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Doptelet
avatrombopag
Adult Dosing .
Dosage forms: TAB: 20 mg
Special Note
- [equivalency or interchangeability info]
- Info: Doptelet not interchangeable w/ Doptelet Sprinkle; do not substitute on a mg to mg basis
chronic hepatic dz-associated thrombocytopenia, pre-procedure
- [Plt <40,000]
- Dose: 60 mg PO qd x5 days; Start: 10-13 days before procedure; Info: procedure should start w/in 5-8 days after last dose; give w/ food
- [Plt 40,000-49,000]
- Dose: 40 mg PO qd x5 days; Start: 10-13 days before procedure; Info: procedure should start w/in 5-8 days after last dose; give w/ food
immune thrombocytopenia, chronic
- [20-40 mg po qd]
- Start: 20 mg PO qd; Max: 40 mg qd; Info: for patients w/ insufficient response to prior tx; see pkg insert for dose adjustments based on Plt response; use lowest effective dose to achieve/maintain Plt >50,000; D/C if Plt <50,000 after 4wk at max dose or Plt >400,000 after 2wk at 20 mg qwk; give w/ food
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: TAB: 20 mg
Special Note
- [equivalency or interchangeability info]
- Info: Doptelet not interchangeable w/ Doptelet Sprinkle; do not substitute on a mg to mg basis
immune thrombocytopenia, persistent or chronic
- [6 yo and older]
- Dose: 20-40 mg po qd; Start: 20 mg PO qd; Max: 40 mg qd; Info: for patients w/ insufficient response to prior tx; see pkg insert for dose adjustments based on Plt response; use lowest effective dose to achieve/maintain Plt >50,000; D/C if Plt <50,000 after 4wk at max dose or Plt >400,000 after 2wk at 20 mg qwk; give w/ food
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: breastfeeding during tx and for at least 2wk after D/C
- caution: thromboembolism risk
Drug Interactions .
Overview
avatrombopag
thrombopoietin agonist
- CYP2C9 substrate
- CYP3A4 substrate
- P-gp substrate
- thrombogenic effects
Avoid/Use Alternative
- avatrombopag
- efavirenz
- eltrombopag
- grapefruit
- lopinavir/ritonavir
- lusutrombopag
- romiplostim
- sotorasib
- tranexamic acid
- vaccinia immune globulin
Monitor/Modify Tx
- abemaciclib
- abrocitinib
- adagrasib
- aflibercept
- aminocaproic acid
- amiodarone
- angiotensin II
- anthrax immune globulin
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- apalutamide
- aprepitant
- asciminib
- asparaginase
- atazanavir
- atidarsagene autotemcel
- avacopan
- axitinib
- azithromycin
- baricitinib
- bazedoxifene
- belumosudil
- berotralstat
- bevacizumab
- binimetinib
- bisoprolol
- bosentan
- botulism immune globulin
- brolucizumab
- butalbital
- C1 esterase inhibitor
- cabozantinib
- calaspargase
- cannabidiol
- carbamazepine
- carfilzomib
- carvedilol
- celecoxib
- cenobamate
- ceritinib
- chloramphenicol
- chorionic gonadotropin
- ciprofloxacin
- clarithromycin
- clofazimine
- clozapine
- coagulation factor IX
- coagulation factor VIIa
- coagulation factor XIII A-subunit
- cobicistat
- concizumab
- conivaptan
- crizotinib
- cyclosporine
- cytomegalovirus immune globulin
- dabrafenib
- danazol
- danicopan
- darbepoetin alfa
- darunavir
- deflazacort
- desogestrel (contraceptive)
- deuruxolitinib
- dexamethasone
- diclofenac
- diclofenac topical
- dienogest (contraceptive)
- diflunisal
- diltiazem
- diosmin
- dronedarone
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- duvelisib
- encorafenib
- enzalutamide
- epirubicin
- epoetin alfa
- erythromycin
- estetrol (contraceptive)
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- ethynodiol (contraceptive)
- etodolac
- etonogestrel (contraceptive)
- etravirine
- everolimus
- factor XIII concentrate
- faricimab
- fedratinib
- fenofibrate
- fenofibric acid
- fenoprofen
- fexinidazole
- fitusiran
- flibanserin
- fluconazole
- fluorouracil
- flurbiprofen
- follitropin
- fosamprenavir
- fosphenytoin
- fruquintinib
- glecaprevir
- hepatitis B immune globulin
- ibuprofen
- idelalisib
- imatinib
- immune globulin
- indomethacin
- iohexol
- iomeprol
- iopamidol
- isavuconazonium
- itraconazole
- ivosidenib
- ketoconazole
- ketoprofen
- ketorolac
- lapatinib
- lazertinib
- ledipasvir
- lefamulin
- lenacapavir
- lenalidomide
- lenvatinib
- letermovir
- levoketoconazole
- levonorgestrel (contraceptive)
- levonorgestrel (hormone replacement)
- lonafarnib
- lorlatinib
- lumacaftor/ivacaftor
- luspatercept
- mavacamten
- mavorixafor
- meclofenamate
- medroxyprogesterone (contraceptive)
- medroxyprogesterone (hormone replacement)
- mefenamic acid
- megestrol
- meloxicam
- menotropins
- methoxy polyethylene glycol-epoetin beta
- methyltestosterone
- mifepristone
- milk thistle
- mitapivat
- mitotane
- modafinil
- momelotinib
- nabumetone
- nafcillin
- naproxen
- necitumumab
- nefazodone
- nelfinavir
- netupitant
- nilotinib
- nintedanib
- nirogacestat
- nitisinone
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norethindrone (hormone replacement)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- olaparib
- ospemifene
- oxaprozin
- pacritinib
- pazopanib
- pegaspargase
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- pibrentasvir
- piroxicam
- pomalidomide
- ponatinib
- porfimer
- posaconazole
- primidone
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- propafenone
- prothrombin complex concentrate (human)
- quinidine (antiarrhythmic)
- raloxifene
- ramucirumab
- ranibizumab
- ranolazine
- repotrectinib
- Rho(D) immune globulin
- ribociclib
- rifabutin
- rifampin
- rifapentine
- rilzabrutinib
- ritlecitinib
- ritonavir
- ruxolitinib
- ruxolitinib topical
- salsalate
- segesterone (contraceptive)
- sipuleucel-T
- sodium tetradecyl sulfate
- sotatercept
- St. John's wort
- sulindac
- tamoxifen
- tepotinib
- testosterone
- thalidomide
- tipranavir
- tivozanib
- tofacitinib
- tolmetin
- toremifene
- trametinib
- tretinoin
- tucatinib
- turmeric
- upadacitinib
- vadadustat
- valoctocogene roxaparvovec
- vamorolone
- varicella zoster immune globulin
- vemurafenib
- verapamil
- vimseltinib
- von Willebrand factor
- voriconazole
- vorinostat
- voxilaprevir
- ziv-aflibercept
- zopapogene imadenovec
Adverse Reactions .
Serious Reactions
- thrombosis
- thromboembolism
- thrombocytosis
- leukocytosis
- hyponatremia
- hypersensitivity rxn
Common Reactions
- headache
- fatigue
- ecchymosis
- epistaxis
- URI
- arthralgia
- gingival bleeding
- fever
- petechiae
- abdominal pain
- nausea
- peripheral edema
- cough
- oropharyngeal pain
Safety/Monitoring .
Monitoring Parameters
Hepatic Dz-Associated Thrombocytopenia: Plt at baseline and on day of procedure
Immune Thrombocytopenia: Plt at baseline, qwk until Plt >50,000, then qmo; Plt qwk for at least 4wk after D/C
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; possible risk of embryo-fetal death based on animal data at 100-600 mg/kg/day
Lactation
Clinical Summary
avoid breastfeeding during tx and for at least 2wk after D/C; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver; CYP450: 2C9, 3A4 substrate
Excretion: feces 88% (34% unchanged), urine 6%; Half-life: 19h
Subclass: Colony Stimulating Factors (CSFs) ; Thrombopoietin Receptor Agonists
Mechanism of Action
binds and activates thrombopoietin (TPO) receptors on hematopoietic cells, increasing platelet production (TPO receptor agonist)
Formulary .
No Formulary Selected
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