Avatrombopag is a '''thrombopoietin receptor agonist'''.
[[File:Avatrombopag.svg|Chemical structure of Avatrombopag|thumb|right]]
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'''Avatrombopag''' is a medication used primarily to treat [[thrombocytopenia]], a condition characterized by abnormally low levels of [[platelets]] in the blood. It is particularly used in patients with chronic [[liver disease]] who are scheduled to undergo a medical or dental procedure, as well as in patients with chronic [[immune thrombocytopenic purpura]] (ITP).
Avatrombopag is a [[thrombopoietin receptor agonist]]. It works by stimulating the production of platelets in the bone marrow. The drug binds to the thrombopoietin receptor on the surface of [[megakaryocytes]] and their precursors, promoting their proliferation and differentiation into platelets. This mechanism helps increase platelet counts in patients with thrombocytopenia.
*This medication is indicated for the treatment of [[thrombocytopenia]] in adult patients with chronic liver disease who are scheduled to undergo a procedure or with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.
=== Clinical Use ===
Avatrombopag is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure. It is also used in adult patients with chronic immune thrombocytopenic purpura who have had an insufficient response to previous treatment.
=='''How does this medicine work?'''==
=== Administration ===
Avatrombopag is administered orally. The dosage and duration of treatment depend on the specific condition being treated and the patient's platelet count. It is important for patients to follow their healthcare provider's instructions regarding dosage and administration.
*Avatrombopag is an orally bioavailable, small molecule [[thrombopoietin receptor gene|thrombopoietin (TPO) receptor]] agonist that results in an increased production of platelets.
=== Side Effects ===
*This medication does not compete with TPO for binding to the TPO receptor and has an additive effect with TPO on platelet production.
Common side effects of avatrombopag include headache, fatigue, and nausea. Serious side effects may include thromboembolic events, such as [[deep vein thrombosis]] or [[pulmonary embolism]]. Patients should be monitored for signs of increased platelet counts and potential thrombotic complications.
=='''Who should not use this medicine?'''==
=== Pharmacokinetics ===
Avatrombopag is absorbed in the gastrointestinal tract and reaches peak plasma concentrations approximately 3 to 6 hours after administration. It is metabolized primarily in the liver and excreted in the feces. The half-life of avatrombopag is approximately 19 hours, allowing for once-daily dosing.
This medicine cannot be used for:
=== Development and Approval ===
Avatrombopag was developed by [[Eisai Co., Ltd.]], a Japanese pharmaceutical company. It was approved by the [[U.S. Food and Drug Administration]] (FDA) in 2018 for the treatment of thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure. It was later approved for use in patients with chronic immune thrombocytopenic purpura.
*Patients with [[chronic liver disease]] in an attempt to normalize platelet counts.
== Related Pages ==
*Patients with chronic immune thrombocytopenia in an attempt to normalize platelet counts.
* [[Thrombocytopenia]]
* [[Thrombopoietin receptor agonist]]
=='''Is this medicine FDA approved?'''==
* [[Chronic liver disease]]
* [[Immune thrombocytopenic purpura]]
*Avatrombopag was approved for use in the United States in 2018.
=='''How should this medicine be administered?'''==
For patients with chronic liver disease:
*Begin DOPTELET dosing based upon platelet count 10 to 13 days prior to the scheduled procedure.
*Take DOPTELET orally once daily for 5 consecutive days with food.
*For platelet count less than 40x10<sup>9</sup>/L, the dose is 60 mg (3 tablets) once daily; for platelet count 40 to less than 50x10<sup>9</sup>/L the dose is 40 mg (2 tablets) once daily.
*In the case of a missed dose, patients should take the next dose of DOPTELET as soon as they remember. Patients should not take two doses at one time to make up for a missed dose, and should take the next dose at the usual time the next day; all 5 days of dosing should be completed.
For patients with chronic immune thrombocytopenia:
*Initiate DOPTELET at 20 mg (1 tablet) once daily.
*Adjust the dose or frequency of dosing to maintain platelet count greater than or equal to 50x10<sup>9</sup>/L.
*Do not exceed 40 mg per day.
=='''What are the dosage forms and brand names of this medicine?'''==
This medicine is available in the following dosage form:
*20 mg tablets
This medicine is available in the following brand nameː '''DOPTELET'''
=='''What side effects can this medication cause?'''==
Common possible side effects of this medicine when used to treat low blood platelet counts in adults with chronic liver disease(CLD) who are scheduled to have a medical or dental procedure include:
*[[fever]]
*[[headache]]
*[[stomach pain]]
*[[tiredness]]
*[[nausea]]
*[[swelling of hands]] or [[feet]]
Common possible side effects of this medicine when used to treat low blood platelet counts in adults with chronic immune thrombocytopenia (ITP) include:
*[[headache]]
*[[joint pain]]
*[[tiredness]]
*[[bleeding gums]]
*[[bruising]]
*purple or red spots on your skin
*[[nosebleed]]
*[[runny nose]]
*[[upper respiratory tract infection]]
Serious possible side effects of this medicine include blood clots and may cause symptoms such as:
*[[swelling]], [[pain]], or [[tenderness]] in your legs
*[[fast heartbeat]]
*[[shortness of breath]]
*[[stomach pain]] or [[tenderness]]
*[[chest pain]]
=='''What special precautions should I follow?'''==
*Follow the dosing guidelines to achieve target platelet counts.
*DOPTELET is a thrombopoietin (TPO) receptor agonist, which is associated with thrombotic and thromboembolic complications in patients with chronic liver disease or chronic immune thrombocytopenia.
*Monitor patients receiving DOPTELET for signs and symptoms of thromboembolic events and institute treatment promptly.
=='''What to do in case of emergency/overdose?'''==
*In the event of overdose, platelet count may increase excessively and result in thrombotic or [[thromboembolic event|thromboembolic complications]]. Closely monitor symptoms and platelet count. Treat thrombotic complications in accordance with standard of care.
*No antidote for DOPTELET overdose is known.
=='''Can this medicine be used in pregnancy?'''==
*Avatrombopag may cause fetal harm when administered to a pregnant woman.
=='''Can this medicine be used in children?'''==
*The safety and effectiveness of Avatrombopag in pediatric patients have not been established.
=='''What should I know about storage of this medication? '''==
*Store at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F).
*Store tablets in the original package.
=='''What are the active and inactive ingredients in this medicine?'''==
Avatrombopag is a medication used primarily to treat thrombocytopenia, a condition characterized by abnormally low levels of platelets in the blood. It is particularly used in patients with chronic liver disease who are scheduled to undergo a medical or dental procedure, as well as in patients with chronic immune thrombocytopenic purpura (ITP).
Avatrombopag is a thrombopoietin receptor agonist. It works by stimulating the production of platelets in the bone marrow. The drug binds to the thrombopoietin receptor on the surface of megakaryocytes and their precursors, promoting their proliferation and differentiation into platelets. This mechanism helps increase platelet counts in patients with thrombocytopenia.
Avatrombopag is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure. It is also used in adult patients with chronic immune thrombocytopenic purpura who have had an insufficient response to previous treatment.
Avatrombopag is administered orally. The dosage and duration of treatment depend on the specific condition being treated and the patient's platelet count. It is important for patients to follow their healthcare provider's instructions regarding dosage and administration.
Common side effects of avatrombopag include headache, fatigue, and nausea. Serious side effects may include thromboembolic events, such as deep vein thrombosis or pulmonary embolism. Patients should be monitored for signs of increased platelet counts and potential thrombotic complications.
Avatrombopag is absorbed in the gastrointestinal tract and reaches peak plasma concentrations approximately 3 to 6 hours after administration. It is metabolized primarily in the liver and excreted in the feces. The half-life of avatrombopag is approximately 19 hours, allowing for once-daily dosing.
Avatrombopag was developed by Eisai Co., Ltd., a Japanese pharmaceutical company. It was approved by the U.S. Food and Drug Administration (FDA) in 2018 for the treatment of thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure. It was later approved for use in patients with chronic immune thrombocytopenic purpura.
