Eltrombopag (Promacta®)

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About this Drug:

Eltrombopag is used to increase platelets. It is given orally (by mouth).

Possible Side Effects

  • Decrease in red blood cells (you may feel more tired)
  • Nausea and vomiting (throwing up)
  • Diarrhea (loose bowel movements)
  • Fever and chills
  • Tiredness and weakness
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • Swelling of your legs, ankles and/or feet
  • Changes in liver function
  • Urinary tract infection
  • Headache
  • Decreased appetite (decreased hunger)
  • Muscle pain
  • Trouble sleeping
  • Cough
  • Upper respiratory infection
  • Itching
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.

Note: Not all possible side effects are included above.

Warnings and Precautions

  • Changes in your liver function, which can cause liver failure and be life-threatening. If you have Hepatitis C, and are taking certain medications, your risk may be higher.
  • Blood clots and events such as stroke and heart attack. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • If you have myelodysplastic syndrome, you may be at risk for progression to acute myeloid leukemia (AML), which could be life-threatening.
  • Clouding of the lens in your eye. This drug may make cataracts worse or may raise the chance of new cataracts.

How to Take Your Medication

  • Take this drug by mouth without food, at least 1 hour before you eat or 2 hours after you eat.
  • If you take antacids, calcium rich foods (e.g., dairy products and calcium-fortified juices), or supplements containing iron, calcium, aluminum, magnesium, selenium and zinc, take eltrombopag at least 2 hours before or 4 hours after you take these medicines.
  • Tablet: Do not crush, split or chew the tablet. Do not mix with food or liquids.
  • Oral Suspension: Prepare suspension with water only. Do not use hot water. Talk to your doctor, nurse and/or pharmacist for proper preparation, dosing and administration.
  • Missed dose: If you miss a dose, do not take the missed dose and do not double up on the next dose. Instead, continue with your regular dosing schedule and contact your physician. Do not  take 2 doses at the same time or extra doses.
  • If you vomit a dose, take your next dose at the regular time. Do not take 2 doses at the same time.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help with decreased appetite, eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better.
  • To help with itching, moisturize your skin several times day and avoid sun exposure and apply sunscreen routinely when outdoors.
  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program  close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.

Food and Drug Interactions

  • There are known interactions of eltrombopag with food such as calcium-rich foods (e.g., dairy products and calcium-fortified juices). This medication should be taken on an empty stomach.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with eltrombopag. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter  medicines, or dietary supplements to make sure that there are no interactions.
  • The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Do not use dietary supplements or alternative diets without your cancer doctor's help.
  • Drugs that treat heartburn and stomach upset such Maalox®, Mylanta®, Protonix®, Nexium®, Prilosec®, Pepcid®, Tagamet®, and Zantac® and drugs containing iron, calcium, aluminum, magnesium, selenium and zinc may lower the effect of your cancer treatment if taken with eltrombopag. Take eltrombopag at least 2 hours before or 4 hours after you take these medicines.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Blurred vision or other changes in eyesight
  • Headache that does not go away
  • Trouble falling or staying asleep
  • Wheezing and/or trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like  pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Diarrhea 4 times in a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Pain or burning when you pass urine
  • Difficulty urinating
  • Feeling like you have to pass urine often, but not much comes out when you do
  • Tender or heavy feeling in your lower abdomen
  • Cloudy urine and/or urine that smells bad
  • Pain on one side of your back under your ribs. This is where your kidneys are.
  • Your leg or arm is swollen, red, warm and/or painful
  • Weight gain of 5 pounds in one week (fluid retention)
  • Swelling of your legs, ankles and/or feet
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning:This drug may have harmful effects on the unborn baby. Females of childbearing potential should use effective contraception during treatment and for at least 7 days after stopping treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breastfeed during treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.

Revised August 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.