Select a medication above to begin.
Doptelet
avatrombopag
Adult Dosing .
Dosage forms: TAB: 20 mg
Special Note
- [equivalency or interchangeability info]
- Info: Doptelet not interchangeable with Doptelet Sprinkle; do not substitute on a mg to mg basis
chronic hepatic disease-associated thrombocytopenia, pre-procedure
- [Plt <40,000]
- Dose: 60 mg PO qd x5 days; Start: 10-13 days before procedure; Info: procedure should start within 5-8 days after last dose; give with food
- [Plt 40,000-49,000]
- Dose: 40 mg PO qd x5 days; Start: 10-13 days before procedure; Info: procedure should start within 5-8 days after last dose; give with food
immune thrombocytopenia, chronic
- [20-40 mg po qd]
- Start: 20 mg PO qd; Max: 40 mg qd; Info: for patients with 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 with 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 with 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 with 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 with 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
- fibrinogen (human)
- fitusiran
- flibanserin
- fluconazole
- fluorouracil
- flurbiprofen
- follitropin
- fosamprenavir
- fosphenytoin
- fruquintinib
- glecaprevir
- hepatitis B immune globulin
- ibuprofen
- idelalisib
- imatinib
- immune globulin
- indomethacin
- iodixanol
- iohexol
- iomeprol
- iopamidol
- iopromide
- iothalamate meglumine
- ioversol
- 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)
- obinutuzumab
- 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 reaction
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 Disease-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: for avatrombopag: liver; CYP450: 2C9, 3A4 substrate
Excretion: for avatrombopag: feces 88% (34% unchanged), urine 6%; Half-life: 19h
Subclass: Colony Stimulating Factors (CSFs) ; Thrombopoietin Receptor Agonists
Mechanism of Action
for avatrombopag: binds and activates thrombopoietin (TPO) receptors on hematopoietic cells, increasing platelet production (TPO receptor agonist)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.