Promacta is a brand-name drug that is prescribed for certain blood disorders. The medication is available in the following forms: an oral tablet and a powder for making an oral suspension.

The Food and Drug Administration (FDA) has approved Promacta to treat these conditions in certain situations:

Promacta also has certain limitations of use. For more information about the uses of Promacta, see the “Promacta uses” section below.

Drug details

  • Drug class: thrombopoietin receptor agonist
  • Drug forms: oral tablet and powder for making an oral suspension (a type of liquid mixture)
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2008

Promacta is available only as a brand-name medication. It’s not currently available in generic form. A generic drug is an exact copy of the active drug in a brand-name medication.

Promacta contains one active drug ingredient: eltrombopag. This means eltrombopag is the ingredient that makes Promacta work.

Promacta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Promacta. These lists don’t include all possible side effects.

For more information on the possible side effects of Promacta, see this article. You can also talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Promacta, you can do so through MedWatch.

Mild side effects

Many of the mild side effects listed below occurred in people who were taking other medications with Promacta. So it’s hard to say whether Promacta caused all these side effects.

The mild side effects of Promacta reported more often in clinical trials include:

The mild side effects of Promacta reported less often in clinical trials include:

Serious side effects

Many of the serious side effects listed below occurred in people who were taking other medications with Promacta. So it’s hard to say whether Promacta caused all these side effects.

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Cataracts (an eye problem). Symptoms can include:
    • cloudy or blurry vision
    • sudden change in eyesight
  • Hemorrhage (bleeding). Symptoms can include:
    • bleeding
    • bruising
    • blood in urine or stool
    • dizziness
    • weakness
  • Thromboembolism (a blood clot in a blood vessel). Symptoms can include:
    • swelling, pain, or tenderness in an arm or leg
    • shortness of breath
    • pain in your abdomen with nausea, vomiting, or diarrhea
  • Severe anemia. Symptoms can include:
    • weakness
    • extreme tiredness
    • skin that is paler than usual
    • dizziness

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Promacta has boxed warnings for liver problems in people with chronic hepatitis C and liver damage. A boxed warning is the most serious warning from the FDA. For more information, see the “Side effect details” section below.

Side effects in children

Side effects reported in children were similar to those seen in adults.

In clinical trials, two of the more common side effects in children were upper respiratory infections and diarrhea.

For more details about side effects, please see the side effects lists above and side effect details below. Your child’s doctor can also discuss Promacta’s side effects with you.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Promacta. However, it’s not known how often allergic reactions occur with Promacta. Clinical trials don’t include reports of allergic reactions or the frequency of such reactions.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Promacta. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Loss of liver function in people with chronic hepatitis C

If you have chronic hepatitis C, it’s possible that taking Promacta can cause your liver to work less well. This is called hepatic decompensation. In fact, Promacta has a boxed warning for liver problems in people with chronic hepatitis C. A boxed warning is the most serious warning from the FDA.

Hepatic decompensation may cause ascites (fluid buildup in the abdomen) or encephalopathy, which affects the brain and causes foggy or confused thinking.

Changes to liver function can be very serious. If you have fluid buildup in your abdomen or notice changes in your thinking, tell your doctor right away. They’ll likely have you stop your Promacta treatment.

Risk of liver damage

It’s not common, but it’s possible that taking Promacta can cause damage to the liver. Note that Promacta has a boxed warning for liver damage. A boxed warning is the most serious warning from the FDA.

In clinical trials, there were reports of liver damage due to medication. Some of the people who experienced this side effect were taking Promacta with other drugs. So it’s hard to say whether Promacta caused the liver damage.

During your Promacta treatment, your doctor will monitor your liver function by looking at liver enzymes such as ALT and AST. (Enzymes are proteins that aid chemical changes in your body.) They’ll also look at your bilirubin level. (Bilirubin is made when blood cells break down.)

Your doctor will check your ALT, AST, and bilirubin levels before you start taking Promacta, every 2 weeks while your dose is being adjusted, and at least monthly after that.

Symptoms of liver problems can include:

  • fluid in the abdomen
  • urine that is darker than usual
  • confusion
  • tiredness
  • yellowing of skin or the white of your eyes
  • itchiness
  • loss of appetite
  • pain in upper stomach area

If you notice any of these symptoms, tell your doctor. They’ll want to check your ALT, AST, and bilirubin levels. If the levels are high, your doctor may recheck you in a few days or have you stop taking Promacta.

The Food and Drug Administration (FDA) approves prescription drugs such as Promacta to treat certain conditions. Promacta is FDA approved to treat the following conditions in certain situations.

You’ll find more details on Promacta’s uses in the sections below.

Promacta also has the following limitations of use:

  • Promacta should not be used to treat myelodysplastic syndrome (MDS), a group of cancers of the blood and bone marrow. For more information, see the “Promacta for MDS (not an approved use)” section below.
  • It’s not known whether Promacta treatment is safe and effective for people with chronic hepatitis C who are taking direct-acting antiviral agents but not also taking interferon. Direct-acting antivirals are drugs that target specific proteins on a virus that stop them from replicating in the body.

Promacta may also be used off-label for other conditions. Off-label use is when a drug that is approved to treat one condition is used to treat a different condition.

Promacta for ITP

Promacta is FDA approved for the treatment of low platelet count in adults as well as children ages 1 year and older who have ITP. You must have already tried treatments that didn’t work. Examples of these treatments include:

With chronic ITP, blood doesn’t clot as expected. It’s an autoimmune condition in which the body’s immune system mistakenly works against itself. People with chronic ITP don’t have enough platelets. (Another name for platelets is thrombocytes.) Platelets help form blood clots when they’re needed, such as when your skin is cut.

People without enough platelets are more likely to have bleeding issues. Examples of these issues include:

  • bruising that you can see on the skin
  • nosebleeds
  • menstrual bleeding that is heavier than usual
  • other external or internal bleeding that isn’t expected in people who don’t have chronic ITP

Chronic ITP lasts at least 6 months, while acute ITP has a shorter time frame.

Effectiveness

Clinical trials found Promacta to be effective in increasing platelet levels in adults and children ages 1 year and older with chronic ITP. For information about these trials, see Promacta’s prescribing information.

Promacta for thrombocytopenia in people with chronic hepatitis C

Promacta is approved by the FDA for the treatment of thrombocytopenia in people with chronic hepatitis C who need to start taking a medication called interferon for their condition. People with thrombocytopenia cannot take interferon alone because it could further decrease platelet levels. Promacta helps treat their thrombocytopenia so they can start and keep taking interferon.

Chronic hepatitis C is a condition caused by a viral infection that affects your liver. If you have chronic hepatitis C, it may cause you to develop thrombocytopenia. This drop in the platelet levels occurs in people with hepatitis C for several reasons. Examples include possible side effects from treatment medications and a decrease in a hormone called thrombopoietin, which is involved in making platelets.

Thrombocytopenia can cause bleeding issues and prevent you from being able to take the medications you need to treat your hepatitis C. For these reasons, your doctor may prescribe Promacta. The drug may help decrease your bleeding risk and allow you to take the medications you need for hepatitis C.

It’s not known whether Promacta treatment is safe and effective for people with chronic hepatitis C who are taking direct-acting antiviral agents but not also taking interferon. Direct-acting antivirals are drugs that target specific proteins on a virus that stop them from replicating in the body.

Effectiveness

Clinical trials found Promacta to be effective for treating low platelet levels in adults with chronic hepatitis C. Note that people in these trials were also taking the medications peginterferon (PegIntron, Pegasys) and ribavirin for hepatitis C. For information about these trials, see Promacta’s prescribing information.

Promacta for severe aplastic anemia with immunosuppressive therapy

Promacta is FDA approved for the treatment of severe aplastic anemia (SAA) in adults as well as children ages 2 years and older. The drug is taken with immunosuppressive therapy, which is a kind of treatment that decreases the activity of your immune system. Immunosuppressive treatment may include horse antithymocyte globulin (h-ATG) and cyclosporine (Neoral, Sandimmune).

Aplastic anemia causes a decrease in the levels of red blood cells, white blood cells, and platelets. This occurs when the stem cells in bone marrow have been harmed. The damage may be due to:

  • an autoimmune condition, in which the immune system works against itself
  • certain medications, such as chemotherapy drugs
  • exposure to certain chemicals in the environment, such as benzene, pesticides, or insecticides

Taking Promacta along with immunosuppressive treatment may help improve your platelet counts and decrease the risk of bleeding.

Effectiveness

Clinical trials found Promacta to be effective in treating SAA in adults and children ages 2 years and older. For information about these trials, see Promacta’s prescribing information.

Promacta for severe aplastic anemia that is refractory

Promacta is FDA approved for the treatment of SAA that is refractory. Refractory means the condition hasn’t been helped by previous treatment. In this case, the previous treatment was immunosuppressive therapy.

For details on aplastic anemia, see the “Promacta for severe aplastic anemia with immunosuppressive therapy” section above.

Effectiveness

A clinical trial found Promacta effective for treating SAA in adults who previously tried immunosuppressive therapy that didn’t fully work. For information about this trial, see Promacta’s prescribing information.

Promacta for other conditions

In addition to the uses listed above, you may wonder whether Promacta is used for certain other conditions. Here we describe a condition that Promacta isn’t used to treat.

Promacta for MDS (not an approved use)

Promacta isn’t approved for the treatment of myelodysplastic syndrome (MDS), which includes certain cancers of the blood and bone marrow. Taking Promacta for MDS may increase the risk of MDS becoming acute myeloid leukemia (AML).

A clinical trial looked at people with MDS who took azacitidine (Vidaza) with either Promacta or a placebo (a treatment with no active ingredient). Researchers found that MDS became AML in significantly more people who took Promacta than in people who took the placebo.

Studies such as this one from 2018 continue to look at the risk of MDS becoming AML with the use of Promacta. Researchers are also looking at possibly using Promacta for treating MDS.

Promacta and children

Promacta is FDA approved to treat:

  • thrombocytopenia in children ages 1 year and older who have chronic ITP
  • SAA in children ages 2 years and older, when taken with immunosuppressive therapy

The drug has been shown to be safe and effective in these children. For details of clinical trials of Promacta in children, see the drug’s prescribing information.

Promacta is often used with other medications. How it’s used with other medications depends on the conditions you have. In some cases, taking Promacta enables you to use important medications for another condition, such as chronic hepatitis C.

Sometimes Promacta is used as an add-on medication to manage thrombocytopenia in people with severe aplastic anemia (SAA). The drug is used with immunosuppressive therapy, which is a kind of treatment that decreases the activity of your immune system.

For chronic immune thrombocytopenia (ITP), Promacta is used after other treatments have failed. These treatments include immunoglobulins (injections of proteins), corticosteroids, and splenectomy (the removal of your spleen).

For more information about how Promacta is used with other medications, see the “Promacta uses” section above.

The Promacta dosage your doctor prescribes will depend on several factors. Dosing guidelines vary and depend on the following:

  • the type and severity of the condition you’re using Promacta to treat
  • your age
  • the form of Promacta you take
  • other medical conditions you may have
  • East Asian or Southeast Asian ancestry

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that is right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

For more about Promacta’s dosage, see this article.

Drug forms and strengths

Promacta comes in two forms:

  • A tablet that you swallow: The tablet is available in these strengths: 12.5 milligrams (mg), 25 mg, 50 mg, and 75 mg.
  • A packet of powder: You mix the powder with water to create a suspension (liquid) that you take using an oral syringe. The powder is available in these strengths: 12.5 mg and 25 mg.

Dosage for ITP

The dosage for chronic immune thrombocytopenia (ITP) will typically be 50 mg once per day. If you’re of East Asian or Southeast Asian descent, your starting dosage will usually be 25 mg once per day.

If you have liver problems, your doctor may recommend a dosage of Promacta that is different than the typical dosage. Talk with your doctor to see what’s right for you.

Your doctor will adjust your Promacta dosage for you to reach a specific platelet count to reduce your risk of bleeding. During your treatment, they’ll give you blood tests often to monitor your progress and adjust your dosage, if necessary.

Dosage for thrombocytopenia in people with chronic hepatitis C

The starting dosage for the treatment of thrombocytopenia in people with chronic hepatitis C is 25 mg once per day. Your doctor will usually adjust the dose every 2 weeks to meet platelet count goals that they’ll set. The maximum dose for this condition is 100 mg of Promacta per day.

Your doctor will have you stop taking Promacta when you stop your antiviral treatment for hepatitis C.

Dosage for severe aplastic anemia with immunosuppressive therapy

The recommended dosage of Promacta for the treatment of severe aplastic anemia (SAA) is 150 mg once per day for 6 months. Promacta will be used with immunosuppressive therapy, which is a kind of treatment that decreases the activity of your immune system. If you’re of East Asian or Southeast Asian descent, your starting dosage will usually be 75 mg once per day for 6 months.

If you have liver problems, your doctor may recommend a dosage of Promacta that is different than the typical dosage. Talk with your doctor to see what’s right for you.

You should not take a higher dosage than your doctor recommends. They’ll decrease or pause your dosage based on your platelet counts. And to make these changes, your doctor will need to monitor you closely.

Dosage for severe aplastic anemia that is refractory

The usual starting dosage for SAA that is refractory (hasn’t gotten better with other treatment) is 50 mg once per day. If you’re of East Asian or Southeast Asian descent, your starting dosage will be 25 mg once per day.

Your doctor will typically adjust the dosage every 2 weeks based on your platelet count. The maximum recommended dosage for this condition is 150 mg once per day. If Promacta doesn’t seem to be helping you after 16 weeks, your doctor will likely have you stop the treatment.

If you have liver problems, your doctor may recommend a dosage of Promacta that is different than the typical dosage. Talk with your doctor to see what’s right for you.

Pediatric dosage

Promacta is approved to be used in children with chronic ITP and SAA.

ITP

Here are the typical recommended starting dosages of Promacta for children with ITP:

  • Ages 6 years and older: 50 mg once per day. If your child is of East Asian or Southeast Asian descent, their starting dosage will usually be 25 mg once per day.
  • Ages 1 year to 5 years: 25 mg once per day

Your child’s doctor will adjust the Promacta dosage for your child to reach a specific platelet count to reduce the risk of bleeding. During your child’s treatment, the doctor will give them blood tests often to monitor their progress and adjust their dosage, if necessary.

If your child has liver problems, their doctor may recommend a dosage of Promacta that is different than the typical dosage. Talk with your child’s doctor to learn more.

Severe aplastic anemia with immunosuppressive therapy

Here are the recommended dosages of Promacta for children with severe aplastic anemia:

  • Ages 12 years and older: 150 mg once per day for 6 months. If your child is of East Asian or Southeast Asian descent, their starting dosage will usually be 75 mg once per day for 6 months.
  • Ages 6 years to 11 years: 75 mg once per day for 6 months. If your child is of East Asian or Southeast Asian descent, their starting dosage will usually be 37.5 mg once per day for 6 months.
  • Ages 2 years to 5 years: 2.5 mg per kilogram of body weight (mg/kg) once per day for 6 months. Your child’s doctor will determine how much Promacta your child will take based on their weight. If your child is of East Asian or Southeast Asian descent, their starting dosage will usually be 1.25 mg/kg once per day for 6 months.

Promacta will be used with immunosuppressive therapy, which is a kind of treatment that decreases the activity of your child’s immune system.

You should not give your child more than the dosage that their doctor recommends. The doctor will decrease or pause the dosage based on your child’s platelet counts. And to make these changes, your child’s doctor will need to monitor them closely.

If your child has liver problems, their doctor may recommend a dosage of Promacta that is different than the typical dosage. Talk with your child’s doctor to learn more.

What if I miss a dose?

If you miss a dose of Promacta, take it as soon as you remember unless it’s close to your next dose. Don’t take more than one Promacta dose in 24 hours.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Promacta is meant to be used as a long-term treatment. If you and your doctor determine that Promacta is safe and effective for you, you’ll likely take it long term. The length of time you take the medication will depend on the condition being treated as well as how your body responds to the medication.

Promacta is used to treat thrombocytopenia, which is a low platelet count that can lead to bleeding. Platelets are the parts of your blood that help it clot. So if you have fewer platelets, you’re more likely to bleed.

Thrombocytopenia can be a very serious condition. It often requires treatment, especially if the condition is severe or chronic (long term). Promacta works by binding to a protein called thrombopoietin receptor. This receptor tells the body to make more platelets, which increases platelet levels. Through this process, Promacta helps prevent bleeding problems.

How long does it take to work?

How long Promacta takes to work depends on the condition the drug is treating.

ITP

In clinical trials of people with chronic immune thrombocytopenia (ITP) who took Promacta for thrombocytopenia, platelet counts generally increased within 1 to 2 weeks of treatment.

Thrombocytopenia in people with chronic hepatitis C

In clinical trials of people with chronic hepatitis C who took Promacta for thrombocytopenia, platelet counts usually started to increase within 1 week of starting to take the drug.

Severe aplastic anemia with immunosuppressive therapy

It’s not known how soon Promacta starts to work in people with severe aplastic anemia (SAA) who also used immunosuppressive therapy. (This is a kind of treatment that decreases the activity of your immune system.)

Severe aplastic anemia

For people with severe aplastic anemia that hasn’t been helped by immunosuppressive therapy, it may take up to 16 weeks of Promacta use for the medication to increase blood counts. This is according to clinical trials. The 16-week time frame includes dosage adjustments.

You should take Promacta according to your doctor’s or healthcare professional’s instructions.

Promacta comes in two forms. One is a tablet that you swallow. The other is a powder that you’ll mix with water to create a suspension (liquid). You take the suspension using an oral syringe.

If your doctor prescribes the suspension form of Promacta, your doctor or pharmacist can show you how to prepare the doses. Keep in mind that you should not use hot water to mix the powder. Also, it’s important to take the dose within 30 minutes of preparing it. After that, you should dispose of the suspension.

When to take

You’ll take Promacta once per day on an empty stomach (without food) or with food that is low in calcium.

It’s also important to take Promacta at least 2 hours before or 4 hours after consuming any of the following:

  • foods or drinks that contain a lot of calcium, such as milk, yogurt, cottage cheese, and fortified juice
  • medications, such as antacids, that contain calcium or magnesium
  • supplements that contain iron, calcium, aluminum, magnesium, selenium, or zinc, including some multivitamins

If you’re not sure what your supplement contains, look at the ingredients or ask your pharmacist or doctor.

To help make sure that you don’t miss a dose of Promacta, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Promacta with food

You can take Promacta with food as long as it’s low in calcium. You can also take it on an empty stomach.

It’s also important to take Promacta at least 2 hours before or 4 hours after consuming foods or drinks that contain a lot of calcium. These can include milk, yogurt, cottage cheese, and fortified juice.

If you’re not sure whether your foods or drinks are high in calcium, ask your pharmacist or doctor.

Can Promacta be crushed, split, or chewed?

No, you should not crush, split, or chew Promacta tablets or mix them with food or liquid. Swallow Promacta tablets whole.

No direct interactions between Promacta and alcohol have been found. However, alcohol can cause or worsen liver problems. And Promacta is known to cause liver problems in people with a liver condition called chronic hepatitis C.* So drinking alcohol with Promacta could make liver damage more likely.

If you have concerns about your alcohol use or wonder whether it’s safe to drink while taking Promacta, talk with your doctor.

* Promacta has a boxed warning for liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Side effect details” in the “Promacta side effects” section above.

Promacta can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Promacta and other medications

Below is a list of medications that can interact with Promacta. This list doesn’t contain all drugs that may interact with Promacta.

Before taking Promacta, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Promacta and antacids containing calcium or magnesium

Taking over-the-counter antacids containing calcium or magnesium too close to your Promacta dose can prevent you from absorbing Promacta. So you should take Promacta at least 2 hours before or 4 hours after using an antacid. This helps prevent the level of Promacta in your body from becoming lower.

If you’re not sure whether your antacid contains calcium or magnesium, check the ingredients. You can also ask your pharmacist or doctor.

Promacta and certain cholesterol medications

Promacta may raise the levels of certain cholesterol medications. And higher levels of the cholesterol drugs may increase the risk of side effects.

Examples of these cholesterol medications include:

If you’re taking a cholesterol drug, tell your doctor before using Promacta. They may recommend other treatments for you.

Promacta and certain blood pressure medications

Promacta may raise the levels of certain blood pressure drugs. And higher levels of the medications may increase the risk of side effects.

Promacta is known to interact with these blood pressure medications:

  • bosentan (Tracleer)
  • olmesartan (Benicar)
  • valsartan (Diovan)

If you’re taking any blood pressure medications, talk with your doctor before using Promacta. They may prescribe other treatments for you.

Promacta and certain diabetes medications

Promacta may raise the levels of certain diabetes medications. And higher levels of the drugs may increase the risk of side effects.

Promacta is known to interact with these diabetes medications:

  • glyburide (DiaBeta)
  • repaglinide

If you’re taking any diabetes medications, talk with your doctor before you use Promacta. They may recommend other treatments for you.

Promacta and rifampin

Promacta may raise the level of an antibiotic called rifampin (Rifadin). A higher level of rifampin may increase the risk of side effects. If you’re taking rifampin, tell your doctor before using Promacta. They may recommend a different treatment for you.

Promacta and certain breast cancer treatments

Promacta may raise the levels of certain breast cancer drugs. And higher levels of the medications may increase the risk of side effects.

Promacta may interact with the following breast cancer treatments:

If you’re taking any breast cancer medications, check with your doctor before using Promacta. They may prescribe other treatments for you.

Promacta and sulfasalazine

Promacta may raise the level of an ulcerative colitis medication called sulfasalazine (Azulfidine). A higher level of sulfasalazine may increase the risk of side effects. Before you take Promacta, tell your doctor if you’re using sulfasalazine. They may recommend a different treatment for you.

Promacta and herbs and supplements

Supplements that contain certain minerals can interact with Promacta and decrease the level of Promacta in the body. So it’s important to take Promacta at least 2 hours before or 4 hours after taking supplements that contain these minerals.

Minerals that can interact with Promacta include:

Keep in mind that multivitamins often contain some of these minerals. If you have questions about any of the supplements you’re taking, talk with your doctor or pharmacist.

There aren’t any herbs that have been specifically reported to interact with Promacta. However, you should still check with your doctor or pharmacist before using any of these products while taking Promacta.

Promacta and foods

Foods and drinks that are high in calcium can prevent you from absorbing Promacta, which can decrease the level of the drug in your body. (Calcium-rich foods and drinks include milk, yogurt, cottage cheese, and fortified juice.) So it’s important to take Promacta at least 2 hours before or 4 hours after consuming foods or drinks that are high in calcium.

If you have questions about the calcium levels in any of the foods you’re eating, talk with your doctor or pharmacist.

As with all medications, the cost of Promacta can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Promacta at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

If you have insurance, the insurance company may require you to get prior authorization before approving coverage for Promacta. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know whether your plan will cover Promacta.

If you’re not sure whether you’ll need to get prior authorization for Promacta, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Promacta, or if you need help understanding your insurance coverage, help is available.

Novartis Pharmaceuticals Corporation, the manufacturer of Promacta, offers several programs that could help lower your cost for Promacta. For information about these programs, call 800-282-7630 or visit the Promacta website.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Promacta, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that is approved to treat one condition is used to treat a different condition.

Alternatives for thrombocytopenia

Thrombocytopenia can be caused by different conditions. Your doctor will choose the best treatment for your thrombocytopenia based on your condition and medical history.

Examples of other drugs that may be used to treat thrombocytopenia include:

Alternatives for severe aplastic anemia

Your doctor will choose the best treatment for your aplastic anemia based on the severity and causes of your condition as well as your medical history.

Examples of other drugs that may be used to treat severe aplastic anemia (SAA) include:

  • antithymocyte globulin (h-ATG, Thymoglobulin)
  • cyclosporine (Neoral, Sandimmune)
  • cyclophosphamide
  • tacrolimus (Prograf)

The medications listed above are forms of immunosuppressive therapy, which is a kind of treatment that decreases the activity of your immune system. In some cases, Promacta may be used in addition to immunosuppressive therapy. If your condition doesn’t improve enough with immunosuppressive therapy, your doctor may recommend that you take Promacta by itself.

You may wonder how Promacta compares with other medications that are prescribed for similar uses. Here we look at how Promacta and dexamethasone are alike and different.

Ingredients

Promacta and dexamethasone don’t contain the same active ingredients, and they belong to different drug classes.

Promacta contains the active ingredient eltrombopag and belongs to a medication class called thrombopoietin receptor agonists.

Dexamethasone contains the active ingredient dexamethasone and belongs to a medication class known as steroids.

Uses

Both Promacta and dexamethasone have several uses.

Promacta uses

The Food and Drug Administration (FDA) has approved Promacta to treat these conditions in certain situations:

Promacta also has certain limitations of use. For more information about the uses of Promacta, see the “Promacta uses” section above.

Dexamethasone uses

Dexamethasone is used off-label for the treatment of ITP. Off-label use is when a drug that is approved to treat one condition is used to treat a different condition.

Dexamethasone is FDA approved for the treatment of numerous conditions, including:

Drug forms and administration

Promacta comes in two forms, either of which you take once per day. One is a tablet that you swallow. The other is a powder that you mix with water to create a suspension (liquid). You take the suspension using an oral syringe.

The forms of dexamethasone that are usually used to treat thrombocytopenia are a tablet or liquid solution that you swallow. You’ll take either of these forms of dexamethasone once per day. An injectable form is also available that a healthcare professional would need to give you.

Side effects and risks

Promacta and dexamethasone can cause some very similar and some very different side effects. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Promacta, with dexamethasone, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Promacta, with dexamethasone, or with both drugs (when taken individually).

  • Can occur with Promacta:
    • hepatotoxicity (harm to the liver)*
    • hemorrhage (bleeding)
    • severe anemia
  • Can occur with dexamethasone:
  • Can occur with both Promacta and dexamethasone:

* Promacta has boxed warnings for liver problems in people with chronic hepatitis C and liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Side effect details” in the “Promacta side effects” section above.

Effectiveness

The only condition Promacta and dexamethasone are both used to treat is thrombocytopenia.

These drugs haven’t been directly compared in studies, but clinical trials have found both Promacta and dexamethasone to be effective for treating thrombocytopenia.

Promacta may be used after other treatment options haven’t worked well. These options include corticosteroids such as dexamethasone.

Costs

Promacta is a brand-name drug. Dexamethasone is available as a generic drug. Brand-name medications usually cost more than generics.

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Promacta compares with other medications that are prescribed for similar uses. Here we look at how Promacta and Thymoglobulin are alike and different.

Ingredients

Promacta and Thymoglobulin don’t contain the same active ingredients, and they belong to different medication classes. (A class of medications is a group of drugs that work in a similar way.)

Promacta contains the active ingredient eltrombopag and belongs to a medication class called thrombopoietin receptor agonists.

Thymoglobulin contains the active ingredient antithymocyte globulin and belongs to the immunoglobulin G medication class.

Uses

Here’s some information about the uses of Promacta and Thymoglobulin.

Promacta uses

The Food and Drug Administration (FDA) has approved Promacta to treat these conditions in certain situations:

Promacta also has certain limitations of use. For more information about the uses of Promacta, see the “Promacta uses” section above.

Thymoglobulin uses

Thymoglobulin is used off-label for the treatment of SAA. Off-label use is when a drug that is approved to treat one condition is used to treat a different condition.

Thymoglobulin is FDA approved to help prevent and treat transplant rejection in people who are receiving a kidney transplant. The drug is meant to be used with other immunosuppressive treatments.

Drug forms and administration

Promacta comes in two forms, either of which you take once per day. One is a tablet that you swallow. The other is a powder that you mix with water to create a suspension (liquid). You take the suspension using an oral syringe.

Thymoglobulin comes as an intravenous (IV) infusion, which is an injection into your vein that is given slowly over time. A healthcare professional administers the IV infusion.

Side effects and risks

Promacta and Thymoglobulin can cause some very similar and some very different side effects. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Promacta, with Thymoglobulin, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Promacta, with Thymoglobulin, or with both drugs (when taken individually).

  • Can occur with Promacta:
    • hepatotoxicity (harm to the liver)*
    • cataracts (an eye problem)
    • hemorrhage (bleeding)
    • thromboembolism (a blood clot in a blood vessel)
    • severe anemia
  • Can occur with Thymoglobulin:
    • cancers, such as kidney cancer and certain lymphomas
    • decreased ability of the immune system to fight serious infections
    • severe infusion reactions that cause heart or breathing problems
    • high levels of lipids (fat) in the blood
  • Can occur with both Promacta and Thymoglobulin:

* Promacta has boxed warnings for liver problems in people with chronic hepatitis C and liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Side effect details” in the “Promacta side effects” section above.

Effectiveness

Promacta and Thymoglobulin have different FDA approved uses, but they’re both used to treat SAA.

These drugs haven’t been directly compared in studies, but clinical trials have found both Promacta and Thymoglobulin to be effective for treating aplastic anemia.

Promacta is often used with immunosuppressive therapy, which is a kind of treatment that decreases the activity of your immune system. This therapy includes Thymoglobulin. Promacta may also be used after other treatment options, such as Thymoglobulin and cyclosporine, have failed.

Costs

Promacta and Thymoglobulin are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Your cost for either drug may depend on the condition you’re using it to treat and your dosage. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

It’s not known whether Promacta is safe to use during pregnancy. Animal studies have shown that there’s possible harm to a fetus when the drug is given to a pregnant animal. However, animal studies don’t always predict what will occur in humans.

If you’re pregnant or planning to become pregnant, let your doctor know. They can talk with you about the right treatment options for your condition.

It’s not known whether Promacta is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Promacta.

It’s recommended that you and your partner use effective birth control while either of you are taking Promacta and for at least 7 days after stopping treatment.

It’s recommended that you avoid taking Promacta while breastfeeding. This is due to possible medication side effects in children who are breastfed. Animal studies have shown that the drug can pass into the breast milk of animals. However, animal studies don’t always predict what will occur in humans.

If you’re breastfeeding or planning to do so, talk with your doctor. They can suggest treatment options other than Promacta for your condition.

Here are answers to some frequently asked questions about Promacta.

Is Promacta a chemotherapy drug?

No, chemotherapy usually refers to medications that are used to treat cancer directly. So in this case, Promacta isn’t chemotherapy.

However, Promacta is often used in people having chemotherapy for the treatment of cancer. Common side effects of certain cancers and cancer treatments include anemia and thrombocytopenia, and Promacta helps treat these conditions. Anemia is a low level of red blood cells, and thrombocytopenia is a low level of platelets (parts of your blood that help it clot).

If you have questions about Promacta, chemotherapy, or other cancer-related treatments, talk with your doctor.

Can Promacta cure my condition?

It depends. Promacta is used to treat chronic immune thrombocytopenia (ITP), thrombocytopenia in people with chronic hepatitis C, and severe aplastic anemia (SAA).

These conditions are often related to the activity of your immune system (your body’s defense against infection) or chronic hepatitis C, which is a long-term condition. This means that your need for treatment, including Promacta, may vary. You may have times when your platelet counts or red blood cell counts rise to healthy levels, and you can stop taking Promacta.

If you have questions about what to expect with Promacta treatment, talk with your doctor. Your treatment plan can depend on other conditions you have, your medical history, and other treatments you’re using.

Why do I have to tell my doctor if I’m Asian before I can use Promacta?

If you’re of East Asian or Southeast Asian descent, you’ll likely need a dose of Promacta that is lower than the typical dose. Clinical trials have shown that people of this ancestry are more sensitive to the drug, so it stays at higher levels in their system. This could result in a greater risk of side effects. (For more about side effects, see the “Promacta side effects” section above.)

Before you take Promacta, be sure to tell your doctor your heritage so they can safely adjust your dose, if needed.

How will my doctor monitor my condition to see whether Promacta is working?

Your doctor will give you blood tests throughout your Promacta treatment to see how the drug is working for you. What types of blood tests you need depends on the condition being treated. So the blood tests may include checks of your platelet or red blood cell counts, and the hepatitis C virus.

How often and when you have the tests depend on when you started taking Promacta, other blood test results, and possibly other medications you’re using.

If you’re wondering about any tests you need while taking Promacta, ask your doctor.

Should I avoid foods and drinks that are high in calcium while I’m taking Promacta?

You may not have to completely avoid foods and drinks that are high in calcium. However, you should not consume them when you take a dose of Promacta.

You should take the drug at least 2 hours before or 4 hours after consuming high-calcium foods or drinks. Otherwise, they can decrease the level of Promacta that your body can absorb. And this might make the medication less effective.

If you’re wondering which foods and drinks are high in calcium, check with your doctor.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Liver problems in people with chronic hepatitis C: If you have a liver condition called chronic hepatitis C, taking Promacta with the medications interferon and ribavirin may increase your risk of liver problems. These include ascites, which is a buildup of fluid in your abdomen, and encephalopathy, a brain condition.

Liver damage: Promacta can be dangerous to the liver, and taking the drug may increase your risk of serious or life threatening liver damage. Your doctor will closely monitor your liver during your treatment and may have you stop taking the drug, if needed.

For more information about these boxed warnings, see “Side effect details” in the “Promacta side effects” section above.

Other precautions

Before taking Promacta, talk with your doctor about your health history. Promacta may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

Blood clots: Although Promacta can lead to clotting issues and serious blood clots in people who take the medication, certain people may be more likely to develop a clot. So if you’ve had blood clots in the past, have chronic liver disease, or have a blood clotting condition such as Factor V Leiden or an antithrombin III (AT-III) deficiency, tell your doctor. They may choose to monitor you more closely or recommend other treatment options.

Liver disease: Taking Promacta can increase your risk of liver problems, including increased liver enzyme levels. If you have or have had liver problems in the past, tell your doctor. This includes hepatitis. Taking certain medications for hepatitis with Promacta can also increase your risk of certain liver side effects. Your doctor may choose to monitor you more closely or recommend other treatment options for you.

Myelodysplastic syndrome: Promacta isn’t approved for the treatment of myelodysplastic syndrome (MDS), which includes certain cancers of the blood and bone marrow. For more information, see “Promacta for MDS (not an approved use)” in the “Promacta uses” section above.

Cataracts: Taking Promacta may lead you to have new or worsening cataracts. Tell your doctor if you have eye issues, including cataracts, before you take Promacta. Your doctor will likely recommend you have eye exams before you start using Promacta and throughout your treatment.

Pregnancy: It’s not known whether it’s safe to take Promacta during pregnancy. For more information, see the “Promacta and pregnancy” section above.

Breastfeeding: It’s recommended that you avoid taking Promacta while breastfeeding. For more information, see the “Promacta and breastfeeding” section above.

Note: For more information about the potential negative effects of Promacta, see the “Promacta side effects” section above.

Using more than the recommended dosage of Promacta can lead to serious side effects.

Don’t use more Promacta than your doctor recommends. You should not take more than one dose of Promacta in 24 hours.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Promacta from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist how to correctly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Promacta tablets at a room temperature of 68°F to 77°F (20°C to 25°C). If needed, you can keep the medication between 59°F and 86°F (15°C and 30°C) for a short time. Store Promacta in a tightly sealed container away from light. Avoid keeping this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Promacta and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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