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Brand name (Generic drug name)

REVOLADE

Active Ingredient: eltrombopag olamine

Drug Class: Thrombopoietin Receptor Agonists

This drug is no longer covered on the Reformulary. There is a generic version of this drug covered on the Reformulary. The generic version requires Special Authorization.

You and your doctor need to fill out and submit a Special Authorization form in order to be considered for coverage.  You can download the form from your insurer/plan administrator website.

REVOLADE is used to treat  
Hepatitis C
Immune thrombocytopenia (ITP)