixing vial with cap and plug (note — the mixing vial may become stained) | |
30 oral dosing syringes for single use |
To prepare and give the dose of Revolade, you need:
Check that the vial, cap, and plug are drybefore using them. Preparing the dose | |
1.Check that the plug is not in the mixing vial. | |
2. Fill the syringewith 20 ml of water from the glass or cup. Use a new oral dosing syringe for each dose of Revolade powder for oral suspension.
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3. Empty the water into the mixing vial.
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4.Take only the number of sachets that your doctor has prescribed for a dose from the kit.
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5. Add the powder from the prescribed number of sachets to the mixing vial.
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6. Screw the plug onto the mixing vial.Make sure the cap is tightly closed with the plug for a tight seal. | |
7. Carefully and slowly shake the mixing vialforward and backwardfor at least 20 secondsto mix the powder with the water.
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Administer the patient's dose | |
8.Make sure the plunger is at the end of the syringe.
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9. Fill the syringe with the medicine.
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10.Administer the medicine to the patient. Do it immediately after preparing the dose.
Make sure the patient has time to swallow. | |
IMPORTANT: You have administered almost all of the dose to the patient. There is still some left in the mixing vial, although you cannot see it. Nowyou need to complete steps 11 to 13to ensure the patient has taken all the medicine. | |
11.Fill the syringeagain, this time with 10 ml of water.
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12. Empty the water into the mixing vial.
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13.Repeat steps 7 to 10— shake the mixing vial gently to mix the remaining medicine, administer the rest of the liquid to the patient. | |
Cleaning up | |
14.If you have spilled the powder or liquid,wipe it clean with a disposable cloth. You can use disposable gloves to prevent your skin from coming into contact with the medicine.
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15. Clean the mixing equipment.
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When you have used all 30 sachets in the kit,dispose of the mixing vial.Always use a complete new kit every 30 sachets. |
Keep Revolade powder for oral suspension, including the dosing kit, and all medicines out of the reach of children.
Have questions about this medication or your symptoms? Connect with a licensed doctor for guidance and personalized care.