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What are the drug interactions of eltrombopag

Release date: 2025-03-26 11:41:51     Recommended: 58

The clinical use of eltrombopag requires special attention to the synergistic or antagonistic effects with other agents.

What are the drug interactions of eltrombopag

Antacids containing aluminum, calcium, or magnesium may reduce eltrombopag bioavailability.

Relationship with antacids and minerals

It is recommended to avoid such drugs 4 hours before or 2 hours after taking the drug to reduce the effect on plasma concentrations.

Effect of drugs related to liver enzyme metabolism

Inducers or inhibitors of the CYP1A2 and CYP2C8 enzymes may alter the rate of eltrombopag metabolism. Dose adjustment is required in combination with a potent enzyme inducer, e.g., rifampicin may reduce serum levels by 40% to 60%.

Synergistic effect of anticoagulant drugs

This product may enhance the effects of vitamin K antagonists such as warfarin. The frequency of INR monitoring should be strengthened during the combination and the anticoagulation regimen should be adjusted if necessary.

Medication management strategies for special populations

Individualized treatment plans are of great significance to improve treatment outcomes.

Adjustment in patients with hepatic dysfunction

The initial dose of Child-Pugh class C should be reduced to 25 mg/day. During treatment, liver function indexes should be monitored every two weeks, and if aminotransferase elevation exceeds 3 times the normal value, the drug should be suspended.

Dosing regimen for elderly patients

A higher risk of bleeding was observed in the patient population over 65 years of age. It is recommended to start with the lowest effective dose and strengthen platelet count monitoring to maintain a target value above 50×10^9/L.

Perioperative management points

The risk of bleeding should be assessed prior to elective surgery, and dose adjustment is recommended 7 days prior to surgery. Patients undergoing emergency surgery should have platelet transfusions in advance, and coagulation should be reassessed when treatment is resumed 48 hours after surgery.

A better understanding of drug-drug interaction mechanisms and individualized medication regimens can optimize treatment outcomes and reduce clinical risk. The medical team should establish a dynamic monitoring system to adjust the treatment strategy based on real-time detection data.