Promacta (eltrombopag) is a prescription drug used to treat certain blood disorders. It comes as an oral tablet and a powder that’s mixed with water to form a liquid suspension that you swallow.

Promacta is used to treat:

Promacta is used for these conditions in certain situations. To learn more, see the “What is Promacta used for?” section below.

Promacta basics

Promacta contains the active ingredient eltrombopag. (An active ingredient is what makes a drug work.)

Promacta is a brand-name medication. It’s not available as a generic drug.

Like most drugs, Promacta may cause mild or serious side effects. The lists below describe some of the more common side effects that Promacta may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Promacta. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Promacta can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Promacta’s prescribing information.

Mild side effects of Promacta that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Promacta can occur, but they aren’t common. If you have serious side effects from Promacta, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Promacta that have been reported include:

* For more information, see the “What should be considered before taking Promacta?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

Some people may have an allergic reaction to Promacta. Although it isn’t clear whether allergic reactions occurred in studies of Promacta, it can still happen.

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, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Promacta. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Promacta that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Forms and strengths

Promacta comes in the following forms and strengths:

  • an oral tablet, available in four strengths: 12.5 milligrams (mg), 25 mg, 50 mg, and 75 mg
  • a powder you mix with water to make a liquid suspension that you swallow, available in two strengths: 12.5 mg and 25 mg

Recommended dosage

Your Promacta dosage will be based on several factors, including:

  • your age
  • the condition you’re taking it to treat
  • other medical conditions you have
  • whether you’re of East or Southeast Asian ancestry
  • how your condition responds to treatment with Promacta

You’ll likely take Promacta once daily. To learn more about Promacta’s dosage, see this article.

Questions about Promacta’s dosing

Below are some common questions about Promacta’s dosing.

  • What if I miss a dose of Promacta? If you miss a dose of Promacta, skip it and take your next dose at its usual time. You should not take any extra doses of Promacta to make up for a missed dose. Doing so can increase your risk of side effects from the drug.
  • Will I need to use Promacta long term? It’s possible. Promacta is used to treat conditions that cause low levels of certain blood cells. You’ll likely take Promacta until your blood cell levels are within a healthy range. How long you’ll take Promacta depends on how quickly your blood cell levels respond to the drug.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A Patient Assistance Now Oncology program and a Universal Co-Pay Card may also be available. Visit the Promacta resources website for more information.

You can also check out this article to learn more about saving money on prescriptions.

Promacta is used to treat specific blood disorders. These include:

Low platelet levels caused by chronic (long-term) immune thrombocytopenia (ITP). With ITP, your immune system mistakenly attacks healthy platelets. (Platelets are a type of red blood cell.) This leads to low platelet levels, which may cause you to bleed or bruise more easily than usual.

Promacta is used to treat low platelet levels caused by ITP in certain adults and in children ages 1 year and older. Specifically, it’s used when their condition hasn’t improved with other treatments. Examples of these treatments include corticosteroids, immunoglobulins, and spleen removal. In addition, Promacta is only prescribed if someone’s ITP is severe enough to increase the risk of bleeding.

Low platelet levels caused by chronic hepatitis C. With chronic hepatitis C, the hepatitis C virus causes a long-term infection of the liver. This can lead to low platelet levels.

Promacta is used to treat low platelet levels caused by chronic hepatitis C in adults who need to start using interferon treatment for their condition. It’s used when their platelet levels are too low to use interferon safely.

Severe aplastic anemia. With aplastic anemia, you have damage to the stem cells in your bone marrow. This leads to low levels of platelets, red blood cells, and white blood cells.

Promacta is used in adults and children ages 2 years and older to treat aplastic anemia in certain situations. If you haven’t tried other drugs for your condition before, you’ll take Promacta with an immunosuppressant drug. Promacta can also be used by itself in adults whose condition hasn’t improved after using immunosuppressants.

Promacta works by stimulating your bone marrow to make more blood cells. For details, see “How does Promacta work?” in the “What are some frequently asked questions about Promacta?” section below.

Find answers to some commonly asked questions about Promacta.

Is Promacta similar to Doptelet, Nplate, or Tavalisse?

Yes, Promacta has similarities to avatrombopag (Doptelet), romiplostim (Nplate), and fostamatinib (Tavalisse). Doctors prescribe these drugs to treat low platelet levels caused by chronic (long-term) immune thrombocytopenia. Promacta, Doptelet, and Nplate have other uses as well.

Promacta, Doptelet, and Nplate belong to the same group of drugs. They work to treat low platelet levels by stimulating your bone marrow to make more platelets. This increases the level of platelets in your blood. For details, see the “How does Promacta work?” section below.

Tavalisse works differently from these medications. The drug helps prevent your body from breaking down platelets, which leads to a higher level of platelets in your blood.

To learn more about how Promacta compares with Doptelet, Nplate, and Tavalisse, talk with your doctor. They can recommend the right treatment for your specific condition.

Does Promacta cause long-term side effects?

In some cases, yes. Although it’s not common, you may develop long-term side effects from taking Promacta. Most of the drug’s side effects are temporary and last only a few days or weeks. Many of them will go away soon after starting or stopping the drug.

But some people may develop serious side effects during Promacta treatment, which could lead to long-term problems. Examples include:

Keep in mind that the length of time Promacta’s side effects last may differ from person to person. If you have other questions about Promacta and its long-term side effects, talk with your doctor or pharmacist.

* Promacta has a boxed warning for this side effect. For more information, see the “What should be considered before taking Promacta?” section.

Is weight gain possible with Promacta?

Promacta isn’t known to directly cause weight gain. This side effect wasn’t reported in studies of the drug. But Promacta can cause swelling of your hands or lower legs, which may lead to temporary weight gain.

Also, other treatments for blood disorders may cause weight gain. For example, weight gain is a common side effect of corticosteroids such as prednisone (Rayos) and dexamethasone (Hemady).

If you’re concerned about weight gain while taking Promacta, talk with your doctor. They can suggest ways to manage your weight during your Promacta treatment.

How does Promacta work? And how long does it take for the drug to start working?

Promacta is used to treat severe aplastic anemia, which leads to low levels of platelets, red blood cells, and white blood cells. The drug is also used to treat low platelet levels caused by certain conditions.

Promacta works to treat low blood cell levels by stimulating your bone marrow to make more blood cells. It does this by attaching to a specific protein that helps produce blood cells.

How long the drug takes to work may depend on the condition you’re taking Promacta to treat. For low platelet levels caused by certain conditions, your platelet count may increase within 1 to 2 weeks after starting treatment. For severe aplastic anemia, it may take up to 16 weeks of treatment for your blood cell levels to increase.

Your doctor will order tests to check your blood cell levels while you’re taking Promacta. The results of these blood tests will help your doctor determine whether the drug is working.

If you have other questions about how Promacta works or how long it takes to work, talk with your doctor or pharmacist.

Below is important information to consider before taking Promacta.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Promacta, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Promacta.

For information about drug-condition interactions, see the “Other warnings” section below.

Interactions with drugs or supplements

Promacta can interact with several types of drugs and supplements. These include:

  • certain antacids, such as calcium carbonate (TUMS) and aluminum hydroxide/magnesium hydroxide (Maalox)
  • certain cholesterol drugs, such as statins and ezetimibe (Zetia)
  • certain diabetes drugs, such as glyburide (DiaBeta, Glynase) and repaglinide
  • certain blood pressure drugs, such as valsartan (Diovan) and olmesartan (Benicar)
  • certain cancer drugs, such as irinotecan (Camptosar, Onivyde) and imatinib (Gleevec)
  • the antibiotic drug rifampin (Rifadin, Rimactane)
  • vitamins or supplements that contain aluminum, calcium, iron, magnesium, selenium, or zinc

This list does not contain all types of drugs that may interact with Promacta. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Promacta.

Other interactions

In addition to the drugs listed above, Promacta may interact with certain foods high in calcium. These include dairy products, such as yogurt and milk, as well as juices that contain calcium. These foods could lower the level of Promacta in your body, making the drug less effective.

For this reason, your doctor will advise you to take Promacta at least 2 hours before or 4 hours after consuming any foods or drinks high in calcium. This should help prevent these foods and drinks from affecting the level of Promacta in your body.

If you have questions about consuming specific foods or drinks with Promacta, talk with your doctor or pharmacist.

Boxed warnings

Promacta has boxed warnings about the risk of liver damage and liver problems in people with chronic (long-term) hepatitis C. 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.

Boxed warnings include:

Risk of liver damage. In some cases, taking Promacta can lead to life threatening liver damage. This side effect was rare in studies of the drug.

Symptoms of liver damage can include:

Your doctor will order blood tests to check how well your liver is working. You’ll have these tests done before you start taking Promacta and regularly during treatment.

If you have a liver problem before starting Promacta treatment, your doctor will determine whether this drug is right for you.

Tell your doctor right away if you have symptoms of liver damage during Promacta treatment. They can determine whether it’s safe for you to continue taking the drug. If you do continue taking Promacta but your liver damage returns or worsens, your doctor may have you switch to a different treatment.

Risk of liver problems in people with chronic hepatitis C. Taking Promacta with certain hepatitis C treatments could increase your risk of decompensated liver disease. This side effect wasn’t common in the drug’s studies.

With decompensated liver disease, your liver doesn’t work as well as it should. This can lead to encephalopathy (a severe brain condition) and ascites (fluid buildup in your abdomen).

Other symptoms of liver problems can include:

If you have symptoms of liver problems while taking Promacta, tell your doctor right away. They may have you stop taking Promacta or your hepatitis C treatments. Your doctor can also determine whether any treatments are needed for your liver problems.

Other warnings

Promacta can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Promacta is a good treatment option for you.

Talk with your doctor about your health history before you take Promacta. Factors to consider include those described below.

Conditions that raise the risk of blood clots. Before starting Promacta treatment, tell your doctor if you have a condition that raises your risk of blood clots. For example, tell them if you have a genetic (inherited) condition that causes blood clots or if you’ve had them in the past.

Blood clots are a possible side effect of Promacta. You may be more likely to have blood clots if you already have a condition that increases your risk. Your doctor can determine whether Promacta is a safe treatment option for you.

Blood cancer. If you have a type of blood cancer called myelodysplastic syndromes (MDS), talk with your doctor. They typically won’t prescribe the drug for people with this condition. This is because Promacta could increase the risk of MDS becoming another type of blood cancer. If you have MDS, your doctor will likely prescribe a treatment other than Promacta.

Cataracts. Promacta may cause cataracts. If you already have cataracts, taking Promacta could worsen your condition. Your doctor may recommend that you see an eye doctor to closely monitor your condition while you take Promacta.

Allergic reaction. If you’ve had an allergic reaction to Promacta or any of its ingredients, your doctor will likely not prescribe Promacta. Ask them what other medications are better options for you.

East or Southeast Asian ancestry. People of East or Southeast Asian ancestry may have a higher risk of side effects from Promacta. If you’re of this ancestry, talk with your doctor before taking the drug. Your doctor may prescribe a lower dosage of Promacta to reduce the risk of side effects. To learn more about Promacta’s dosage, see this article.

Promacta and alcohol

It’s likely safe to drink moderate amounts of alcohol while taking Promacta.

But drinking large amounts of alcohol may cause liver damage. Promacta may cause liver damage and liver problems in people with chronic (long-term) hepatitis C.* So drinking large amounts of alcohol while taking Promacta could raise your risk of liver problems even more.

If you drink alcohol, talk with your doctor about how much (if any) may be safe to drink during your Promacta treatment.

* Promacta has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above

Pregnancy and breastfeeding

It isn’t known whether Promacta is safe to take during pregnancy or while breastfeeding.

To be safe, your doctor may recommend that you not take this drug while pregnant or breastfeeding. If you have questions about this, talk with your doctor. They can tell you about the risks and benefits of taking Promacta during these times.

Your doctor will explain how you should take Promacta. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Promacta

Promacta comes in two oral forms:

  • a tablet
  • a powder you mix with water to make a liquid suspension that you swallow

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

  • have large print
  • use braille
  • contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Promacta in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.

Taking Promacta with other drugs

For severe aplastic anemia, you may take Promacta with immunosuppressant drugs. These are drugs that weaken your immune system. An example is cyclosporine (Gengraf, Neoral, Sandimmune).

For its other uses, your doctor can tell you whether Promacta will be used by itself or with other treatments.

Questions about taking Promacta

Below are some common questions about taking Promacta.

  • Can Promacta be chewed, crushed, or split? Promacta tablets should not be chewed, crushed, or split. You should swallow the tablets whole. If you have trouble swallowing tablets, check out this article, or talk with your doctor. They may prescribe the powder form of Promacta instead. (The powder is mixed with water to make a liquid suspension that you swallow.)
  • Should I take Promacta with food? You can take Promacta without food or with food that’s low in calcium. It’s best to take Promacta at least 2 hours before or 4 hours after consuming any foods or drinks high in calcium. Doing so will help prevent these foods and drinks from affecting the level of Promacta in your body. To learn more about Promacta and high-calcium foods, see the “What should be considered before taking Promacta?” section above.
  • Is there a best time of day to take Promacta? No, you can take Promacta at any time of day. But try to take your doses at least 2 hours before or 4 hours after consuming any foods or drinks high in calcium.

Do not take more Promacta than your doctor prescribes. Using more than this can lead to negative effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Promacta

Call your doctor if you think you’ve taken too much Promacta. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

If you have questions about taking Promacta, talk with your doctor or pharmacist. Questions you may want to ask include:

  • Do any other medications I take interact with Promacta?
  • Will I take Promacta along with other treatments for my condition?
  • Will my condition get worse if I stop taking Promacta?

To learn more about Promacta, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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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