Trombonamo 25mg Tablet (Eltrombopag Olamine)

The Trombonamo 25mg 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. Food, dairy products, calcium, iron, magnesium, and other polyvalent cations can markedly reduce absorption; however, strict medical supervision is necessary during the treatment.

Eltrombopag 25mg is used for the treatment in:

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

Trombonamo 25mg Tablet is employed in cases of ITP in situations where the platelet counts are extremely low with a risk of bleeding, particularly when other first-line therapies fail to provide adequate effects. The drug is also administered in cases of severe aplastic anemia, either alone or in combination with drugs that modulate the immune system or even in case other treatments are not effective. The dosage varies depending on the type of condition, and in some individuals the initial dose should be lower due to certain factors.

Trombonamo 25mg Tablet binds to the receptor for thrombopoietin (c-MPL) found on the surface of cells responsible for the production of blood in the bone marrow. It causes signals that help in the development and maturation of the cells to megakaryocytes, which in turn manufacture platelets.

RAISE: Eltrombopag 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.​

Eltrombopag 25mg tablets are usually safe to use, although some individuals might encounter adverse effects while on medication. This could occur in mild or severe form and require medical help. Common adverse effects are

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: Dose and regimen must be prescribed by the treating specialist. Tablet/vial strength is not necessarily the patient dose. Do not start, stop, split, combine, or substitute treatment based on website information.

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 CBC should be monitored on a weekly basis until a steady dose of Eltrombopag 25mg tablets has been determined, and afterwards on a regular basis.
  
• Liver function tests should be performed periodically because Trombonamo 25mg Tablet may have an effect on the liver.
  
• Pay attention to the symptoms of blood clots, like sudden swelling, pain, chest pain, and trouble breathing.
  
• Visual examinations, including cataracts, may be required if there is any problem with vision.
  
• In SAA patients, the bone marrow examination and chromosome testing may be performed at the discretion of the physician.
  

• 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://pubmed.ncbi.nlm.nih.gov/20739054/​
  
• 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​