Avatrombopag

How it works

It binds and activates the thrombopoietin receptor on megakaryocyte precursors, stimulating platelet production.

Prescribing in practice

• Because it raises platelet counts, there is a risk of thrombosis, so avoid driving the count above the target range and assess thrombotic risk.
• It is taken with food, which enhances absorption.
• When used for a procedure in liver disease it is given as a short defined course rather than continuous therapy.

Monitoring

Monitor the platelet count to guide dosing and to avoid excessive counts that increase thrombotic risk.

Counselling the patient

• Take the medicine with food.
• Attend blood tests so your platelet count can be checked and the dose adjusted.
• Report symptoms that could suggest a clot, such as leg swelling, chest pain or breathlessness.

Evidence & guidelines

NICE recommends avatrombopag for thrombocytopenia in chronic immune thrombocytopenia and to reduce bleeding risk around procedures in chronic liver disease.