Drug interactions of Eltrombopag

1 Polyvalent Cations (Chelation)  

Eltrombopag chelates polyvalent cations (such as iron, calcium, aluminum, magnesium, selenium, and zinc) in  foods, mineral supplements, and antacids.  

Take PROMACTA at least 2 hours before or 4 hours after any medications or products containing polyvalent  cations, such as antacids, dairy products, and mineral supplements to avoid significant reduction in absorption  of PROMACTA due to chelation.

2 Transporters  

Use caution when concomitantly administering PROMACTA and drugs that are substrates of OATP1B1 (e.g.,  atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, olmesartan, pitavastatin, pravastatin, rosuvastatin,  repaglinide, rifampin, simvastatin acid, SN-38 [active metabolite of irinotecan], valsartan) or breast cancer  resistance protein (BCRP) (e.g., imatinib, irinotecan, lapatinib, methotrexate, mitoxantrone, rosuvastatin,sulfasalazine, topotecan). Monitor patients closely for signs and symptoms of excessive exposure to the drugs  that are substrates of OATP1B1 or BCRP and consider reduction of the dose of these drugs, if appropriate. In  clinical trials with PROMACTA, a dose reduction of rosuvastatin by 50% was recommended.

3 Protease Inhibitors  

HIV Protease Inhibitors: No dose adjustment is recommended when PROMACTA is coadministered with  lopinavir/ritonavir (LPV/RTV). Drug interactions with other HIV protease inhibitors have not been evaluated.  

Hepatitis C Virus Protease Inhibitors: No dose adjustments are recommended when PROMACTA is  coadministered with boceprevir or telaprevir. Drug interactions with other hepatitis C virus (HCV) protease  inhibitors have not been evaluated.  

4 Peginterferon Alfa-2a/b Therapy  

No dose adjustments are recommended when PROMACTA is coadministered with peginterferon alfa-2a  (PEGASYS®) or -2b (PEGINTRON®).

from FDA，2021.10