Avatrombopag

(a va TROM boe PAG)

Avatrombopag is an orally bioavailable, small molecule TPO receptor agonist that stimulates proliferation and differentiation of megakaryocytes from bone marrow progenitor cells resulting in an increased platelet production. Avatrombopag does not compete with TPO for binding at the TPO receptor and has an additive effect with TPO on platelet production.

Distribution

Vd: ~180 L

Metabolism

Hepatic; primarily by CYP2C9 and CYP3A4

Excretion

Feces (88%; 34% as unchanged drug); urine (6%)

Platelet count steadily declines within 7 days of procedure (Terrault 2018); platelet count return to baseline: 35 days

Half-Life Elimination

~19 hours

Protein Binding

>96% to human plasma proteins

Oral: Administer with food.

Adverse events were observed in animal reproduction studies.

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

Medical Disclaimer

• Tell all of your health care providers that you take avatrombopag. This includes your doctors, nurses, pharmacists, and dentists.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• Blood clots have happened with avatrombopag. The chance of blood clots may be raised in people with long-term liver disease and people with some blood clotting problems. Tell your doctor if you have ever had a blood clot. If you have questions, talk with your doctor.
• This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking avatrombopag, call your doctor right away.

Unless your doctor tells you otherwise, continue your normal diet.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

1. swollen, painful, red or tender leg
2. shortness of breath, cough, chest pain, fast heartbeat
3. stomach pain or tenderness

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before you start treatment to decide your dose of avatrombopag and on the day of the procedure.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.