Romiplostim

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

Other drugs may interact with romiplostim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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

While using romiplostim, you will need frequent blood tests.

Using romiplostim long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders. To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often.

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

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

Overdose can cause signs of a blood clot, including sudden numbness or weakness, problems with vision or speech, chest pain, or pain and swelling in one or both legs.

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

Romiplostim is a prescription medication used to treat low blood platelet counts in patients with chronic immune thrombocytopenia (ITP). Romiplostim belongs to a group of drugs called thrombopoietin receptor agonists, which work by causing bone marrow to increase platelet production.

This medication comes in an injectable form to be given just under the skin by a healthcare provider. It is usually given once a week.

Common side effects of romiplostim include headache, joint pain, and dizziness.

Tell your healthcare provider about all your medical conditions, including if you:

• Have had surgery to remove your spleen (splenectomy).
• Have a bone marrow problem, including a blood cancer or MDS.
• Have or had a blood clot.
• Have chronic liver disease.
• Have bleeding problems.
• Have any other medical condition.
• Are pregnant, or plan to become pregnant. It is not known if romiplostim will harm your unborn baby.
• Are breastfeeding or plan to breastfeed. It is not known if romiplostim passes into your breast milk. You and your healthcare provider should decide whether you will take romiplostim or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products.

Romiplostim is a man-made form of a protein that increases production of platelets (blood-clotting cells) in your body.

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 usually given after other medications have been tried without successful treatment of symptoms.

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

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

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.

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

While using romiplostim, you will need frequent blood tests.

Using romiplostim long-term can cause harmful effects on your bone marrow that may result in serious blood cell disorders. To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often.

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

Idiopathic Thrombocytopenic Purpura

Treatment of chronic idiopathic thrombocytopenic purpura (ITP; also known as immune thrombocytopenic purpura) in patients who have had an inadequate response to corticosteroids, immunoglobulins, or splenectomy and in whom the degree of thrombocytopenia and clinical status increase bleeding risk.1 3

Do not use to normalize platelet counts since excessive increases in platelet count may increase the risk of thromboembolic complications.1

Not indicated for the treatment of thrombocytopenia associated with myelodysplastic syndrome or thrombocytopenia associated with any condition other than chronic ITP.1

• It is used to raise platelet counts.

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• Use care to prevent injury and avoid falls or crashes.
• Low platelet levels and a raised chance of bleeding may happen when romiplostim is stopped. If this medicine is stopped, have your blood work checked for at least 2 weeks after stopping it. Talk with your doctor.
• This medicine may raise the chance of blood clots, a stroke, or a heart attack. Talk with the doctor.
• This medicine is not approved to treat myelodysplastic syndrome (MDS). If you have MDS, talk with your doctor.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using romiplostim while you are pregnant.

• Nplate

• Colony Stimulating Factor
• Hematopoietic Agent
• Thrombopoietic Agent

Platelet counts return to baseline by day 28 (Wang, 2004)

Half-Life Elimination

Median: 3.5 days (range: 1 to 34 days)

Administer SubQ. Administration volume may be small; use appropriate syringe (with graduations to 0.01 mL) for administration. Verify calculations, final concentration, and volume drawn up for administration.