Usage and dosage of eltrombopag/eltrombopag ethanolamine tablets

Eltrombopag is usually taken without meals or with a low-calcium meal (≤50 mg). Take eltrombopag at least 2 hours before or 4 hours after taking other medications (such as antacids), calcium-rich foods (containing >50 mg of calcium, such as dairy products, calcium-fortified juices, and certain fruits and vegetables), or supplements containing polyvalent cations (such as iron, calcium, aluminum, magnesium, selenium, and zinc).

1. Recommended dosage:

(1) Persistent or chronic immuneThrombocytopenia (ITP):Eltrombopag is administered at a dose of 25 mg once daily in pediatric patients 1 to 5 years of age; 50 mg once daily in adult and pediatric ITP patients 6 years and older; patients with ITP and mild, moderate, or severe hepatic impairment (Child-Pugh) For patients in categories A, B, and C), the starting dose is 25 mg once daily. For patients with ITP of East/Southeast Asian ancestry, start eltrombopag at a dose of 25 mg once daily; in patients with ITP and mild, moderate, or severe hepatic impairment, start with eltrombopag at a dose of 12.5 mg once daily.

Studies have shown that after starting eltrombopag, the dose needs to be adjusted to achieve and maintain a platelet count≥50*109/L to reduce the risk of bleeding. Do not exceed the daily dose of 75 mg. Platelet counts usually increase within 1 to 2 weeks after starting treatment with the drug and decrease within 1 to 2 weeks after stopping it. If platelet counts do not increase to a level sufficient to avoid clinically important bleeding after 4 weeks of treatment with a maximum daily dose of 75 mg, discontinue eltrombopag.

(2) Thrombocytopenia associated with chronic hepatitis C (ITP): Patients should be treated with eltrombopag at an initial dose of 25 mg once daily; the dose is subsequently adjusted in 25 mg increments every 2 weeks to achieve the target platelet count required to initiate antiviral therapy. Before starting antiviral therapy, monitor platelet counts weekly. Do not exceed daily dose of 100mg. Eltrombopag should be discontinued when antiviral therapy is discontinued.

(3)Severe aplastic anemia (AA):

[1] First-line severe AA: Initiate eltrombopag concurrently with standard immunosuppressive therapy at a dose of 2.5 mg/kg for pediatric patients 2 to 5 years old; 75 mg for pediatric patients 6 to 11 years old; and 150 mg for patients 12 years and older, once daily for 6 months. The first-line treatment dose is reduced by 50% for patients with severe AA of East Asian/Southeast Asian ancestry or patients with mild, moderate, or severe hepatic impairment.

[2] Refractory severe AA: The initial dose of eltrombopag for patients is 50 mg once daily; for patients with severe AA of East Asian/Southeast Asian origin or patients with mild, moderate or severe liver function impairment, the initial dose is 25 mg once daily; subsequently, the dose is adjusted in 50 mg increments every 2 weeks to achieve a platelet count ≥50*109/L. Do not exceed daily dose of 150mg.

If no hematologic response occurs after 16 weeks of treatment with eltrombopag, discontinue treatment; consider discontinuation if new cytogenetic abnormalities are observed; excessive platelet count response or significant liver test abnormalities may also warrant discontinuation of eltrombopag.