Indication: Elopag, also referred to as Eltrombopag based on the International Nonproprietary Name (INN), is prescribed for adults with chronic immune thrombocytopenia (ITP) who have not adequately responded to corticosteroids, immunoglobulins, or splenectomy.

Pharmacology: Operating as a thrombopoietin receptor agonist, Elopag boosts platelet production by engaging with the thrombopoietin receptor’s transmembrane domain. This interaction initiates intracellular signaling cascades promoting megakaryocyte growth and differentiation, ultimately increasing platelet production.

Dosage and Administration: Adults with chronic ITP typically receive Elopag orally at a recommended 50 mg dose once daily. Adjustments may be needed based on individual patient response to reach and maintain the desired platelet count. Elopag can be taken with or without food, ideally at the same time daily.

Interactions: Elopag may interact with drugs affecting cytochrome P450 enzymes, notably CYP2C8 and CYP3A4. Caution is warranted when co-administering with potent CYP2C8 inhibitors or inducers, and careful monitoring is essential when combining with drugs increasing bleeding risk.

Side Effects: Common side effects of Elopag include headache, fatigue, nausea, diarrhea, upper respiratory tract infections, and peripheral edema. Serious adverse reactions may comprise thromboembolic events, hepatotoxicity, and cataracts.

Precautions and Warnings:

• Thromboembolic events require close monitoring, particularly in patients with predisposing factors.
• Regular liver function tests are recommended due to potential hepatotoxicity linked with Elopag use.
• Ophthalmic monitoring is advised due to the risk of cataract development.
• Caution is advised in patients with chronic liver disease, who may have an elevated risk of portal vein thrombosis with Elopag administration.

Overdose Effect: In case of Elopag overdose, supportive care is advised. There is no specific antidote for Elopag overdose, emphasizing the importance of close monitoring for adverse reactions and prompt initiation of symptomatic treatment as necessary.