Tavalisse
Tavalisse (fostamatinib) is a medication that raises platelet count in adults with immune thrombocytopenia (ITP). It should only be used by people with ITP if other treatments didn't work well. Tavalisse (fostamatinib) is taken by mouth twice daily and can cause side effects such as high blood pressure, infection, and liver problems. It's brand name only, so it can be expensive.
What is Tavalisse (fostamatinib)?
What is Tavalisse (fostamatinib) used for?
- Treatment of long-term immune thrombocytopenia in adults who haven't responded well to other treatments.
How Tavalisse (fostamatinib) works
Tavalisse (fostamatinib) is a tyrosine kinase inhibitor. When Tavalisse (fostamatinib) blocks tyrosine kinases (a type of protein) in your spleen, it stops antibodies in your immune system from destroying your platelets.
Drug facts
Side effects of Tavalisse (fostamatinib)
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
- Diarrhea (31%)
- High blood pressure (28%)
- Nausea (19%)
- Dizziness (11%)
- Fever, cough, congestion, tiredness, and other symptoms of nose, throat, or lung infection (11%)
- High liver enzymes (9-11%)
Less Common Side Effects
- Rash
- Stomach pain
- Fatigue
- Chest pain
- Low white blood cell count
Tavalisse (fostamatinib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Dangerously high blood pressure: chest pain, severe headache, nausea, vomiting, anxiety, shortness of breath, changes in vision
- Liver problems: yellowing of your skin or the whites of your eyes, confusion, fatigue, low appetite, nausea, stomach discomfort, vomiting
- Serious infection: fever, tiredness, body aches, chills, cough, congestion, trouble breathing
The following Tavalisse (fostamatinib) 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
- Increase in blood pressure
- Infection—fever, chills, cough, or sore throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Chest pain
- Diarrhea
- Dizziness
- Fatigue
- Nausea
- Stomach pain
Pros and cons of Tavalisse (fostamatinib)
Pros
- Works well for raising platelet counts in people with ITP
- Can be taken with or without food
- Available as tablets taken by mouth
Cons
- Brand name only, which can be expensive
- Can't be used in pregnant or nursing females
- Commonly causes upset stomach (e.g., diarrhea and nausea) and high blood pressure
Pharmacist tips for Tavalisse (fostamatinib)
- Mark your appointments to see your provider or get your lab tests done on your calendar to make sure you're being closely monitored while taking Tavalisse (fostamatinib). You'll need to get tests to check your blood cell count, liver health, and blood pressure regularly while taking this medication.
- Tavalisse (fostamatinib) can be taken with or without food.
- Tavalisse (fostamatinib) interacts with a lot of medications. Make sure to tell your provider and pharmacist about all the medications you're taking, including over-the-counter medications, vitamins, and supplements, before starting Tavalisse (fostamatinib). Don't start any new medications while taking Tavalisse (fostamatinib) without talking to your provider or pharmacist first. Sometimes, your provider might need to change your dose of Tavalisse (fostamatinib) depending on what other medications you're taking.
- Mild-to-moderate diarrhea and nausea are common side effects. Some tips to help treat these include drinking fluids to stay hydrated, having a healthy and balanced diet, and using medications (antidiarrheals or antiemetics) if your provider says it's safe to do so. If you have symptoms of diarrhea or dehydration (e.g., lightheadedness, dizziness, muscle cramps), contact your provider.
Common questions about Tavalisse (fostamatinib)
Immune thrombocytopenia (ITP) is a condition where your immune system attacks and destroys your platelets, which causes your platelet level to drop. As a result, you're not able to form blood clots properly and this puts you at high risk for bleeding, which can be severe and life-threatening. Signs and symptoms of ITP include bleeding gums, bleeding for a long time, frequent bleeds, and skin that easily bruises. Tavalisse (fostamatinib) helps by stopping your immune system from destroying your platelets, which keeps your platelet level from dropping too low.
There isn't a specific amount of time you need to take Tavalisse (fostamatinib). Your provider will have you continue taking the medication as long as you're responding to the medication well and you're not having side effects. If your platelet level doesn't get better after taking Tavalisse (fostamatinib) for 3 months, you'll have to stop the medication to avoid a risk of severe bleeding.
Yes, because your dose of Tavalisse (fostamatinib) depends on your platelet count and because this medication can cause side effects that affect different parts of your body, your provider will order tests to check your health regularly throughout treatment. Some tests you can expect include those that check your liver health, as well as your blood pressure and complete blood count. Ask your provider if you have any questions about these tests or what they're used to check for.
It's not known how safe or how well Tavalisse (fostamatinib) works in children less than 18 years old. It's recommended to avoid using Tavalisse (fostamatinib) in children because of potential effects on bone strength, growth, and development. If your child is diagnosed with ITP, ask your child's provider for available treatment options.
No, pregnant and breastfeeding females shouldn't use Tavalisse (fostamatinib) because it can cause severe harm to your unborn and nursing baby. If you’re female and able to become pregnant, you'll need to take a pregnancy test before starting treatment to make sure you're not currently pregnant. In addition, you should use birth control during treatment with Tavalisse (fostamatinib) and for at least 1 month after your last dose. If you're lactating, you shouldn't breastfeed your baby during and for at least 1 month after treatment with Tavalisse (fostamatinib), so talk with your provider about other feeding options.
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Risks and warnings for Tavalisse (fostamatinib)
Tavalisse (fostamatinib) 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.
High blood pressure
- Risk factors: High blood pressure
Tavalisse (fostamatinib) can raise your blood pressure, especially if you already have high blood pressure before starting Tavalisse (fostamatinib). You'll need to monitor your blood pressure every 2 weeks until it seems stable, then you can monitor it once per month. If your blood pressure gets too high while taking the medication, you'll need start taking or change your dose of blood pressure medication. If your blood pressure continues to stay high, you'll need to have your Tavalisse (fostamatinib) dose lowered or you'll need to stop taking Tavalisse (fostamatinib). If you get any symptoms of severe high blood pressure, such as changes in vision, chest pain, bad headache, nausea, vomiting, anxiety, or difficulty breathing, call 911 right away.
Harm to unborn babies
If you're pregnant or thinking about becoming pregnant, talk with your provider before taking Tavalisse (fostamatinib) because this medication isn't recommended during pregnancy. Although it hasn't been studied in human pregnancy, it has caused birth defects and death to unborn babies in animal studies. If you’re female and taking this medication (and if you are able to become pregnant), make sure to use birth control while taking Tavalisse (fostamatinib). Continue to use birth control for at least 1 month after your last dose.
If you're having diarrhea or vomiting and you're taking birth control medications by mouth (oral contraceptives), your body might not be absorbing all of your birth control medication, which raises your risk for getting pregnant. If you have vomiting or diarrhea, you should use back-up methods (e.g., condoms or spermicide) and ask your provider about other available types of birth control not taken by mouth.
Liver problems
Although rare, Tavalisse (fostamatinib) might cause liver problems. You'll need to get monthly blood tests to make sure your liver is working properly. If your lab results show signs of liver problems, your provider might temporarily stop your Tavalisse (fostamatinib) in order to figure out whether the medication is causing these problems. Get medical attention right away if you notice signs of liver problems, such as yellowing of your skin or the whites of your eyes, fatigue, low appetite, nausea, stomach discomfort, confusion, or changes in your personality.
Low white blood cell counts
Tavalisse (fostamatinib) can lower your white blood cell (WBC) count, which can raise your risk for serious infections. Your provider check your WBC count monthly while you're taking this medication. If it drops too low, your provider will likely have to stop your treatment of or lower your dose of Tavalisse (fostamatinib). Let your provider know right away if you have symptoms of an infection, such as fever, cough, chills, body aches, and tiredness.
Diarrhea
Diarrhea is one of the most common side effects caused by Tavalisse (fostamatinib). If you experience diarrhea, talk with your provider right away. You might be able to treat diarrhea with changes to your diet, drinking water to keep hydrated, and taking antidiarrheal medications, such as loperamide (Imodium A-D). But sometimes, your provider might need to lower your dose of Tavalisse (fostamatinib) or stop it all together.
Tavalisse (fostamatinib) dosage
Typical dosage for Tavalisse (fostamatinib)
The typical starting dose is 100 mg by mouth twice daily. After 1 month, your provider might raise your dose to 150 mg twice daily, depending on your platelet levels.
Your provider might continue to change your dose depending on your platelet level and whether you're having side effects, such as high blood pressure or diarrhea.
What are alternatives to Tavalisse (fostamatinib)?
Tavalisse (fostamatinib) images
