What is Nplate Uses, warnings & interactions
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Nplate (romiplostim) is an injectable medication that is manufactured by Amgen. It was approved by the FDA in 2008 to increase platelet counts and prevent bleeding if you have a blood disorder called immune thrombocytopenia (ITP). It is typically used after your spleen has been removed or when other medications, such as corticosteroids or immunoglobulins, do not work. Nplate is also used to treat acute radiation syndrome if you have been exposed to high levels of radiation.
If your doctor has prescribed Nplate to you, you may want to know more about what it is and how it works. Here we’ll explain what Nplate is used for, how it works, its side effects, and more.
What is Nplate used for?
Nplate is a thrombopoietin receptor agonist that is used to treat low blood platelet counts (thrombocytopenia) in:
- Adults with immune thrombocytopenia (ITP) who did not respond to corticosteroids, immunoglobulins, or splenectomy.
- Pediatric patients 1 year of age and older with ITP for at least 6 months who did not adequately respond to corticosteroids, immunoglobulins, or splenectomy.
- Adult and pediatric patients who have been exposed to high doses of radiation to increase their survival rate.
How does Nplate work?
Nplate is a thrombopoietin receptor agonist that works the same way as the hormone thrombopoietin, which helps with platelet production. Platelets help your body form clots to prevent excessive bleeding. Nplate is given to increase your platelet levels and reduce your risk of bleeding if you have a condition where your immune system attacks your platelets (immune thrombocytopenia). It is also used to increase platelet production if you have been exposed to high levels of radiation.
What are the most commonly prescribed doses of Nplate?
Nplate is available as a lyophilized powder for injection in strengths of 125 mcg, 250 mcg, or 500 mcg.
Before taking Nplate
Before taking Nplate, tell your healthcare provider about your medical conditions, including if you:
- Have had your spleen removed (splenectomy)
- Have bone marrow problems such as blood cancer or myelodysplastic syndromes (MDS)
- Have a history of blood clots
- Have chronic liver disease
- Have bleeding problems
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Nplate
- Read the Patient Information, Instructions for Use, and Medication Guide that comes with Nplate.
- Nplate is typically given as an injection under the skin by your doctor once a week when treating ITP. It is given as a one-time injection under the skin when treating exposure to high levels of radiation.
- Your doctor will perform blood tests to monitor your platelet counts each week and change your dose of Nplate if needed. After discontinuing Nplate, you will have blood tests for at least 2 weeks to make sure your platelet levels do not drop too low.
- Notify your doctor if you develop any unusual bruising or bleeding while on Nplate.
- If you miss a dose of Nplate, call your doctor to reschedule immediately.
You should not use Nplate if you have a known hypersensitivity to romiplostim or any inactive ingredients in its formulation.
- There is an increased risk of acute myelogenous leukemia (AML) in patients with myelodysplastic syndromes (MDS).
- Blood clots in the liver have been reported with the use of Nplate in patients with chronic liver disease.
What drugs should not be taken with Nplate?
When Nplate is taken with other medications, it may change how they work or increase the frequency and severity of side effects. You should ask your doctor if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may cause drug interactions with Nplate.
What are some possible side effects of Nplate?
The most common side effects of Nplate seen in clinical trials when compared to placebo include:
- Joint pain
- Stomach pain
- Trouble sleeping
- Muscle pain
- Shoulder pain
- Inflammation of the sinuses (sinusitis)
- Injection site reactions
- Mouth or throat pain
- Upper respiratory tract infections
Nplate can sometimes cause more serious side effects, including:
- Severe, life-threatening allergic reactions (hives, swelling of your face or throat, and trouble breathing)
- Progression from myelodysplastic syndromes (MDS) to acute myelogenous leukemia (AML)
- Increased risk of bleeding when Nplate therapy is discontinued
- Bone marrow fibrosis (reticulin)
- Increased risk of thrombosis (blood clots), stroke, and heart attacks
Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Nplate. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your doctor can prescribe other medications if Nplate is not right for you. Some alternative FDA-approved options include:
- Neupogen (filgrastim)
- Aranesp (darbepoetin alfa)
- Promacta (eltrombopag)
- Mulpleta (lusutrombopag)
- Doptelet (avatrombopag)
Can you take Nplate while you are pregnant or breastfeeding?
Based on animal reproduction studies, fetal harm may occur when Nplate is given to pregnant females. While there is no information available on whether Nplate is found in breast milk, breastfeeding is not recommended while on this medication. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
How long can you stay on Nplate?
Nplate is given as a once-weekly subcutaneous injection when treating ITP. It should be stopped after 4 weeks of treatment at the maximum dose of 10 mcg/kg a week if your platelet levels do not increase enough to prevent bleeding.
Is Nplate a chemotherapy drug?
No, Nplate is not a type of chemotherapy. It is a prescription medication used to treat low platelet counts and reduce the risk of bleeding in people with chronic immune thrombocytopenic purpura (ITP).
How long does it take for Nplate to work?
While results will vary between patients, a single dose of Nplate increased platelet counts over a 2-3 week period, according to the results of clinical studies.
How much does Nplate cost?
Currently, there is no generic Nplate available on the market. The average cost of 4 vials of Nplate 500 mcg is over $28,000. However, you can save on brand-name drugs like Nplate through NiceRx if eligible for assistance.