Eltrombopag

Say it: el-TROM-boe-pag · Brand names: Promacta, Alvaiz

Eltrombopag is a pill that helps your bone marrow make more platelets and other blood cells.

What it is

Eltrombopag works like a natural hormone called thrombopoietin. It turns on the bone marrow cells that make platelets, the cells that help blood clot. In aplastic anemia, it also helps the marrow make red and white blood cells.

Often used for

• immune thrombocytopenia (ITP), when platelets stay low after other treatment
• severe aplastic anemia
• low platelets in people with hepatitis C, so they can get hepatitis treatment

How you get it

Eltrombopag is a pill you take by mouth once a day at home. Your team will change the dose based on your platelet count. Many people take it for months or longer. Your schedule may be different.

Common side effects and what helps

• Nausea or diarrhea. Tell your team if it does not get better.
• Headache. Ask your team what pain medicine is safe.
• Feeling tired. Rest when you need to.
• Muscle aches or back pain.
• Changes in liver blood tests. Your team will check these often.
• Cough or cold symptoms.

Call your care team right away if you have

• Yellow skin or eyes, dark urine, or pain on the right side of your belly
• Pain, swelling, or warmth in an arm or leg
• Sudden shortness of breath or chest pain
• Signs of a stroke, such as weakness on one side, trouble speaking, or a bad headache
• Unusual bleeding or bruising, especially after stopping the medicine
• Blurry or cloudy vision

Before you start, tell your team

• If you are pregnant, may become pregnant, or are breastfeeding
• If you have liver problems or hepatitis
• If you have had blood clots
• If you are of East or Southeast Asian ancestry, since you may need a lower dose
• If you have had cataracts
• All the medicines, vitamins, and herbal products you take

Good to know

• It can harm the liver. You will have liver blood tests before you start and often during treatment. In people with hepatitis C who take interferon and ribavirin, it can raise the risk of serious liver failure.
• Platelets that go too high can raise the risk of blood clots. Your team will check your counts often.
• If you stop it, your platelets may drop and bleeding may come back. Do not stop unless your team tells you.
• It can cause cataracts. You may need eye exams.

At home

• For Promacta: take it on an empty stomach, at least 1 hour before or 2 hours after a meal.
• Take it at least 2 hours before or 4 hours after dairy products, calcium-rich foods, antacids, and supplements with calcium, iron, magnesium, aluminum, zinc, or selenium. These block the medicine. Alvaiz has its own food rules, so ask your team.
• Swallow tablets whole. Promacta also comes as a powder to mix with water for children. Follow the instructions exactly.
• If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
• Store at room temperature, away from children and pets.

Questions to ask

• What time of day is best for me to take it with my meals?
• How should I time it with dairy, antacids, and vitamins?
• How often will my platelets and liver be checked?
• What platelet count are we aiming for?

Part of these treatment plans

• ATG and cyclosporine

Side effect guides

• Fatigue (tiredness)
• Nausea and vomiting
• Diarrhea
• Cough
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.