Revolade 50mg Tablet (Eltrombopag 50mg)

Revolade 50mg Tablet contains eltrombopag, an oral thrombopoietin-receptor agonist that stimulates platelet production. It is used in selected patients with persistent/chronic immune thrombocytopenia (ITP) and severe aplastic anemia (SAA); some labels also retain an indication for thrombocytopenia associated with chronic hepatitis C treatment, though interferon-era use is now uncommon.

The goal is not to normalize the platelet count but to maintain a count that reduces clinically important bleeding. However, food, dairy products, calcium, iron, magnesium, and other polyvalent cations can markedly reduce absorption.

The Eltrombopag 50mg tablet is prescribed for the following indications:

• Immune thrombocytopenia (ITP)
  
• Severe aplastic anemia (SAA)

​Eltrombopag tablets are prescribed when there is an increased risk of bleeding because of low platelet count or if other therapies are insufficient. The dosage of eltrombopag 50mg is varied in accordance with ITP or severe aplastic anemia. The reduced initial dose may be required in some cases of liver dysfunction or in individuals of East or Southeast Asian descent.

Eltrombopag 50mg tablets bind with the thrombopoietin receptor (c-MPL) on some of the blood cell-forming cells in the bone marrow. The signals released promote the growth of these cells to become megakaryocytes, which then form platelets. As a result, the body can make more platelets and increase the platelet count.

RAISE: Revolade 50mg Tablet improved platelet responses and reduced bleeding-related outcomes in chronic ITP.

Severe aplastic anemia studies: NIH and subsequent studies demonstrated hematologic responses in refractory SAA and strong responses when added to immunosuppressive therapy in selected treatment-naïve patients.​​

Revolade tablet side effects may be varied, depending on the dosage and patient reaction to the medication. Side effects can be managed, but some may need immediate medical attention. These include:

Common side effects

• Nausea
  
• Diarrhea
  
• Headache
  
• Upper respiratory infection
  
• Increased liver enzymes
  
• Muscle aches
  

Serious side effects

• Hepatotoxicity
  
• Thromboembolic events
  
• Bone-marrow reticulin/fibrosis concerns
  
• Cataracts
  
• Clonal cytogenetic evolution in SAA populations

Important: Dosage and scheduling will always be determined by the treating physician. The strength indicated on the packaging may not equate to the dose of the medicine for the patient. Do not make any changes in the regimen based on information gathered from the Internet.

If a dose is missed, skip it and take the next scheduled dose. Do not take more than one dose in 24 hours unless specifically instructed.

• The platelet count and complete blood count (CBC) should be checked on a weekly basis while tapering the dosage and then on a regular basis after the dosage reaches a stable level.
  
• Liver function tests need to be carried out regularly because of the adverse effects of the Revolade 50mg Tablet on the liver.
  
• Keep an eye out for any signs of blood clots like swollen extremities, pain, chest pain, or difficulty breathing.
  
• Tests on the eyes and cataracts could be required if there are any visual complaints or clinical indications.
  
• In the case of SAA, bone marrow biopsy and chromosomal analysis might be done based on the doctor's discretion.
  

• Current eltrombopag prescribing information (Promacta/Revolade reference) https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/022291lbl.pdf​
  
• Cheng G, et al. RAISE. Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60959-2/abstract​
  
• Townsley DM, et al. Eltrombopag with immunosuppression in severe aplastic anaemia. New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMoa2109965​