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Avatrombopag

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Indications

Avatrombopag is used for thrombocytopenia in adults with chronic liver disease (CLD) who are scheduled to undergo a procedure. It is also used for thrombocytopenia in people with chronic immune thrombocytopenia (ITP). Treatment of thrombocytopenia in patients with chronic liver disease (CLD): the medicine is indicated for adult patients with chronic liver disease who are scheduled to undergo a procedure. Treatment of thrombocytopenia in patients with chronic immune thrombocytopenia (ITP): avatrombopag is indicated for adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Mechanism of Action

Avatrombopag is a small molecule TPO receptor agonist, and it is well absorbed when taken by mouth. It stimulates bone marrow progenitor cells to multiply and mature into megakaryocytes, so the body makes more platelets. It does not compete with TPO for binding to the TPO receptor, and its effect on platelet production adds to the effect of TPO.

Pharmacodynamics: Platelet Response

In adults, avatrombopag raised platelet counts, and the rise depended on both the dose and the exposure. The count began to go up within 3 to 5 days of the start of a 5-day treatment course, and the peak came after 10 to 13 days. After that, platelet counts fell gradually and returned to near baseline values after 35 days.

Pharmacodynamics: Cardiac Electrophysiology

At exposures similar to those reached with the 40 mg and 60 mg doses, it did not prolong the QT interval to any clinically relevant extent. Data from the pooled clinical trials in patients were analysed, and based on that, mean QTc prolongation effects of more than 20 ms are not anticipated with the highest recommended therapeutic dosing regimen.

Pregnancy & Breastfeeding

Pregnancy

Animal reproduction studies suggest that Avatrombopag may cause harm to the fetus when a pregnant woman takes it. There isn't enough data on Avatrombopag in pregnant women to say whether it carries a risk of adverse developmental outcomes. Pregnant women should be told about the possible risk to the fetus.

Lactation

Nothing is known about whether Avatrombopag passes into human milk, what effect it has on a breastfed child, or what effect it has on milk production. Because Avatrombopag could cause serious adverse reactions in a breastfed child, breastfeeding is not recommended during treatment and for at least 2 weeks after the last dose.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Recommended dosage for patients with chronic liver disease The recommended dose and duration for patients with chronic liver disease who are scheduled to undergo a procedure depend on the platelet count. If the count is less than 40X109/L, the dose is 60 mg (3 tablets) for 5 days. If it is 40 to less than 50X109/L, the dose is 40 mg (2 tablets) for 5 days. Recommended dosage for patients with chronic immune thrombocytopenia For the initial dose regimen, begin Avatrombopag at a starting dose of 20mg (1tablet) once daily with food. Dose adjustments for patients with chronic immune thrombocytopenia are based on the platelet count. If it is less than 50 x 109/L after at least 2 weeks of Avatrombopag, increase one dose level. Then wait 2 weeks to assess the effects of this regimen and any later dose adjustments. If the count is between 200 and 400 x 109/L, decrease one dose level, and again wait 2 weeks to assess the effects of this regimen and any later dose adjustments. If the count is greater than 400 x 109/L, stop Avatrombopag and increase platelet monitoring to twice weekly. When the platelet count falls below 150 x10 9 /L, decrease one dose level per Table 3 and restart therapy. Stop Avatrombopag if the count is still less than 50 x 109/L after 4 weeks of Avatrombopag 40 mg once daily. Stop it as well if the count is greater than 400 x 109/L after 2 weeks of Avatrombopag 20 mg weekly. Or, as directed by the registered physician.