Eltrombopag (Revolade) is a thrombopoietin receptor agonist, primarily used clinically for the treatment of chronic immune thrombocytopenia (ITP), chronic hepatitis C-associated thrombocytopenia, and severe aplastic anemia.
How to Use Eltrombopag (Revolade)
Fasting Administration
Take the medication on an empty stomach, either 1 hour before meals or 2 hours after meals, to ensure optimal absorption.
Foods, especially those high in calcium (such as dairy products and calcium-fortified juices), can significantly reduce drug absorption.
Avoiding Drug Interactions
When taking eltrombopag, maintain an interval of at least 2 hours between eltrombopag and other medications (e.g., antacids). For medications and supplements containing polyvalent cations (e.g., iron, calcium, aluminum, magnesium, selenium, and zinc), an interval of 4 hours is required.
Preparation of Oral Suspension
When using the oral suspension, prepare it with warm water (hot water is not allowed). Take the prepared suspension immediately; discard any suspension that is not taken within 30 minutes.
Seek guidance from professionals before preparing and using the suspension.
Dosage Adjustment of Eltrombopag (Revolade)
Dosage Adjustment for Chronic Immune Thrombocytopenia (ITP)
Initial Dose: For patients aged 6 years and older: 50mg once daily (usually); for children aged 1–5 years: 25mg once daily.
For East Asian patients or patients with hepatic impairment: Halve the initial dose.
Dosage Adjustment Principles: If platelet count is <50×10⁹/L for at least 2 weeks: Increase the daily dose by 25mg (maximum 75mg/day).
If platelet count is 200–400×10⁹/L: Decrease the daily dose by 25mg.
If platelet count is >400×10⁹/L: Suspend medication, and restart with a lower dose once platelet count drops to <150×10⁹/L.
If platelet count remains >400×10⁹/L even at the lowest dose: Discontinue the medication permanently.
Dosage Adjustment for Chronic Hepatitis C-Associated Thrombocytopenia
Initial Dose: 25mg once daily for all patients.
Dosage Adjustment: If platelet count is insufficient for at least 2 weeks: Increase the dose by 25mg every 2 weeks (maximum 100mg/day).
If platelet count is 200–400×10⁹/L: Decrease the daily dose by 25mg.
If platelet count is >400×10⁹/L: Follow the same management principles as for ITP.
Dosage Adjustment for Severe Aplastic Anemia
Initial Dose: 50mg once daily for most patients; 25mg once daily for East Asian patients or those with hepatic impairment.
Dosage Adjustment: If therapeutic effect is insufficient for at least 2 weeks: Increase the dose by 50mg every 2 weeks (maximum 150mg/day).
If platelet count is 200–400×10⁹/L: Decrease the daily dose by 50mg.
If platelet count is >400×10⁹/L: Suspend medication for 1 week, then restart with a lower dose.
Medication for Special Populations of Eltrombopag (Revolade)
Patients with Hepatic Impairment
For all indications: Reduce the initial dose by 50%.
For ITP patients: Extend the interval between dosage adjustments to 3 weeks.
For East Asian patients with concurrent hepatic impairment: Consider a further dose reduction to 12.5mg once daily.
Strengthen liver function monitoring; discontinue medication promptly if signs of hepatotoxicity appear.
East Asian Population
For ITP patients (adults): Initial dose is 25mg once daily.
For patients with severe aplastic anemia: Initial dose is 25mg once daily.
East Asian patients with hepatic impairment may require an even lower initial dose.
Pediatric Patients
Only for use in children aged 1 year and older.
For ITP children aged 1–5 years: Fixed dose of 25mg once daily.
For ITP children aged 6 years and older: Refer to the adult dosage adjustment plan.
Adjust the dose individually based on body weight and therapeutic effect.
Pregnancy and Lactation
Animal studies suggest potential fetal harm; use only if the potential benefit outweighs the risk.
During lactation, weigh the importance of the drug to the mother and decide whether to discontinue the drug or stop breastfeeding.
