In the clinical studies, there was one report of overdose where the patient ingested 5,000 mg of Revolade. Reported adverse events included mild rash, transient bradycardia, fatigue and elevated transaminases. Liver enzymes measured between Days 2 and 18 after ingestion peaked at 1.6-fold ULN in AST, 3.9-fold ULN in ALT, and 2.4-fold ULN in total bilirubin. The platelet counts were 672,000/microL on day 18 after ingestion and the maximum platelet count was 929,000/microL. All events resolved without sequelae following treatment.
In the event of overdose, platelet counts may increase excessively and result in thrombotic/thromboembolic complications. In case of an overdose, oral administration of a metal cation-containing preparation, such as calcium, aluminium, or magnesium preparations to chelate eltrombopag and thus limit absorption should be considered. Platelet counts should be closely monitored. Treatment with Revolade should be reinitiated in accordance with dosing and administration recommendations (see DOSAGE & ADMINISTRATION).
Because eltrombopag is not significantly renally excreted and is highly bound to plasma proteins, hemodialysis would not be expected to be an effective method to enhance the elimination of eltrombopag.