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Eltombopag and cough

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8 years 6 months ago #58380 by Margaret k
Eltombopag and cough was created by Margaret k
I have been on 75 mg eltrombopag daily for 15 months and I have developed a persistent dry cough over the past 3 weeks. It comes and goes and does not have with it significant symptoms of a cold apart from a slightly runny nose. I note that coughing is a potential side effect of eltrombopag . Anyone else experienced this? As it is a lifesaver for me I will be devastated if I have become allergic to it.
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8 years 6 months ago #58382 by Christine
Replied by Christine on topic Eltombopag and cough
I have been on electromag for about one month and I seem to have those symptons also. I was beginning to worry and it has put my mind at rest knowing someone else has it.
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8 years 6 months ago #58383 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Christine ,I am due a hospital consult in 3 weeks. I will discuss it then. This is a new symptom for me after being on eltrombopag since Sept 2012 except for a gap of 6 months. The dosage is however high so maybe if it is lowered, as it could be because I have now reached a safe level, hopefully the cough might go . What dose are you on?
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 6 months ago #58384 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
Both medicines.org & UpToDate.com list a cough as a common side effect
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8 years 6 months ago #58391 by Christine
Replied by Christine on topic Eltombopag and cough
75 mg per day.
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8 years 6 months ago #58403 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Me too. I have Emailed my consultant and asked his thoughts about reducing the dose . Will update you asap.
  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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8 years 6 months ago - 8 years 6 months ago #58405 by Hal9000
Replied by Hal9000 on topic Eltombopag and cough
I notice that coughing is a feature of NPlate as well.

It would be interesting if a mild blood thinner reduces the coughing. Maybe Omega3 capsules, or a couple meals of fish, or baby aspirin?
ITP Types and Treatments by HAL
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8 years 6 months ago #58417 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
It would be Hal but since I don't have any information on the etiology of the cough I am not inclined yet to be a one woman experiment. I usually eat fish about 3 times a week, not always oily fish admittedly but I also eat greens often. Have asked the prof if he has any information about the natural history of the cough side effect but no reply as yet. It is very tiresome during the day but fortunately does not trouble me during the night.
  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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8 years 6 months ago #58431 by Hal9000
Replied by Hal9000 on topic Eltombopag and cough
Oh, fish 3 times a week. LOL, you're already doing what I was thinking. One never knows until one asks. Sounds like a little thinning has no effect. Was just curious, thanks.

It will be interesting to hear what the doc/experts have to say. Or, barring that, if the cough goes away when/if the dose is reduced to 50mg.
ITP Types and Treatments by HAL
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8 years 6 months ago #58445 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Went to GP surgery today . Could only seen nurse practioner. My chest is clear and all she offered me was a steroid nose spray for a ? Naso pharyngeal drip which I will not use as I don't feel congested enough to justify its use. Consultant says that if I was going to have a reaction to eltrombopag I would have had it before now ( like Christine who is coughing after one month) but he agreed to me dropping to 50 mg on two days of the week if I want. However I'm going to stick with the 75 mg for 3 weeks till my next app't and if nothing has changed I'll drop a bit.
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8 years 6 months ago #58482 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
I am glad to say that the cough has gone , as mysteriously as it arrived, after almost 5 weeks.
I didn't in the end reduce the dose ,so am still on 75mg for at least another 2 weeks
Christine I hope your cough is a false alarm too.
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8 years 6 months ago #58510 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Spoke too soon, it's back! Might try the nasal spray after all.
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8 years 6 months ago #58565 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Have been using the nasal spray ( mometasane furuoate)for 5 days and the cough has gone. I will stop it in 2 days and see what happens then.
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8 years 6 months ago #58618 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
After a week with no nasal spray the runny nose and cough are back. It seems most likely that I do have an allergic reaction. Going to clinic tomorrow so will negotiate a reduction in eltrombopag dose and see what happens.
  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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8 years 6 months ago #58621 by Hal9000
Replied by Hal9000 on topic Eltombopag and cough
Would continuing Mometasone Furoate for the long term be a bad idea? Could it be used every 2 or 3 days?
Being a steroid, is the drug expected to raise counts, on the margin?
ITP Types and Treatments by HAL
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8 years 6 months ago #58630 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
The hema I saw today agrees it is a side effect of drug but feels that the value of eltrombopag to me outweighs the side effect. He would be OK with me using the steroid spray long term as it is a very low dose. He uses it long term for a pet allergy! Although it seems to be effective for me in relieving the nasal symptoms I expect it will have no effect on my platelets as I was completely refractory to steroids regarding my ITP. My count today was similar to last month's--104( was 110). Although a bit iffy about change because I seem to be stable at present he was willing to let me reduce the dose a little, eg down to 50 mg from 75 mg on 2 days of the week. Will do this and get a count in 3 weeks to check there is no big drop.
The following user(s) said Thank You: Hal9000
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 6 months ago #58640 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
Have developed a runny nose and a cough, don't feel at all ill so am wondering if I am in the same predicament as you Margaret
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8 years 6 months ago #58646 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Oh dear, sorry to hear that has happened so soon into your treatment. Another problem sent to try us. The nasal spray is very effective for me, you could give it a try , the brand name in UK is Nasonex.
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8 years 5 months ago #58764 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
I now use the spray only once a day and that is enough to stop the cough.
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 5 months ago #58766 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
My cough seems to be abating despite increase in Eltrombopag dose. Maybe it just took a while to shake of the virus.
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8 years 5 months ago #58964 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
For 5 weeks now I have been taking 75mg5x week and 50 mg 2x a week. The cough has gone completely so who knows whether virus or allergy? Despite the slight reduction in dose my count has stayed up in the 100s ,was 112 today. It's the most stable I have been in the almost 5 years I have had ITP.
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 5 months ago #58971 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
This looks promising Margaret, are you going to try lowering the dose any more?
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8 years 4 months ago #59025 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
At next app't in 3 weeks I will discuss taking 50mg 3x a week and 75 4x. I have a feeling that my body does not like sudden changes of dose. I have a theory that the platelet destruction response actually increases in line with increased production on a high dose and does not reduce immediately in response to lowered production of platelets when the dosage is suddenly reduced . Hence the tendency to crash after a sudden dose change. Have you any knowledge of any research in this area.?
  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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8 years 4 months ago #59042 by Hal9000
Replied by Hal9000 on topic Eltombopag and cough
Margaret, I think they call that 'rebounding' to a lower count, briefly, when one doesn't taper off Promacta/NPlate properly. But I don't think it is universally true for all ITPer's. Some may gradually loose response just as they gradually gained response. Because of this difference I suspect rebounding is a problem with certain types of ITP.

For what it's worth and on a slightly different subject, I came across 'tacmom' (and daughter Caitlin) posts recently. Caitlin didn't respond to steroids, or IVIG, or even Rituxan. But she did respond to NPlate. After 6 years achieved remission.
pdsa.org/discussion-group/search.html?searchuser=tacmom&exactname=1&searchdate=all&order=inc&childforums=1&start=540
ITP Types and Treatments by HAL
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 4 months ago #59044 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
Interesting theory Margaret. Have just spent half an hour looking for evidence but unfortunately have come up with nothing conclusive to either prove or disprove it
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 4 months ago #59163 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
Hi Margaret
This is an interesting read
www.ncbi.nlm.nih.gov/pmc/articles/PMC2789970/
The following user(s) said Thank You: poseymint
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8 years 4 months ago #59220 by Margaret k
Replied by Margaret k on topic Eltombopag and cough
Thank you Mrs B - it's a bit hard to digest but I'll keep persevering. Maybe I'll pass ITP 101 eventually!
It's interesting though that it has been found that not only does eltrombopag improve the platelet count of those with ITP ,it also improves the red and white cell counts of those such as me who had pancytopenia and apparently restores the viability of the bone marrow.
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 4 months ago #59222 by mrsb04
Replied by mrsb04 on topic Eltombopag and cough
Interestingly my finger nails have grown quicker since using Eltrombopag. A desirable drug side effect, that's a new concept !!
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