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Safety Advices
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CONSULT YOUR DOCTOR
It is not known whether it is safe to consume alcohol with R-Pag 25. Please consult your doctor.
CONSULT YOUR DOCTOR
R-Pag 25 may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
CONSULT YOUR DOCTOR
R-Pag 25 is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
UNSAFE
R-Pag 25 may cause side effects which could affect your ability to drive.
R-Pag 25 can make you dizzy and have other side effects that make you less alert. This may affect your driving ability.
SAFE IF PRESCRIBED
R-Pag 25 is safe to use in patients with kidney disease. No dose adjustment of R-Pag 25 is recommended.
However, inform your doctor if you have a kidney disease. Regular monitoring of kidney function tests may is advisable while you are taking this medicine.
CAUTION
R-Pag 25 should be used with caution in patients with liver disease. Dose adjustment of R-Pag 25 may be needed. Please consult your doctor.
Medicine Overview of R-Pag 25mg Tablet
Introduction
R-Pag 25 is used to treat low platelet count due to chronic immune (idiopathic) thrombocytopenic purpura (ITP) or chronic hepatitis C virus (HCV) infection. It is also used to treat severe aplastic anemia. R-Pag 25 is a thrombopoietin agonist. It works by stimulating the formation of new platelets in the blood. The function of platelets is to help reduce bleeding. It should be taken in a dose and duration as advised by the doctor. You may take it on an empty stomach. This medicine is to be swallowed as a whole. Do not chew, crush or break it. Inform your...
... Show moreUses of R-Pag 25
- Low platelet count due to ITP or HCV infection
Side effects of R-Pag 25
Common
- Nausea
- Diarrhea
- Upper respiratory tract infection
- Vomiting
- Increased liver enzymes
- Muscle pain
- Urinary tract infection
How to use R-Pag 25
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. R-Pag 25 is to be taken empty stomach.
How R-Pag 25 works
R-Pag 25 is a thrombopoietin agonist. It works by stimulating the formation of new platelets in the blood. Platelets help to reduce or prevent bleeding.
What if you forget to take R-Pag 25?
If you miss a dose of R-Pag 25, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
- Take R-Pag 25 on an empty stomach, either 1 hour before or 2 hours after meals.
- Take R-Pag 25 at least 2 hours before or 4 hours after eating dairy products and calcium-fortified juices.
Brief Description
Indication
Adult chronic immune (idiopathic) thrombocytopenic purpura (ITP), Hepatitis C Virus (HCV) related, Thrombocytopenia, Aplastic anemia
Administration
Should be taken on an empty stomach: Take at least 4 hr before or after antacids, dairy products or other Ca-containing food products or mineral supplements containing polyvalent cations.
Adult Dose
Adult Chronic ITP: Initial dose 50 mg once daily. Adjust to maintain platelet count greater than or equal to 50×109 /L Chronic hepatitis C associated thrombocytopenia: Initial recommended dose is 50 mg once daily and do not exceed a daily dose of 100 mg. Severe aplastic anemia: Initial recommended dose is 50 mg once daily, adjust to maintain platelet count greater or equal 50×109 /L. Do not exceed 150 mg per day Max: 75 mg daily. After adjustment, platelet counts should be monitored at least weekly for 2-3 weeks. Wait for at least 2 weeks to see the effect of...
... Show moreChild Dose
Child 6 years or older
Chronic ITP: Initial dose 50 mg once daily.
Child 1 to 5 year
The initial dose is 25 mg once daily.
Adjust to maintain platelet count greater than or equal to 50×109 /L
Renal Dose
Renal Impairment: No dose adjustment is necessary in ITP patients with renal impairment.
Contraindication
Eltrombopag is contraindicated in patients with severe hepatic impairment and who are hypersensitive to any of its excipients.
Mode of Action
Small-molecule thrombopoietin (TPO)-receptor agonist that interacts with human TPO receptor transmembrane domain of human TPO-receptor & initiates signaling cascades that induce proliferation & differentiation of megakaryocytes from bone marrow progenitor cells.
Precaution
Regularly monitor clinical haematology, platelet counts & serum liver test throughout therapy. Renal & hepatic impairment; hepatic disease. Thrombotic/thromboembolic complications. Increased risk of bleeding upon discontinuation of treatment. Bone marrow reticulin formation & risk of bone marrow fibrosis. Malignancies & progression of malignancies. Pregnancy & lactation. Childn <18 yr, elderly.
Side Effect
Most common adverse reactions are nausea diarrhea, upper respiratory tract infection, increased ALT, mayalgia, urinanry tract infection, fatigue, headache, Insomnia; headache, paraesthesia; cataract, dry eye; GI & hepatobiliary disorders; rash, pruritus, alopecia; arthralgia, muscle spasm, bone pain; fatigue, peripheral oedema; thromboembolic events.
Pregnancy Category Note
Pregnancy Available data from published case reports and postmarketing experience with use in pregnant women are insufficient to assess any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes Animal data In animal reproduction and developmental toxicity studies, oral administration of eltrombopag to pregnant rats during organogenesis resulted in embryolethality and reduced fetal weights at maternally toxic doses Effects were observed at doses resulting in exposures that were 6 times the human clinical exposure based on AUC in patients with chronic ITP at 75 mg/day, and 3 times the AUC in patients with chronic hepatitis C...
... Show moreInteraction
Increased plasma Cmax & AUC of HMG-CoA reductase inhibitors. Caution w/ methotrexate, topotecan. Increased conc w/ fluvoxamine; decreased conc w/ rifampicin & lopinavir/ritonavir. Reduced absorption by antacids, dairy products & other products containing polyvalent cations (eg Fe, Ca, Mg, Al, Se, Zn). Reduced plasma AUC & Cmax w/ high-calorie & -fat meal. Monitor platelet counts when used in combination w/ lopinavir/ritonavir & other drugs for treatment of idiopathic thrombocytopenic purpura (ITP).
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