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Avatrombopag Dosage

Medically reviewed by Drugs.com. Last updated on Jul 5, 2019.

Applies to the following strengths: 20 mg

Usual Adult Dose for Thrombocytopenia

Chronic Liver Disease:
Platelet count less than 40 x 10(9)/L: 60 mg orally once a day starting 10 to 13 days prior to the scheduled procedure
Platelet count 40 to less than 50 x 10(9)/L: 40 mg orally once a day starting 10 to 13 days prior to the scheduled procedure

Duration of therapy: 5 days

Comments:
-Patients should undergo their procedure 5 to 8 days after the last dose of this drug.
-Do not use this drug to normalize platelet counts.

Use: Treatment of thrombocytopenia in patients with chronic liver disease who are scheduled to undergo a procedure.

Chronic Immune Thrombocytopenia:
Initial dose: 20 mg orally once a day with food

Dose adjustments:
-Platelet count less than 50 x 10(9)/L after at least 2 weeks of treatment with this drug: Increase one dose level and wait 2 weeks to assess the effects of this regimen and any subsequent dose adjustments.
-Platelet count between 200 and 400 x 10(9)/L: Decrease one dose level and wait 2 weeks to assess the effects of this regimen and any subsequent dose adjustments.
-Platelet count greater than 400 x 10(9)/L: Stop this drug and increase platelet monitoring to twice a week. When platelet count is less than 150 x 10(9)/L, decrease one dose level and reinitiate therapy.
-Platelet count less than 50 x 10(9)/L after 4 weeks at 40 mg once a day: Discontinue this drug.
-Platelet count greater than 400 x 10(9)/L after 2 weeks at 20 mg once a week: Discontinue this drug.

Dose levels for titration:
-Dose level 6: 40 mg once a day
-Dose level 5: 40 mg three times a week AND 20 mg on the four remaining days of each week
-Dose level 4: 20 mg once a day
-Dose level 3: 20 mg three times a week
-Dose level 2: 20 mg twice a week OR 40 mg once a week
-Dose level 1: 20 mg once a week

Maximum dose: 40 mg/day

Comments:
-Use the lowest dose needed 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.
-Do not use this drug to normalize platelet counts.

Use: Treatment of thrombocytopenia in patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

This drug should not be administered to normalize platelet counts.

Dose Adjustments

Chronic Immune Thrombocytopenia:
Concomitant moderate or strong dual inhibitors of CYP450 2C9 and 3A4: Initial dose: 20 mg orally 3 times a week
Concomitant moderate or strong dual inducers of CYP450 2C9 and 3A4: Initial dose: 40 mg orally once a day

Precautions

CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Administer with food.
-In case of a missed dose, the next dose should be administered as soon as possible; do not administer two doses at one time to make up for a missed dose. The next regularly scheduled dose should be administered at the usual time the next day.

Monitoring:
-Hematologic: Platelet count (chronic liver disease: prior to starting this drug and on the day of a procedure; chronic immune thrombocytopenia: weekly until a stable platelet count greater than or equal to 50 x 10(9)/L has been achieved, monthly thereafter, and weekly for at least 4 weeks following discontinuation)

Patient advice:
-Advise women not to breastfeed during treatment with this drug and for at least 2 weeks after the final dose.
-Advise pregnant women of the potential risk to a fetus.
-Advise females of reproductive potential to inform their prescriber of a known or suspected pregnancy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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