[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/) › Eltrombopag

[Pharmacology](https://durgical.com/en/pharmacology/) · [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/)

# Eltrombopag

An oral thrombopoietin receptor agonist for immune thrombocytopenia and severe aplastic anaemia. It can harm the liver and binds calcium and iron.

Updated 2026-11-01

- Class: [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/)
- Receptor: Thrombopoietin receptor (MPL, c-Mpl) on megakaryocytes
- ATC code: B02BX05

## Mechanism of action

Eltrombopag is a small non-peptide molecule that binds the transmembrane domain of the thrombopoietin receptor (MPL). It activates the receptor's signalling without competing with natural thrombopoietin, increasing megakaryocyte growth and platelet production.

- Eltrombopag enters the membrane part of MPL
- The receptor signals without thrombopoietin
- Megakaryocytes release more platelets

## Pharmacokinetics

**Absorption**
Oral; absorption falls sharply with calcium, iron, magnesium, aluminium, zinc or selenium

**Elimination**
Mainly in faeces

**Half-life**
Long (about a day or more)

## Indications

- Chronic immune thrombocytopenia with inadequate response to other treatments [Immune thrombocytopenia (ITP) →](https://durgical.com/en/conditions/immune-thrombocytopenia/)
- Severe aplastic anaemia (first-line, together with immunosuppression) [Aplastic anaemia →](https://durgical.com/en/conditions/aplastic-anaemia/)
- Thrombocytopenia in chronic hepatitis C, to allow interferon-based treatment

## Adverse effects

### Common

- Headache
- Cough, fever, tiredness

### Serious (rare, important)

- Liver injury: jaundice, dark urine, right upper abdominal pain
- Hepatic decompensation with interferon and ribavirin in chronic hepatitis C
- Thrombosis, including portal vein thrombosis in advanced liver disease

## Contraindications

- Caution in liver disease, previous thrombosis, cataract and myelodysplastic syndrome
- Pregnancy (contraception is advised)

## Key interactions

**Antacids and supplements with calcium, aluminium, magnesium, iron, zinc or selenium; dairy foods**
Chelation blocks absorption; eltrombopag is taken hours apart from them

**Interferon and ribavirin (hepatitis C)**
Higher risk of hepatic decompensation

## What is monitored

- Liver function tests before and during treatment
- Platelet count
- Signs of thrombosis

## Administration and safety

- Oral, once daily, separated by hours from calcium-rich foods, antacids and mineral supplements
- Lower starting doses for people of East or Southeast Asian ancestry and for those with liver impairment

## Nursing care

- Teach the timing with respect to dairy, antacids and supplements
- Teach the signs of liver injury and when to report them
- Bleeding precautions continue while platelets recover

## Pregnancy and breastfeeding

Pregnancy is avoided during treatment and for a short time after; effective contraception is advised and breastfeeding is avoided.

## Memory aid

ELTROmbopag «ELudes calcium»: keep it away from dairy, antacids and iron; watch the liver.

## Test yourself

Think of the answer, then tap the question to see it.

## Where on the receptor does eltrombopag bind?

The transmembrane domain of MPL.

## Which organ must be monitored?

The liver (hepatotoxicity).

## Why is it separated from milk and antacids?

Calcium and other polyvalent cations chelate it and block absorption.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/eltrombopag/)

## Related drugs

- [Romiplostim](https://durgical.com/en/pharmacology/romiplostim/)
- [Ferrous sulfate](https://durgical.com/en/pharmacology/ferrous-sulfate/)

## Related conditions

- [Immune thrombocytopenia (ITP)](https://durgical.com/en/conditions/immune-thrombocytopenia/)
- [Aplastic anaemia](https://durgical.com/en/conditions/aplastic-anaemia/)

[← Back to the class: Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Eltrombopag: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a609011.html) (MedlinePlus (U.S. National Library of Medicine), 2026); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 33 (McGraw Hill, 2025); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 45 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=B02BX05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/eltrombopag/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/eltrombopag/