Romiplostim (Subcutaneous route)

Pronunciation:

roe-mi-PLOE-stim

Brand Names:

  • Nplate

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Hematopoietic

Pharmacologic—

Thrombopoietin Receptor Agonist

Uses of This Medicine:

Romiplostim injection is used to treat low blood platelet counts (thrombocytopenia) and help prevent bleeding in patients with a blood disorder called chronic (long-lasting) immune thrombocytopenia (ITP). This medicine is used after a splenectomy (surgery to remove the spleen) or when other medicines (eg, steroids or immunoglobulins) have not worked well enough in adults or children 1 year of age and older with ITP for at least 6 months. Platelets help clot the blood, so a person with thrombocytopenia may have bleeding problems. Romiplostim works by stimulating the bone marrow to produce more platelets.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of romiplostim injection in children 1 year of age and older with ITP for at least 6 months. However, safety and efficacy have not been established in children younger than 1 year of age with ITP.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of romiplostim injection in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving romiplostim injection.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems or
  • Blood cancer or
  • Blood clots, or history of or
  • Bone marrow problems (eg, myelodysplastic syndrome or MDS)—Use with caution. May make these conditions worse.
  • Liver disease (including cirrhosis), chronic—Use with caution. May increase risk for more serious problems.
  • Thrombocytopenia caused by myelodysplastic syndrome (MDS) or conditions other than chronic ITP—Should not be used in patients with this condition.

Proper Use of This Medicine:

A doctor or other trained health professional will give you this medicine in a medical facility. It is given as a shot under your skin once a week.

This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Missed dose—

Call your doctor or pharmacist for instructions.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests will be needed to check for unwanted effects.

Do not stop receiving this medicine without checking first with your doctor. Stopping this medicine suddenly may cause the number of platelets to go below the number you had before you started receiving the medicine. This will increase your risk for bleeding. Your doctor will check your platelet levels and progress when you stop receiving the medicine.

If you receive this medicine and you have a bone marrow problem called myelodysplastic syndromes (MDS), it may worsen and become an acute leukemia (white blood cell cancer).Talk to your doctor if you have concerns about this.

This medicine may increase your risk of developing blood clots. Check with your doctor right away if you or your child have swelling and pain in your arms, legs, or stomach, chest pain, troubled breathing, loss of sensation, confusion, or problems with muscle control or speech.

Portal vein thrombosis (a blood clotting problem in the liver) may occur in patients receiving this medicine, usually in those who have low platelet counts caused by chronic liver disease (eg, cirrhosis). Check with your doctor right away if you have abdominal or stomach pain, blood in the stool, fever, low back pain, yellow skin or eyes, or if you are vomiting blood.

Your condition can cause you to bleed too much when injured. Be extra careful to avoid injuries. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Gently brush and floss your teeth. Be careful when using sharp objects, including razors and fingernail clippers.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
body aches or pain
change in hearing
chills
cough
diarrhea
difficulty in breathing
ear congestion or pain
ear drainage
fever
headache
loss of appetite
loss of voice
nausea
pain or tenderness around the eyes and cheekbones
rapid weight gain
sneezing
sore throat
stomach pain
stuffy or runny nose
tightness of the chest
tingling of the hands or feet
unusual tiredness or weakness
unusual weight gain or loss
upper stomach pain
Incidence not known
Burning pain, warmth, swelling, or redness of the hands and feet
fast heartbeat
feeling of warmth
hives, itching, skin rash
hoarseness
irritation
joint pain, stiffness, or swelling
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
redness of the skin
troubled swallowing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Belching
bruise
difficulty with moving
diarrhea
dizziness
headache
heartburn
indigestion
mouth or throat pain
muscle pains, cramps, or stiffness
pain in the shoulder, arms, or legs
stomach discomfort, upset, or pain
trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 6/18/2019

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
All rights reserved.

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