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Romiplostim

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

Medically reviewed by Drugs.com on Jan 28, 2019 – Written by Cerner Multum

What is romiplostim?

Romiplostim 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.

Romiplostim is for use in adults and children who are at least 1 year old.

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

Romiplostim is usually given after other treatments have failed.

Romiplostim may also be used for purposes not listed in this medication guide.

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

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

Using romiplostim 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.

Tell your doctor if you have ever had:

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

  • liver disease; or

  • bleeding problems or a blood clot.

It is not known whether romiplostim 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 to track the effects of romiplostim on the baby.

You should not breast-feed while using romiplostim.

How is romiplostim given?

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

Using romiplostim long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders. You will need frequent blood tests.

It may take up to 4 weeks of before romiplostim is completely effective in preventing bleeding episodes. 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.

What happens if I miss a dose?

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

What happens if I overdose?

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

What should I avoid while receiving romiplostim?

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

Romiplostim side effects

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

Call your doctor at once if you have:

  • severe or ongoing diarrhea;

  • purple or red spots under your skin;

  • signs of an ear infection (more common in children)--fever, ear pain or full feeling, trouble hearing, drainage from the ear, fussiness in a child;

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

  • 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--swelling, warmth, or redness in an arm or leg.

Common side effects may include:

  • bruising;

  • headache;

  • dizziness;

  • muscle or joint pain;

  • pain in your arms, legs, or shoulder;

  • numbness, tingling, or swelling in your hands or feet;

  • trouble sleeping;

  • stomach pain, indigestion, diarrhea;

  • eye redness;

  • rash;

  • fever; or

  • cold symptoms such as stuffy nose, sneezing, sinus pain, cough, sore throat.

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.

Romiplostim dosing information

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura:

Initial dose: 1 mcg/kg subcutaneous injection once a week based on actual body weight; adjust the weekly dose by increments of 1 mcg/kg until the patients achieves a platelet count of 50 x 10(9)/L or greater

Maintenance dose: Use the lowest dose to achieve and maintain a platelet count of 50 x 10(9)/L or greater as needed to reduce bleeding risk.

Maximum dose: 10 mcg/kg/week

Duration of therapy: Discontinue this drug if platelets remain insufficient to avoid clinically important bleeding after 4 weeks at the maximum dose.

Comments: In clinical studies, most patients who responded to this drug achieved and maintained platelet counts of 50 x 10(9)/L or greater with a median dose of 2 mcg/kg.

Use: Treatment of thrombocytopenia in patients with chronic immune thrombocytopenia (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy; use only in patients with ITP whose degree of thrombocytopenia and clinical condition increases the risk for bleeding.

Usual Pediatric Dose for Idiopathic (Immune) Thrombocytopenic Purpura:

1 Year or Older:
Initial dose: 1 mcg/kg subcutaneous injection once a week based on actual body weight; adjust the weekly dose by increments of 1 mcg/kg until the patients achieves a platelet count of 50 x 10(9)/L or greater

Maintenance dose: Use the lowest dose to achieve and maintain a platelet count of 50 x 10(9)/L or greater as needed to reduce bleeding risk.

Maximum dose: 10 mcg/kg/week

Comments:
-Dose adjustments are based on changes in platelet counts and changes in body weight. Reassessment of body weight is recommended every 12 weeks.
-In a pediatric placebo-controlled clinical study, the median dose was 5.5 mcg/kg.

Use: Treatment of thrombocytopenia in patients with immune thrombocytopenia (ITP) for at least 6 months who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy; use only in patients with ITP whose degree of thrombocytopenia and clinical condition increases the risk for bleeding.

What other drugs will affect romiplostim?

Other drugs may affect romiplostim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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

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