Romiplostim

Romiplostim is a thrombopoietin receptor agonist (TPO-RA) used to treat low platelet counts (thrombocytopenia). It works by stimulating the production of platelets in the bone marrow, reducing the risk of bleeding in patients with specific conditions.

Indications

-Chronic immune thrombocytopenia (ITP) in adults and children who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. -Not indicated for the treatment of thrombocytopenia due to other causes such as myelodysplastic syndrome (MDS) or chemotherapy-induced thrombocytopenia.

Dosage

-Adult Starting Dose: 1 mcg/kg subcutaneously once weekly, adjusted based on platelet response. -Pediatric Starting Dose: 1 mcg/kg subcutaneously once weekly, adjusted based on platelet response.

Contra-Indications

-Hypersensitivity to romiplostim or any excipient in the formulation. -Conditions involving excessive clotting or a history of thrombosis.

Special Precautions

-Risk of thromboembolic complications; monitor platelet counts closely. -Potential for bone marrow fibrosis with long-term use; regular monitoring recommended. -Use cautiously in patients with hepatic or renal impairment. -Not for use in patients with underlying conditions causing thrombocytopenia unrelated to ITP. -Avoid abrupt discontinuation to prevent sudden drop in platelet count.

Side Effects

-Common: Headache, fatigue, dizziness, joint pain, muscle pain, and abdominal discomfort. -Serious: Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism), bone marrow fibrosis, hypersensitivity reactions. -Rare: Worsening of blood disorders or splenic rupture.

Drug Interactions

-Concomitant use with anticoagulants or antiplatelet drugs increases bleeding risk. -Avoid simultaneous use with other thrombopoietin receptor agonists to prevent excessive platelet production. No significant CYP450 interactions reported.