Generic Name and Formulations:
Romiplostim (recombinant) 250mcg, 500mcg; per vial; lyophilized pwd for SC inj after reconstitution; contains sucrose and mannitol; preservative-free.
Indications for NPLATE:
Treatment of thrombocytopenia in patients with chronic immune thrombocytopenia (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.
Give by SC inj. To reduce risk of bleeding: use lowest effective dose to achieve and maintain platelets ≥50x109/L. ≥18yrs: initially: 1mcg/kg weekly; may increase by 1mcg/kg if platelets <50x109/L; max: 10mcg/kg weekly. May reduce by 1mcg/kg if platelets >200x109/L for 2 consecutive weeks. Do not dose if platelets >400x109/L; resume Nplate at a dose reduced by 1mcg/kg when platelets fall to <200x109/L. Discontinue if platelets have not increased after 4 weeks at max dose.
<18yrs: not established.
Not for normalization of platelet counts or to treat thrombocytopenia due to MDS or any cause of thrombocytopenia other than chronic ITP. Risk of progression from MDS to acute myelogenous leukemia. Worsened thrombocytopenia and bleeding risk may develop after discontinuation. Monitor CBCs with platelets weekly during dose adjustments then monthly after achieving stable dose; and weekly for at least 2wks after discontinuation of therapy. Monitor after initial response for formation of neutralizing antibodies. Renal or hepatic impairment: not studied. Pregnancy (Cat.C). Nursing mothers: not recommended.
May increase bleeding risk with anticoagulants or antiplatelet agents.
Thrombopoietin receptor agonist.
Arthralgia, dizziness, insomnia, myalgia, pain in extremity, abdominal pain, shoulder pain, dyspepsia, paresthesia, headaches; bone marrow reticulin formation, thrombotic/thromboembolic complications (eg, portal vein thrombosis in chronic liver disease).
To enroll pregnant patients in Amgen's Pregnancy Surveillance program, call (800) 772-6436.
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Triiodothyronine in the Treatment of Bipolar Depression
- Antidepressants Increase Seizure Risk in Youth and Severely Depressed
- Intranasal Oxytocin Reduces Negative Effects, Improves Cognitive Function in Schizophrenia
- E-Cigarettes Associated With More Harms Than Benefits at Population Level
- Examining Rates of Long-Term Opioid Use in Youth With Psychiatric Disorders
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Researchers Identify Novel Potential Biomarkers for Autism
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Supported Employment vs Transitional Work in Veterans With PTSD
- Comparing Pharmacologic Treatments for Prevention of Rehospitalization in BP
- Preliminary Evidence Suggests Suicidal Thinking Is Self-Reinforcing
- Lower Fluoxetine Efficacy in Elderly Patients With Major Depressive Disorder
- Personal Health Information Found in Recycling