Avatrombopag is an orally bioavailable, small molecule TPO receptor agonist that stimulates proliferation and differentiation of megakaryocytes from bone marrow progenitor cells, resulting in an increased production of platelets. Avatrombopag does not compete with TPO for binding to the TPO receptor and has an additive effect with TPO on platelet production.

DOPTELET is a thrombopoietin receptor agonist indicated for:

• Thrombocytopenia in adult patients with Chronic Liver Disease (CLD) scheduled for a medical or dental procedure.
• Chronic Immune Thrombocytopenia (ITP) in adults who have had an insufficient response to previous treatments.

For Chronic Liver Disease:

• Administer orally once daily with food for 5 days, starting 10–13 days before the procedure.

• Dosage depends on baseline platelet count:

  • <40×10⁹/L: 60 mg (3 tablets) daily

  • 40 to <50×10⁹/L: 40 mg (2 tablets) daily

For Chronic Immune Thrombocytopenia:

• Start with 20 mg (1 tablet) daily with food.
• Adjust dosing to maintain platelets ≥50×10⁹/L but not to normalize count.
• Do not exceed 40 mg/day.
• Monitor platelets weekly until stable, then monthly.

With CYP2C9 and CYP3A4 Inducers/Inhibitors:

• Adjust starting dose:

  • Inhibitors: 20 mg three times a week

  • Inducers: 40 mg daily

In CLD (≥3% incidence):

• Pyrexia, abdominal pain, nausea, headache, fatigue, peripheral edema.

In ITP (≥10% incidence):

• Headache, fatigue, bruising, nosebleeds, URTI, joint pain, gingival bleeding, petechiae, nasopharyngitis.

None

Risk in patients with CLD and ITP.

Monitor for signs/symptoms and adjust dosing accordingly.