Managing Drug Interactions of Alvaiz

Written by Michelle Vermeulen, PharmD
Medically Reviewed by Beth Johnston, BCPS, PharmD on September 10, 2026

Alvaiz (eltrombopag) is a thrombopoietin receptor agonist used to raise platelet counts in people with persistent or chronic immune thrombocytopenia (ITP). Like many medicines, it can interact with certain other medicines, supplements, and foods — meaning these can change how well Alvaiz works or raise the risk of side effects. This article covers the possible drug interactions with Alvaiz, along with tips for managing them.

This isn't a complete list of every possible interaction. Tell your health care provider and pharmacist about everything you take, including prescription medicines, over-the-counter (OTC) products, vitamins, and herbal supplements so they can check for interactions specific to your situation.

Alvaiz can bind to certain minerals in your gut through a process called chelation. This can significantly lower how much of the medicine your body absorbs. In one study, taking Alvaiz with a calcium-containing antacid lowered the level of eltrombopag in the blood by about 70%.

This applies to products containing calcium, iron, aluminum, magnesium, selenium, or zinc, including:

  • Antacids used for heartburn or upset stomach, such as those containing calcium carbonate or aluminum hydroxide
  • Calcium supplements
  • Iron supplements
  • Multivitamins or mineral supplements
  • Calcium-rich foods, such as dairy products, calcium-fortified juices, and certain fruits and vegetables

To avoid this interaction, take Alvaiz at least two hours before or four hours after any of these products. If you take a daily multivitamin or a calcium supplement, plan the timing of both around your Alvaiz dose so you don't accidentally take them too close together.

Alvaiz can raise the levels of certain statin medicines in your body by affecting a transport system your body uses to clear them. Higher statin levels can raise your risk of statin side effects, including muscle pain or weakness. In one study, taking Alvaiz with rosuvastatin increased the amount of rosuvastatin in the blood by more than 50%.

Here are some statins that Alvaiz can affect:

If you take Alvaiz along with one of these statins, your health care provider may lower your statin dose or monitor you more closely for side effects such as unexplained muscle pain, tenderness, or weakness. Don't adjust your statin dose on your own; let your health care provider decide.

Beyond statins, Alvaiz can raise the levels of several other medicines that rely on the same transport systems in the body (called OATP1B1 and BCRP) to move through your liver and other organs. Examples include:

  • The diabetes medicine glyburide
  • Blood pressure medicines such as bosentan, olmesartan, and valsartan
  • The cholesterol medicine ezetimibe
  • The antibiotic rifampin
  • Certain cancer medicines, including imatinib, irinotecan, lapatinib, methotrexate, mitoxantrone, sulfasalazine, and topotecan

If you take Alvaiz with one of these medicines, your health care provider may want to monitor you more closely for signs of increased side effects from that medicine and may adjust its dose if needed. Don't stop or change the dose of any of these medicines on your own; talk to your health care provider first.

If you're taking Alvaiz and also being treated for HIV or hepatitis C, it's important to tell your health care provider. Studies show that Alvaiz doesn't need a dose change when taken with the HIV medicine combination lopinavir and ritonavir, or with the hepatitis C medicines boceprevir or telaprevir. Interactions with other HIV or hepatitis C protease inhibitors haven't been studied, so your health care provider will want to know about any of these medicines you're taking.

The prescribing information for Alvaiz doesn't list a specific interaction with alcohol. However, Alvaiz already carries a risk of liver problems, and heavy alcohol use can also affect your liver. Ask your health care provider how much alcohol, if any, is safe for you while taking Alvaiz, especially if you have any history of liver problems.

Does Alvaiz interact with food or supplements?

Yes. Calcium-rich foods and mineral supplements containing calcium, iron, aluminum, magnesium, selenium, or zinc can lower how much Alvaiz your body absorbs if taken too close together. Take Alvaiz at least two hours before or four hours after these foods or supplements, as described above.

 

Here are a few simple steps that can lower your risk of interactions while taking Alvaiz:

  • Tell your pharmacist and other health care providers about everything you take, including prescription medicines, OTC products, vitamins, and herbal supplements.
  • Ask your health care provider before starting or stopping any medicine or supplement while you're taking Alvaiz.
  • Keep all recommended lab-test and monitoring appointments.
  • Tell your health care provider about any new or worsening symptoms, especially muscle pain, weakness, or signs of a liver problem.

Your health care provider can adjust your treatment plan as needed based on the other medicines you take. Don't change or stop Alvaiz or any other medicine on your own.

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