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Avatrombopag: Brands, Price & Uses in Bangladesh
Avatrombopag is indicated for the treatment of thrombocytopenia in patients scheduled to undergo a procedure and more.
About Avatrombopag
Indications of Avatrombopag
Avatrombopag is indicated for the treatment of thrombocytopenia in patients scheduled to undergo a procedure, and for the treatment of chronic immune thrombocytopenia (ITP) in patients who have had an insufficient response to a previous treatment.
Established / FDA-approved uses
- Chronic liver disease (CLD) with thrombocytopenia, prior to a scheduled procedure: Avatrombopag is used short-term (a 5-day course) in adults with chronic liver disease to raise platelet counts high enough to safely undergo a planned invasive or surgical procedure.
- Chronic immune thrombocytopenia (ITP) in adults: Avatrombopag is used for adults with chronic ITP who have had an insufficient response to a previous therapy (e.g., corticosteroids, immunoglobulins, splenectomy).
- Chronic/persistent ITP in children 1 year of age and older: Avatrombopag is also approved for pediatric patients with persistent or chronic ITP who have had an insufficient response to a previous treatment; see Pediatric Uses.
Avatrombopag does not address the underlying cause of thrombocytopenia. It is intended to be used as part of a broader treatment plan, under the supervision of a specialist (hepatologist for chronic liver disease, or hematologist for ITP).
Dosage & Administration of Avatrombopag
Dosing of Avatrombopag differs substantially by indication and must be individualized to the patient's baseline platelet count and treatment goal. The lowest dose needed to achieve the desired platelet count for the intended purpose should be used - the goal is not to normalize the platelet count.
Chronic liver disease (CLD), prior to a scheduled procedure
| Baseline platelet count | Avatrombopag dose | Duration |
|---|---|---|
| Less than 40 x 10^9/L | 60 mg once daily | 5 consecutive days |
| 40 to less than 50 x 10^9/L | 40 mg once daily | 5 consecutive days |
Dosing should begin 10 to 13 days before the scheduled procedure, with the procedure performed 5 to 8 days after the last dose. Platelet count should be checked on the day of, or immediately before, the procedure. This regimen is not intended for patients with chronic ITP.
Chronic immune thrombocytopenia (ITP) - adults
Starting dose: 20 mg once daily. The dose is titrated in 20 mg increments/decrements (maximum 40 mg once daily) at intervals of at least 2 weeks, based on platelet count response, aiming for a platelet count sufficient to reduce bleeding risk (generally at or above 50 x 10^9/L) rather than a normal count. If an adequate response is not seen after 2 weeks at the maximum dose, discontinue Avatrombopag.
Chronic/persistent ITP - pediatric patients (1 year and older)
| Age group | Formulation | Starting dose | Maximum dose |
|---|---|---|---|
| 1 to less than 6 years | Oral granules (sprinkle) | 10 mg once daily | 20 mg once daily |
| 6 years and older | Tablet or granules | 20 mg once daily | 40 mg once daily |
Doses are titrated based on platelet count response at intervals of at least 2 weeks. See Pediatric Uses for further detail.
Administration instructions
Avatrombopag must be taken with food; taking it on an empty stomach substantially reduces absorption. Tablets should be swallowed whole. Oral granules should be sprinkled onto a small amount (one tablespoon) of soft food (e.g., pudding, yogurt, applesauce) or mixed into a small amount of water or milk immediately before administration and consumed within a short period - do not prepare in advance.
Missed dose
If a dose is missed, it may be taken the same day once remembered; the patient should not double the dose the next day to make up for a missed one.
Renal and hepatic dose adjustment
No dose adjustment is required based on renal impairment or hepatic impairment (avatrombopag has been studied specifically in patients with chronic liver disease, including more advanced Child-Pugh classes, for the CLD indication).
Side Effects of Avatrombopag
Chronic liver disease (short 5-day course before a procedure)
Most common: pyrexia (fever), abdominal pain, nausea/vomiting, headache, fatigue, and peripheral edema.
Chronic ITP - adults
Most common: headache, fatigue, contusion (bruising), epistaxis (nosebleed), petechiae, myalgia (muscle pain), and upper respiratory tract infection.
Chronic/persistent ITP - pediatric patients
Most common: viral infection, pyrexia, cough, oropharyngeal pain (sore throat), upper respiratory tract infection, and vomiting.
Serious adverse effects
With Avatrombopag, thrombotic/thromboembolic events (see Precautions and Warnings) and hepatic decompensation in patients with chronic liver disease have been reported; seek prompt medical attention for symptoms such as leg swelling/pain, chest pain, shortness of breath, or worsening confusion/jaundice.
Contraindications of Avatrombopag
Avatrombopag is contraindicated in patients with known hypersensitivity to avatrombopag or to any component of the formulation.
Frequently Asked Questions about Avatrombopag
What is Avatrombopag used for?
Avatrombopag is used to raise platelet counts in adults with chronic liver disease who are about to undergo a scheduled procedure, and in adults and children 1 year and older with chronic immune thrombocytopenia (ITP) who have not responded well enough to a previous treatment.
Why must Avatrombopag be taken with food?
Food increases the absorption of Avatrombopag into the bloodstream. Taking it on an empty stomach can significantly reduce how much medicine is absorbed, which may make it less effective, so it should always be taken with a meal.
Is Avatrombopag safe during pregnancy?
Avatrombopag has not been well studied in pregnant women, and animal studies have shown it can affect the fetus at doses relevant to human use. It should be used in pregnancy only if a physician decides the benefit clearly outweighs the potential risk, and pregnant patients should discuss this carefully with their doctor.
What is the most important risk to know about with Avatrombopag?
The most important risk is of blood clots (thrombotic or thromboembolic events), including clots in the portal vein of the liver, particularly in people with chronic liver disease. To reduce this risk, doctors aim for a platelet count that is high enough to be safe rather than a completely normal count, and patients should report leg swelling, chest pain, or shortness of breath immediately.
Can I stop taking Avatrombopag suddenly?
Avatrombopag should only be stopped under a doctor's guidance. After stopping, platelet counts can fall - sometimes below the level they were before treatment - which can increase bleeding risk, so doctors typically monitor platelet counts weekly for several weeks after discontinuation.
What should I do if I take too much Avatrombopag?
If an overdose of Avatrombopag is suspected, seek immediate medical attention or contact a poison control center right away, since an excessive rise in platelet count can increase the risk of blood clots.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.