Doptelet
Doptelet (avatrombopag) raises your platelet levels. It's used by adults who have chronic (long-term) liver disease (CLD) with low platelets before they undergo a procedure. It also treats adults who have low platelets due to chronic (long-term) immune thrombocytopenia (ITP) when other medications haven't worked. This medication is convenient because it can be taken by mouth once daily, but it can be expensive since there is no lower-cost generic available.
What is Doptelet (avatrombopag)?
What is Doptelet (avatrombopag) used for?
- Low platelet levels in adults with chronic liver disease (CLD) before a scheduled procedure
- Low platelet levels in adults with chronic immune thrombocytopenia (ITP) when other medications haven’t worked
How Doptelet (avatrombopag) works
Doptelet (avatrombopag) is a thrombopoietin (TPO) receptor agonist. TPO is a natural hormone that signals your body to make more platelets. By acting like TPO, Doptelet (avatrombopag) helps to raise your platelet levels. Platelets are blood cells that help your body form blood clots to prevent bleeding. When your platelet levels are low, you are at a higher risk for severe bleeding.
Drug facts
Side effects of Doptelet (avatrombopag)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Chronic Liver Disease (CLD):
- Fever (10%)
- Stomach pain (7%)
- Nausea (7%)
- Headache (6%)
- Tiredness (4%)
- Swelling in the legs, feet, ankles, arms, and hands (3%)
Chronic Immune Thrombocytopenia (ITP):
- Headache (31%)
- Tiredness (28%)
- Bruising (26%)
- Nosebleeds (19%)
- Upper Respiratory Tract Infections (15%)
- Joint Stiffness (13%)
- Bleeding Gums (13%)
- Bleeding that causes purple or red spots under the skin (11%)
- Common Cold (10%)
Less Common Side Effects
- Allergic Reactions: itchy skin, rash, swelling of the face, swollen tongue, swelling of the throat, choking sensation
Doptelet (avatrombopag) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Blood clot in the liver: nausea, vomiting, diarrhea, fever, stomach pain or tenderness, yellowing of skin or eyes
- Other types of blood clots: legs (swelling, redness, pain, tenderness), lungs (difficulty breathing, chest pain, fast heartbeat), heart attack (chest pain, pain in the arms or shoulders, pain in the neck or jaw), stroke (numbness, difficulty speaking, facial drooping, confusion)
The following Doptelet (avatrombopag) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Doptelet (avatrombopag)
Pros
- Available as an oral tablet which can be taken conveniently at home
- No injection required
- Taken once a day
- Patient assistance is available for some people to help with medication cost
Cons
- Must be taken with food
- Need to get lab tests done (platelet levels) to check if the medication is working
- Potential risk in pregnancy and not recommended in breastfeeding
- Only available as a brand medication so it might be expensive
Pharmacist tips for Doptelet (avatrombopag)
- Take Doptelet (avatrombopag) with food. This is because your body absorbs the medication more consistently when taken with food.
- Take Doptelet (avatrombopag) at the same time every day to make sure your body has a steady level. Set an alarm to help you remember.
- If you’re taking Doptelet (avatrombopag) for CLD to prepare for a procedure, you must complete the full 5-day course without missing a dose. Missing a dose might cause your platelet levels to be lower than the goal set for your procedure. This means you might need to take another 5-day course of the medication and reschedule your procedure.
- Your provider will check your platelet levels to make sure your dose of Doptelet (avatrombopag) is working. With CLD, your provider will check your platelet levels the day before and the day of your procedure. With ITP, your provider will check your platelet levels before you start and weekly until you reach your goal, then monthly thereafter.
- Doptelet (avatrombopag) interacts with other medications. Some medications like rifampin (Rifadin) can cause Doptelet (avatrombopag) to not work as well. And other medications like fluconazole (Diflucan) and itraconazole (Sporanox) raise your risk for Doptelet (avatrombopag) side effects. Let your provider know about all medications you are taking because your starting dose of Doptelet (avatrombopag) might need to be changed.
- Make sure you take Doptelet (avatrombopag) as prescribed by your provider. Stopping the medication can put you at a risk for bleeding. Signs and symptoms of bleeding include coughing up blood, vomit that looks like coffee grounds, blood in the urine, and bloody or dark tarry stools. Contact your provider immediately if you notice any of these signs.
- Taking Doptelet (avatrombopag) can put you at risk for developing blood clots because it works by raising your platelet levels. Signs and symptoms of a blood clot include chest pain, shortness of breath, fast heartbeat, and pain or tenderness in the legs. If you have any of these signs and symptoms, call 911 or go to the emergency department right away.
Common questions about Doptelet (avatrombopag)
Chronic immune thrombocytopenia (ITP) is a long-term blood condition where your immune system attacks your platelets by mistake. Platelets are blood cells that help your blood clot. Chronic ITP lowers the number of platelets in your body, which puts you at a higher risk for bleeding. Doptelet (avatrombopag) is an oral medication that raises your platelet level to help prevent serious bleeding.
Doptelet (avatrombopag) can start working in a few days. In clinical studies, Doptelet (avatrombopag) started raising platelet levels in about 3 to 5 days. And it took around 10 to 13 days for platelet levels to reach the highest point. That’s why, if you’re using Doptelet (avatrombopag) for CLD, you start taking it 10 to 13 days before your scheduled procedure. And if you’re being treated for ITP, your provider might stop Doptelet (avatrombopag) if your platelet levels haven’t improved in 4 weeks because you likely won’t see any more improvements even if you keep taking the medication.
If you forget to take a dose of Doptelet (avatrombopag), take it as soon as you remember. Take your next dose at the usual time the next day. Do not take two doses to catch up on a missed dose, this can put you at a higher risk for more side effects. Let your healthcare provider know if you missed a dose of Doptelet (avatrombopag).
While alcohol doesn’t directly interact with Doptelet (avatrombopag), alcohol can lower your platelet levels and put you at risk for bleeds. Your risk is higher if you already have low platelet levels. And if you have liver problems like CLD, drinking alcohol can worsen your liver health. Talk to your healthcare provider before you consider drinking alcohol while on this medication.
There isn't enough information to show whether Doptelet (avatrombopag) is safe in human pregnancy. But in animal studies, Doptelet (avatrombopag) did cause harm during development of the unborn baby. Let your healthcare provider know right away if you are pregnant or plan to become pregnant. Your healthcare provider will talk with you about the benefits and risks of receiving this medication during pregnancy.
Breastfeeding isn't recommended while taking Doptelet (avatrombopag). This medication likely passes into breast milk and might cause harm to your baby. If you’re taking Doptelet (avatrombopag), it's recommended that you stop breastfeeding. Instead, you can pump and throw away any breast milk during the time you are taking the medication and for at least 2 weeks after your last dose. Contact your provider about other options to feed your baby during this time.
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Risks and warnings for Doptelet (avatrombopag)
Doptelet (avatrombopag) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Blood Clots
- Risk Factors: Blood clotting conditions | History of blood clots | High platelet levels | Chronic liver disease (CLD) | Chronic immune thrombocytopenia (ITP)
Because Doptelet (avatrombopag) helps to raise your platelet levels, it can put you at risk for blood clots. That’s why your provider will monitor your platelet levels to make sure they don’t get too high. Doptelet (avatrombopag) shouldn't be used to make your platelet levels normal. Your provider will monitor your platelet levels to make sure they are at their target goal.
Blood clots can occur anywhere in the body. One area they can occur is in the liver, where it’s called portal vein thrombosis. This is very rare and happened in less than 1% of people taking Doptelet (avatrombopag) in clinical studies. If you have abdominal pain, vomiting, fever, yellowing of the skin or eyes, get medical help right away as these could be signs of a blood clot in your liver. Let your provider know if you have a history of blood clots or a blood condition as your risk for blood clots is higher. Signs and symptoms of other types of blood clots include chest pain, shortness of breath, fast heartbeat, pain or swelling or tenderness in the leg. If you have any of these symptoms, call 911 or go to the emergency department right away.
Doptelet (avatrombopag) dosage
Typical dosage for Doptelet (avatrombopag)
Doptelet (avatrombopag) is typically taken by mouth once daily with food. Your dose might be different depending on your condition, platelet levels, and other medications you take.
- Chronic Liver Disease (CLD): You’ll start taking the medication 10 to 13 days before your scheduled procedure. The typical dose is 40 mg (2 tablets) or 60 mg (3 tablets) by mouth once daily with food for 5 days. You will finish your last dose 5 to 8 days before your procedure.
- Chronic Immune Thrombocytopenia (ITP): The typical starting dosing is 20 mg tablet (1 tablet) by mouth once daily with food. The maximum dose is 40 mg once daily. Your provider might adjust your dose based on your platelet level.
What are alternatives to Doptelet (avatrombopag)?
Doptelet (avatrombopag) images
