Promacta

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not take more than 1 dose in 24 hours. Do not double the dose to catch up.

Read the Medication Guide provided by your pharmacist before you start using eltrombopag and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Only patients enrolled in the PROMACTA CARES program may obtain and use eltrombopag. After talking with your doctor about the risks and benefits of treatment, you will need to sign an enrollment form at your doctor's office before receiving your first prescription. Consult your doctor or pharmacist for more details about the PROMACTA CARES program and for more information about the risks and benefits of using this medication. Take this medication by mouth, usually once daily or as directed by your doctor. Take on an empty stomach, either 1 hour before a meal or 2 hours after a meal. Take this medication at least 4 hours before or after taking any products that contain magnesium, aluminum, or calcium. Some examples include antacids, vitamins/minerals, quinapril, certain forms of didanosine (chewable/dispersible buffered tablets or pediatric oral solution), and sucralfate. Follow the same instructions with dairy products (such as milk, yogurt), calcium-enriched juice, bismuth subsalicylate, iron, selenium, and zinc. These products bind with eltrombopag, preventing its full absorption. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Dosage is based on your medical condition and response to treatment. Do not take more than 75 milligrams a day. Your doctor will order blood tests (platelet counts) to find the right dose for you. Keep all medical/lab appointments. Follow your doctor's directions carefully. If you are of Asian descent or if you have liver problems, your doctor may direct you to start with a lower dose because you may be more sensitive to its effects. Your risk of bleeding may increase when you stop using eltrombopag. After your last dose, your doctor should order a blood test once a week for at least 4 weeks to check for bleeding problems. Tell your doctor immediately if you develop any bleeding/bruising. Ask your doctor if you should continue taking your other medications for ITP (such as corticosteroids, azathioprine, danazol) while you are using eltrombopag. Tell your doctor if your condition (bleeding/bruising) persists or worsens.

See also How to Use. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use. Eltrombopag may slow the removal of other drugs from your body, increasing the risk of side effects. These affected drugs include "statin" drugs (such as atorvastatin, fluvastatin, rosuvastatin), methotrexate, repaglinide, rifampin. This is not a complete list. This document does not contain all possible interactions. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Do not share this medication with others. Although this medication increases platelets and decreases the risk of bleeding, continue to avoid activities that can increase your risk of bleeding (such as contact sports, using sharp objects like razors and nail cutters). This medication must be used under close medical supervision so that your doctor can monitor your blood counts. Laboratory and/or medical tests (such as blood/platelet counts) should be performed before you start treatment, weekly when first starting the drug, and then monthly to monitor your progress and check for side effects. See also Warnings section. Consult your doctor for more details.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

Before using eltrombopag, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood clots/clotting problems (such as Factor V Leiden), other blood disorders (such as blood cancer, myelodysplastic syndrome), certain eye problem (cataracts), liver disease. Before having surgery, tell your doctor or dentist that you are using this medication. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Store at room temperature at 77 degrees F (25 degrees C). Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

See also Warning section. Nausea, painful/heavy menstrual periods, muscle pain, and tingling/numbness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these rare but very serious side effects occur: vision changes. This medication may rarely cause serious problems from blood clots in the heart, brain, or lungs (such as heart attack, stroke, pulmonary embolism), especially if your platelet counts are too high. Keep all medical/lab test appointments. Seek immediate medical attention if you experience: sudden shortness of breath, chest/jaw/left arm pain, coughing up blood, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, slurred speech, weakness on one side of the body, vision problems/changes. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Rarely, eltrombopag has caused severe (possibly fatal) liver problems. Seek immediate medical attention if you develop symptoms of liver problems (such as persistent nausea, stomach/abdominal pain, dark urine, yellowing eyes/skin). To help decrease the risk of liver problems, your doctor will order blood tests (liver function tests). It is very important that you keep all medical appointments and have all laboratory tests ordered by your doctor. Your doctor will order liver tests before you start eltrombopag, every 2 weeks as the dose is changed, and monthly after you have been taking the same dose for a while.