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Revolade (Eltrombopag)
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Revolade is part of the thrombopoietin receptor agonist (TPO-RA) class of medications. Thrombopoietin is a hormone that regulates the production of platelets in the bone marrow. Thrombopoietin receptor agonists like Revolade mimic the action of thrombopoietin by binding to and activating its receptor on bone marrow cells. This stimulates the production and release of platelets into the bloodstream.
This class of medications is specifically designed to increase platelet counts in conditions associated with low platelet levels, such as thrombocytopenia. Ultimately, revolved increases the amount of platelets in the blood. This reduces the risks of uncontrolled bleeding and bruising that thrombocytopenia patients experience.
Precautions and Warnings About Revolade
Revolade is an effective medication for treating thrombocytopenia but there are important precautions and warnings to consider before and during its use. Patients with a history of severe liver disease should not use Revolade because it can exacerbate liver problems. Regular monitoring of liver function is recommended during treatment.
Revolade can increase the risks of thromboembolism due to loose blood clots. Patients with a history of blood clots or clotting disorders may not be good candidates for taking Revolade. Revolade is not typically the first choice medication for pediatric patients, even those with chronic ITP, because it is associated with increased liver toxicity. However, it can be the best choice for children who don’t respond to other treatments.
Revolade should not be used during pregnancy unless necessary, as its safety in pregnant women has not been established. Breastfeeding mothers should also consult with their healthcare provider before using Revolade because this medicine may pass into breast milk.
Additionally, you should not take Revolade if you are allergic to eltrombopag or any of its active ingredients.
Side Effects of Revolade
Revolade patients may experience a range of side effects. Many of these are mild and can be managed with lifestyle changes or over-the-counter medication. Occasionally, Revolade causes more serious side effects. Tell your doctor about any side effects you experience, especially if your symptoms get worse or time or do not go away.
Revolade side effects include:
- Headache
- Nausea, diarrhea, or abdominal pain
- Fatigue
- Muscle aches
- Respiratory tract infections
- Insomnia
- Cough
- Dizziness
Allergic Reactions
Rarely, Revolade causes serious problems including allergic reactions, liver toxicity, increased risk of blood clots, and vision decline in patients with pre-existing cataracts. Contact your doctor immediately if you notice:
- Dark urine
- Severe abdominal pain
- Yellow skin or eyes
- Vision changes
- Trouble breathing, speaking, or swallowing
- Rash
- Elevated heart rate
Revolade Drug Interactions
Revolade changes the contents of your blood so it may impact how your body uses other medications. Medications that are perfectly safe to take individually can interfere with each other when you combine them. Tell your doctor about all the medications you take, including prescriptions, over-the-counter medicine, herbs, supplements, alcohol, cannabis, and other drugs. Your doctor may prescribe different medicines that are safe to use with Revolade, adjust the schedule of your drugs, or even choose a different thrombocytopenia treatment.
Antacids, calcium supplements, and other products with multivalent cations can bind to Revolade in the digestive tract. This action decreases how much Revolade your body absorbs. Heartburn medication and other drugs that change the pH balance of your digestive tract also impact how Revolade is digested. If you take these medications, your doctor will likely recommend you take them at different times. Most patients need to take Revolade either two hours before, or four hours after, antacids, calcium supplements, proton pump inhibitors, and more.
Some drugs interact with the enzyme that digests Revolade. These include fluoxetine, gemfibrozil, rifampin, and more. Taking blood thinners like warfarin alongside Revolade can also increase the risk of bleeding since both of these drugs impact blood contents and behavior.
The following drugs are known to interact with Revolade:
- Antacids
- Calcium supplements
- Iron supplements
- Multivitamins or mineral supplements containing calcium, iron, or zinc
- Omeprazole
- Esomeprazole
- Lansoprazole (e.g. Dexilant)
- Ranitidine
- Famotidine
- Gemfibrozil
- Fluoxetine (e.g. Prozac)
- Firampin
- Warfarin
- Digoxin
- Simvastatin
- Cyclosporine (e.g. Restasis)
- Tacrolimus
- Hormonal birth control
- Methotrexate
- Phenytoin
- Carbamazepine
- John’s Wort
Strengths and Dosages of Revolade
Revolade tablets come in a range of strengths to treat various conditions. The ideal dose for each patient depends on their condition, medical history, risks, treatment tolerance, size, age, and much more. Your doctor will prescribe the Revolade treatment that’s best for your needs.
Revolade tablets come in 12.5, 25, 50, 75, and 100 mg dosages. Typical treatment plans include the following:
| Condition | Typical Dosage |
| Low platelet count caused by ITP in adults and children 6+ years | 50 mg daily |
| Low platelet count caused by ITP in children ages 1-5 years | 25 mg daily |
| Low platelet count caused by chronic hepatitis C | between 25-100 mg daily |
| Severe aplastic anemia as a first-choice treatment in adults and children 12+ years | 150 mg daily for 6 months |
| Severe aplastic anemia as a first-choice treatment in children ages 6-11 years | 75 mg daily for 6 months |
| Severe aplastic anemia as a first-choice treatment in children ages 2-5 years | 2.5 mg/kg daily for 6 months |
| Non-responsive severe aplastic anemia in adults and children ages 2+ | 50 mg daily |
Revolade FAQs
Why was I prescribed Revolade?
Revolade is a thrombopoietin receptor agonist that prompts your body to make more platelets. This medicine is prescribed for people who have low platelet counts. Most people with this symptom have thrombocytopenia but it also occurs in patients with hepatitis C or severe aplastic anemia. Your doctor prescribed Revolade because you have one of these conditions.
What are common Revolade side effects?
Common side effects of Revolade may include nausea, headache, fatigue, diarrhea, muscle aches, upper respiratory tract infections, abdominal pain, insomnia, cough, and dizziness. Patients need to report any side effects to their healthcare provider.
What are some warnings before I use Revolade?
There are several precautions and warnings to consider when using Revolade. It should not be taken by individuals with a history of severe liver disease, and regular monitoring of liver function is recommended during treatment. Revolade may also increase the risk of blood clots and should be used cautiously in patients with a history of blood clots or cardiovascular disease. Additionally, Revolade is not recommended for use during pregnancy unless necessary, and breastfeeding mothers should consult with their healthcare provider before using Revolade.
Are There Alternatives to Revolade?
Yes, there are other ways to treat thrombocytopenia besides Revolade. Other thrombopoietin receptor agonists include Avatrombopag and Lusutrombopag.
What is the cost of Revolade in America?
Revolade is a specialty medicine that is not typically carried at pharmacies. It often needs to be special-ordered. Revolade is priced by its manufacturer at $62.50 per 25 mg tablet. A patient taking 25 mg each day will pay approximately $22,800 for Revolade each year. This cost does not include discounts, coupons, or insurance copayments.
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IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.
