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Nplate

Generic Name: romiplostim (ROM i PLOS tim)
Brand Names: Nplate

What is Nplate?

Nplate (romiplostim) is a man-made form of a protein that increases production of platelets (blood-clotting cells) in your body.

Nplate is used to prevent bleeding episodes in people with chronic immune thrombocytopenic purpura (ITP), a bleeding condition caused by a lack of platelets in the blood.

Nplate is usually given after other medications have been tried without successful treatment of symptoms.

Nplate is not a cure for ITP and it will not make your platelet counts normal if you have this condition.

Important information

Nplate is available only under a special program called Nplate NEXUS. You must be registered in the program and sign documents stating that you understand the risks and benefits of taking this medication.

Nplate is not a cure for ITP and it will not make your platelet counts normal if you have this condition.

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Before you use Nplate, tell your doctor if you have kidney or liver disease.

Using Nplate long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders. To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often. Do not miss any scheduled visits to your doctor.

It may take up to 4 weeks of using this medicine before it is completely effective in preventing bleeding episodes. Talk with your doctor if you have any bruising or bleeding episodes after 4 weeks of treatment.

After you stop using Nplate, your risk of bleeding may be even higher than it was before you started treatment. Be extra careful to avoid cuts or injury for at least 2 weeks after you stop using Nplate. Your blood will need to be tested weekly during this time.

Before receiving this medicine

You should not use Nplate if you are allergic to romiplostim.

Using Nplate may increase your risk of developing blood cancers, especially if you have a myelodysplastic syndrome (bone marrow failure disorder, sometimes called "preleukemia"). Talk with your doctor if you have concerns about this risk.

To make sure Nplate is safe for you, tell your doctor if you have:

  • blood or bone marrow cancer such as leukemia, or myelodysplastic syndrome;

  • liver disease; or

  • a history of bleeding problems or a blood clot.

It is not known whether Nplate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of romiplostim on the baby.

It is not known whether romiplostim passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How is Nplate given?

Nplate is injected under the skin, usually once per week. A healthcare provider will give you this injection.

While using Nplate, you will need frequent blood tests.

Using Nplate long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders. To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often.

It may take up to 4 weeks of before Nplate is completely effective in preventing bleeding episodes. For best results, keep receiving the medication as directed. Talk with your doctor if you have any bruising or bleeding episodes after 4 weeks of treatment.

After you stop using romiplostim, your risk of bleeding may be even higher than it was before you started treatment. Be extra careful to avoid cuts or injury for at least 2 weeks after you stop using romiplostim. Your blood will need to be tested weekly during this time.

Nplate dosing information

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura:

Initial dose: 1 mcg/kg subcutaneous injection based on actual body weight.

Use the lowest dose of romiplostim to achieve and maintain a platelet count greater than or equal to 50 x 10^9/L as necessary to reduce the risk for bleeding. Administer romiplostim as a weekly subcutaneous injection with dose adjustments based upon the platelet count response. Romiplostim should not be used in an attempt to normalize platelet counts.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Nplate injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose can cause signs of a blood clot, including sudden numbness or weakness, problems with vision or speech, chest pain, or pain and swelling in one or both legs.

What should I avoid while receiving Nplate?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Nplate side effects

Get emergency medical help if you have signs of an allergic reaction to Nplate: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

  • signs of a blood clot in the lung - chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or

  • signs of a blood clot in your leg - pain, swelling, warmth, or redness in one or both legs.

Common Nplate side effects may include:

  • headache;

  • dizziness;

  • muscle or joint pain;

  • pain in your arms, legs, or shoulder;

  • numbness or tingly feeling;

  • sleep problems (insomnia); or

  • stomach pain or indigestion.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Nplate?

Other drugs may interact with romiplostim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Nplate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Nplate only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2015 Cerner Multum, Inc. Version: 4.01. Revision Date: 2015-08-03, 8:07:25 AM.

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