Revolade

Revolade - Uses | Dosage | Interactions

Revolade contains eltrombopag and belongs to the group of thrombopoietin receptor agonists. Thrombopoietin is a glycoprotein hormone that stimulates the production and differentiation of megakaryocytes, which are responsible for the production of blood platelets. Revolade binds to the thrombopoietin receptor, exhibits agonistic effects and imitates the physiological function of thrombopoietin.

Uses

It is used for the treatment of immune (idiopathic) thrombocytopenic purpura when corticosteroid treatment, splenectomy (spleen removal) or immunoglobulin therapy did not yield adequate results. Thrombocytopenic purpura is caused by a reduced number of platelets which leads to an increased risk of bleeding. Patients with low platelet count may have the following symptoms: bruising, epistaxis, bleeding gums, petechiae (round, red spots that appear on the skin and are caused by bleeding into the skin layers) and difficulty in controlling and stopping the bleeding.

It is also used in patients with hepatitis C to allow the initiation of therapy with interferon.

It is also used in patients who have a severe form of aplastic anemia that does not respond to therapy with immunosuppressive drugs.

Peak plasma concentrations are achieved after 2-6 hours after oral administration. The largest part of the drug is excreted through the feces (60%) and about 30% is excreted through the urine.

Warnings

There are no known contraindications to this medicine.

Caution should be exercised in patients with impaired hepatic function, as well as in patients who have had a thrombotic event or have a history of thrombotic events in the family. Revolade increases the risk of blood clot (thrombus) formation. Patients taking oral contraceptives and patients with obesity have an increased risk of thrombus formation, and Revolade should be used with caution in such patients.

Revolade, Pregnancy and Breastfeeding

FDA pregnancy category: C. There is a positive evidence of the embryolethal effects of this drug, and its use during pregnancy must be avoided. Studies in rats that tested doses that are 6 times higher than those used in humans, revealed that this drug increases the incidence of fetal death.

It is not known whether this drug is excreted in breast milk, and breastfeeding should be discontinued while you're taking this medicine.

Dosage

The usual starting dose for the treatment of idiopathic thrombocytopenic purpura and aplastic anemia in patients above the age of 6, is 50 mg once a day, while an initial dose of 25 mg once a day is recommended in patients aged 1-5 years.

The usual starting dose in the treatment of idiopathic thrombocytopenic purpura and aplastic anemia in patients of East-Asian origin is 25 mg once a day.

The maximum daily dose in the treatment of idiopathic thrombocytopenic purpura is 75 mg.

The maximum daily dose in the treatment of severe aplastic anemia is 150 mg.

The usual starting dose in the treatment of thrombocytopenia associated with chronic hepatitis C is 25 mg once a day. The dose may be increased gradually to a maximum of 100 mg daily.

Milk, dairy products and calcium-containing antacids can reduce absorption and, consequently, the effects of Revolade. For this reason, do not take milk, dairy products or antacids 4 hours before or after taking Revolade.

Interactions

Revolade can interact with the following drugs:

  • Antacids containing calcium, magnesium or aluminum.
  • HMG CoA reductase inhibitors (statins), such as:
  • Vitamin and mineral preparations containing iron, zinc, calcium, magnesium and selenium.
  • Methotrexate - a medicine used to treat cancer.
  • Azathioprine - a medicine used for organ transplants and in the treatment of autoimmune diseases.
  • Danazol - a medicine used to treat endometriosis.

Side effects

Revolade can cause the following side effects:

  • Nausea and vomiting
  • Inflammation of the muscles and muscle pain
  • Inflammation of the joints and joint pain
  • Diarrhea
  • Constipation
  • Stomach pain
  • Presence of blood in the stool
  • Bone pain
  • Blurred vision
  • Mood disorders (anxiety and depression)
  • Pruritus
  • Speech disorder
  • Taste disorder
  • Fatigue
  • Alopecia
  • Hyperbilirubinemia
  • Elevated liver enzymes
  • Paresthesia
  • Heart problems (tachycardia and acute myocardial infarction)
  • Thromboembolic events
  • Loss of appetite
  • Elevated blood uric acid levels and gout

References

  1. accessdata link
  2. PIL