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Promacta

Generic Name: eltrombopag (el TROM boe pag)
Brand Names: Promacta

Medically reviewed on August 12, 2018

What is Promacta?

Promacta (eltrombopag) is a man-made form of a protein that increases production of platelets (blood-clotting cells) in your body. Eltrombopag can lower the risk of bleeding by increasing platelets in your blood.

Promacta is used to prevent bleeding episodes in people with chronic immune thrombocytopenic purpura (ITP), a bleeding condition caused by a lack of platelets in the blood. This medicine is for use in adults and children who are at least 1 year old, after other medicines have been tried without success.

Promacta is also used to prevent bleeding in adults with chronic hepatitis C who are treated with an interferon (such as Intron A, Infergen, Pegasys, PegIntron, Rebetron, Redipen, or Sylatron).

Promacta is also used to treat severe aplastic anemia in adults after other medicines have been tried without success.

Promacta is not a cure for ITP and it will not make your platelet counts normal if you have this condition.

Important Information

Before you take Promacta tell your doctor if you have kidney disease, blood cancer, a bone marrow disorder, high platelet levels, liver problems (if you are not being treated for hepatitis C), a history of cataracts or blood clot, if your spleen has been removed, or if you are of East Asian descent. Also tell your doctor about all other medications you use.

Take Promacta on an empty stomach, at least 1 hour before or 2 hours after a meal. Do not take this medication with milk. Avoid all dairy products or products that contain calcium (including fortified fruit juice) for at least 4 hours before or after you take Promacta.

If you have chronic hepatitis C, taking Promacta with ribavirin and interferon treatment can increase your risk of liver problems. Call your doctor at once if you have signs of liver problems: nausea, upper stomach pain, confusion, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

After you stop taking this medicine, your risk of bleeding may be even higher than it was before you started treatment. Be extra careful to avoid cuts or injury for at least 4 weeks after you stop taking this medicine. Your blood will need to be tested weekly during this time.

Call your doctor at once if you have signs of liver problems: nausea, upper stomach pain, confusion, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Before taking this medicine

You should not use Promacta if you are allergic to eltrombopag.

Tell your doctor if you have ever had:

  • a blood clot;

  • liver disease (unless you are being treated for hepatitis C);

  • kidney disease;

  • myelodysplastic syndrome (also called "preleukemia");

  • cataracts;

  • surgery to remove your spleen; or

  • if you are of East Asian descent (Chinese, Japanese, Taiwanese, or Korean).

If you have myelodysplastic syndrome, taking Promacta can increase your risk of developing leukemia (a blood cancer that can be fatal). Talk with your doctor if you have concerns about this risk.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of eltrombopag on the baby.

You should not breast-feed while using this medicine.

How should I take Promacta?

Take Promacta exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take Promacta on an empty stomach, at least 1 hour before or 2 hours after a meal.

Do not take Promacta with dairy products or calcium-fortified juice.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Mix the oral suspension powder only with water. Use a new dosing syringe each time you mix the medicine, to measure the water and to give the correct dose.

Swallow the tablet whole and do not crush, chew, or break it.

You will need frequent blood tests to check your liver function. Your eyes may also need to be checked for signs of cataract formation.

If you take Promacta with medication to treat chronic hepatitis C, tell your doctor if you stop using any of your hepatitis medications.

Taking Promacta long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders.

It may take up to 4 weeks of taking this medicine before it is completely effective in preventing bleeding episodes. Keep taking the medication as directed and tell your doctor if you have any bruising or bleeding episodes after 4 weeks of treatment.

Store at room temperature away from moisture and heat. Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative. After mixing Promacta oral suspension, store the liquid at room temperature and use it within 30 minutes.

After you stop taking Promacta, your risk of bleeding or bruising may be even higher than it was before you started treatment. Be extra careful to avoid cuts or injury for at least 4 weeks after you stop taking this medicine. Your blood will need to be tested weekly during this time.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Promacta?

Avoid all dairy products or products that contain calcium (including fortified fruit juice) for at least 4 hours before or 2 hours after you take Promacta.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Promacta side effects

Get emergency medical help if you have signs of an allergic reaction to Promacta: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You could develop a blood clot if your platelet count gets too high while you are using Promacta. Call your doctor or get emergency medical help if you have:

  • signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

  • signs of a blood clot in the stomach - severe stomach pain, vomiting, diarrhea;

  • signs of a blood clot in the lung - chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or

  • signs of a blood clot in your leg - pain, swelling, warmth, or redness in one or both legs.

Call your doctor at once if you have:

  • vision changes, tunnel vision, eye pain, or seeing halos around lights;

  • flu symptoms such as fever, chills, cough, sore throat, headache, body aches, tired feeling;

  • increased or frequent need to urinate, pain or burning when you urinate;

  • low red blood cells (anemia) - pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

  • liver problems - confusion, nausea, upper stomach pain, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common Promacta side effects may include:

  • nausea, vomiting, diarrhea, stomach pain, loss of appetite;

  • cold symptoms such as stuffy nose, sneezing, cough, sore throat;

  • fever, flu symptoms, anemia;

  • mouth pain, tooth pain;

  • muscle pain, back pain, headache;

  • swelling in your feet or ankles;

  • feeling weak or tired;

  • sleep problems (insomnia);

  • itching, tingling, or burning under your skin;

  • skin rash;

  • hair loss; or

  • abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Promacta?

Some medicines can make Promacta much less effective when taken at the same time. If you take any of the following medicines, take your Promacta dose 2 hours before or 4 hours after you take the other medicine.

  • an antacid; or

  • vitamin or mineral supplements that contain aluminum, calcium, iron, magnesium, selenium, or zinc.

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may interact with eltrombopag, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Promacta only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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