Formulary
Romiplostim: Indications, Dosing, Side Effects and Interactions
Romiplostim is an Fc-peptide fusion protein that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production.
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Romiplostim: Indications, Dosing, Side Effects and Interactions
Romiplostim is an Fc-peptide fusion protein that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production.
Drug action
Romiplostim is an Fc-peptide fusion protein that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production.
Indications and dose
**Chronic immune (idiopathic) thrombocytopenic purpura in patients refractory to other treatments (such as corticosteroids or immunoglobulins) (under expert supervision)**
- **Adult** (By Subcutaneous Injection): Initially 1 microgram/kg once weekly, adjusted in steps of 1 microgram/kg once weekly (max. per dose 10 micrograms/kg once weekly) until a stable platelet count of 50x10 9 /litre or more is reached, consult product literature for further details of dose adjustments, discontinue treatment if inadequate response after 4 weeks at maximum dose.
**Chronic immune (idiopathic) thrombocytopenic purpura in patients refractory to other treatments (such as corticosteroids or immunoglobulins) (under expert supervision) for romiplostim**
- **Child 1-17 years** (By subcutaneous injection): Initially 1 microgram/kg once weekly, adjusted in steps of 1 microgram/kg once weekly (max. per dose 10 micrograms/kg once weekly) until a stable platelet count of 50x109 /litre or more is reached, consult product literature for further details of dose adjustments; reassess bodyweight every 12 weeks, discontinue treatment if inadequate response after 4 weeks at maximum dose.
Cautions
Risk factors for thromboembolism
Side effects
Common or very common Anaemia; angioedema; arthralgia; asthenia; bone marrow disorders; chills; constipation; diarrhoea; dizziness; embolism and thrombosis; fever; flushing; gastrointestinal discomfort; headaches; hypersensitivity; increased risk of infection; influenza like illness; muscle complaints; nausea; pain; palpitations; peripheral oedema; sensation abnormal; skin reactions; sleep disorders Uncommon Alopecia; appetite decreased; chest pain; clonus; cough; dehydration; depression; dry throat; dysphagia; dyspnoea; erythromelalgia; eye disorders; eye pruritus; feeling hot; feeling jittery; gastrooesophageal reflux disease; gout; haemorrhage; hair growth abnormal; hypotension; irritability; leucocytosis; malaise; muscle weakness; myocardial infarction; nasal complaints; neoplasms; oral disorders; papilloedema; peripheral ischaemia; peripheral neuropathy; photosensitivity reaction; pleuritic pain; portal vein thrombosis; skin nodule; splenomegaly; taste altered; thrombocytosis; tooth discolouration; vertigo; vision disorders; vomiting; weight changes
Interactions
**Other interactions (4):**
- The potential interactions of romiplostim with coadministered medicinal products due to binding to plasma proteins remain unknown.
- Medicinal products used in the treatment of ITP in combination with romiplostim in clinical trials included corticosteroids, danazol, and/or azathioprine, intravenous immunoglobulin (IVIG), and...
- Platelet counts should be monitored when combining romiplostim with other medicinal products for the treatment of ITP in order to avoid platelet counts outside of the recommended range (see section...
- Corticosteroids, danazol, and azathioprine use may be reduced or discontinued when given in combination with romiplostim (see section 5.1).
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises caution; consider avoiding in moderate to severe impairment (risk of thromboembolic complications).
Renal impairment
Manufacturer advises caution-no information available.
Medicinal forms
Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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