Apple Pharmaceuticals

Epag 50 – Eltrombopag 50mg Tablet

Description

Epag 50 – Eltrombopag 50mg Tablet is an oral thrombopoietin (TPO) receptor agonist that stimulates platelet production by activating the TPO receptor (c-Mpl) on bone marrow cells. It helps increase platelet counts in patients with certain blood disorders.

Uses

Epag 50 – Eltrombopag 50mg Tablet is used to treat:

• Chronic Immune Thrombocytopenia (ITP) in adults and children who have not responded adequately to other treatments
• Severe aplastic anemia (refractory or in combination therapy)
• Thrombocytopenia in chronic hepatitis C patients to allow initiation and maintenance of interferon-based therapy

Metabolism

• Primarily metabolized in the liver
• Involves CYP1A2 and CYP2C8 enzymes
• Also undergoes glucuronidation and oxidation
• Not extensively metabolized by CYP3A4

Distribution

• Highly protein-bound (>99%), mainly to albumin
• Widely distributed in the body
• Does not significantly cross the blood–brain barrier

Excretion

• Eliminated mainly via the feces
• Minor excretion through urine
• Elimination half-life: approximately 21–32 hours

Adverse Effects

Common Adverse Effects

• Headache
• Nausea, diarrhea
• Fatigue
• Upper respiratory tract infections
• Increased liver enzymes (ALT, AST)

Serious Adverse Effects

• Hepatotoxicity
• Thromboembolic events (blood clots)
• Bone marrow fibrosis (with long-term use)
• Cataracts (reported in some patients)

Dosage

• Dosage is individualized based on platelet count and condition
• Common starting doses:
  • Adults with ITP: 50 mg once daily
  • East Asian patients or hepatic impairment: 25 mg once daily
• Dose adjustments are made to maintain platelet counts at safe levels (not normal levels)

Important: Eltrombopag should be taken on an empty stomach, at least 2 hours before or 4 hours after foods or supplements containing calcium, iron, magnesium, aluminum, or zinc.