All the Therapeutic System Drugs
Thrombopoietin Receptor Agonist. Eltrombopag (as Olamine) 25 mg, 50 mg. F.C. TABS: 14, 28 x 25 mg, 50 mg.
In all indic. dosing requirem. must be individualised based on the pt’s platelet counts.
The objective of tmt. with eltrombopag should not be to normalise platelet counts.
ITP- lowest dose of eltrombopag to achieve and maintain a platelet count ≥ 50,000/µl should be used.
Adult. & Ped. population aged 6-17 yrs.: The recommend. init. dose of eltrombopag is 50 mg×1/d. For pts. of East Asian ancestry (such as Chinese, Japanese, Taiwanese, Korean or Thai), eltrombopag should be init. at a reduced dose of 25 mg×1/d.
Dose adjust. of eltrombopag in ITP pts.
Platelet count: <50,000/µl follow. at least 2 wks. of ther., incr. dly. dose by 25 mg to a max. of 75 mg/d. (for pts. taking 25 mg eltrombopag once every other day, increase dose to 25 mg×1/d).
Platelet count ≥ 50,000/µl ≤ 150,000/µl: Use lowest dose of eltrombopag and/or concom. ITP tmt. to maintain platelet counts that avoid or reduce bleed.
Platelet count > 150,000/µl - ≤ 250,000/µl: Decr. the dly. dose by 25 mg. Wait 2 wks. to assess the effects of this and any subseq. dose adjust. (for pts taking 25 mg eltrombopag once dly., consideration should be given to dosing at 12.5 mg given as 25 mg once every other day).
HCV assoc. thrombocytopenia-During antiv. ther., the aim of tmt. should be to keep platelet counts at a level that prevents the risk of bleed.
Initial dose regimen Eltrombopag should be init. at a dose of 25 mg×1/d. No dosage adjust. is necessary for HCV pts. of East Asian ancestry or pts. with mild hep. impair. Monitor. and dose adjust. The dose of eltrombopag should be adjusted in 25 mg increm. every 2 wks. as necessary to achieve the target platelet count requir. to initiate anti-viral ther. Platelet counts should be monitor. every week prior to starting antivir. ther.
Refractory sev. aplastic anaemia: Use the lowest dose of eltrombopag to achieve and maintain a haemat. response. Dose adjust. are based upon the platelet count. Haematologic response require. dose titrat., generally up to 150 mg, and may take up to 16 wks. after starting eltrombopag.
Init. Dose Regimen: Initiate eltrombopag at a dose of 50 mg×1/d. For pts. with sev. aplastic anaemia in patients of East Asian ancest. or those with mild, moder., or severe hep. impair. (Child-Pugh Class A, B, C), initiate eltrombopag at a reduced dose of 25 mg×1/d.
Adjust the dose of eltrombopag in 50-mg increm. every 2 wks. as necessary to achieve the target platelet count ≥ 50,000/µl as necessary. Do not exceed a dose of 150 mg dly.
Dose adjust. of eltrombopag in pts. with refractory sev. aplastic anaemia. See lit.
Tmt. of pts. aged 6 year and above with primary immune thrombocytopenia (ITP) lasting 6 mnths. or longer from diagnosis and who are refractory to other tmts. (e.g. corticosteroids, immunoglobulins).
Tmt. of adult pts. with sev. aplast. anaemia who have had an insuffic. response to immunosuppress. therapy.
Tmt. of thrombocytopenia in adult pts. with chron. HCV infec. to allow the init. and mainten. of interferon-based ther.
In comb. with standard immunosuppress. ther. for the first-line tmt. of adult & ped. pts. 6 yrs. and older with severe aplast. anemia.