4 Easy Steps To Calculate Your Patient's Total Nplate® Injection Volume1
This dosing calculator provides assistance only. It is not designed or intended to replace the physician’s clinical judgment in determining the appropriate dose for his or her patient.
STEP 3: Note total dose (mcg) and injection volume (mL)
STEP 4: Determine Nplate® vial(s) required for single useUsing your patient's total dose and/or injection volume calculated in STEP 3, refer to the full Prescribing Information to determine the appropriate vial required for single-use dose.
Individualize ITP treatment
Tips for dosing success
*The recommended starting dose for Nplate® is 1 mcg/kg.
DOSING & TITRATION GUIDE
Use the lowest dose of Nplate® to achieve and maintain a platelet count ≥ 50 x 109/L as necessary to reduce the risk for bleeding. Administer Nplate® as a once-weekly subcutaneous injection with dose adjustments based upon the platelet count response. Do not exceed maximum weekly dose of 10 mcg/kg.
Nplate® dose based on body weight (week 1)1
Initial dose: 1 mcg/kg based on actual body weight
Dose to stabilize platelet count (week 2 to n)1
Adjust Nplate® weekly based upon platelet count response. The goal is to find the dose at which platelet count is between 50–200 x 109/L for ≥ 4 weeks without further changes in dose. Nplate® dosing can be individualized and allows for a maximum weekly dose of up to 10 mcg/kg.
Weekly CBCs including platelet counts are required until dose is adjusted. In clinical studies, most adult patients who responded to Nplate® achieved and maintained platelet counts ≥ 50 x 109/L with a median dose of 2–3 mcg/kg.
Monthly stable platelet count over time (week n+1)1
Once an Nplate® stable dose is achieved—platelet count is 50–200 x 109/L
for ≥ 4 weeks without having changed the dose—maintain dose and monitor monthly (CBCs including platelet counts).
Titrate Nplate® according to individual patient response; adjust the weekly dose of Nplate® by increments of 1 mcg/kg until the patient achieves a platelet count of ≥ 50 x 109/L, as necessary, to reduce the risk of bleeding.1
Do not exceed maximum weekly dose of 10 mcg/kg.1
To mitigate against medication errors (both overdose and underdose), ensure that the preparation and administration instructions in the full Prescribing Information are followed.
Discontinue Nplate® if the platelet count does not increase to a level sufficient to avoid clinically important bleeding after 4 weeks of Nplate® therapy at the maximum weekly dose of 10 mcg/kg. Obtain CBCs, including platelet counts, weekly for at least 2 weeks following discontinuation of Nplate®.1
CBC, complete blood count; ITP, immune thrombocytopenia.
IMPORTANT FACTORS OF TREATMENT
No need to
remember to take
a pill every day1,3-5
No liver monitoring,
no known drug interactions
(eg, antacids, statins, and
No known dietary restrictions, including bread, milk and cereal, ice cream, cheese, tofu, calcium-fortified orange juice, yogurt, pizza, and leafy green vegetables1
DOSING & ADMINISTRATION VIDEOS
See what Nplate® dosing* and administration might look like for you and your practice
Always reference the complete dosing and administration information in the full Prescribing Information for Nplate®. Download now >
ITP specialist Steven Fein gives a quick and comprehensive overview of personalized adult dosing with Nplate® and what it means for patients.
An overview of the preparation and administration process of Nplate®.
Two leading hematologists, Dr Michael Tarantino and Dr Terry Gernsheimer, discuss Nplate® dosing and titration to address their patients’ needs.
*The recommended starting dose for Nplate® is 1 mcg/kg.1 Please see the Nplate® full Prescribing Information for complete dosing instructions, including guidelines for dose adjustments.
Nplate® administration may increase the risk for development or progression of reticulin fiber formation within the bone marrow. This formation may improve upon discontinuation of Nplate®. In a clinical trial, one patient with ITP and hemolytic anemia developed marrow fibrosis with collagen during Nplate® therapy.
Nplate® is a thrombopoietin receptor agonist indicated for the treatment of thrombocytopenia in adult patients with immune thrombocytopenia (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. Nplate® is indicated for the treatment of thrombocytopenia in pediatric patients 1 year of age and older with ITP for at least 6 months who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.
Nplate® is not indicated for the treatment of thrombocytopenia due to myelodysplastic syndrome (MDS) or any cause of thrombocytopenia other than ITP. Nplate® should be used only in patients with ITP whose degree of thrombocytopenia and clinical condition increase the risk for bleeding. Nplate® should not be used in an attempt to normalize platelet counts.
References: 1. Nplate® (romiplostim) prescribing information, Amgen. 2. Newland A, Godeau B, Priego V, et al. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol. 2016;172(2):262-273. 3. Promacta® (eltrombopag) full Prescribing Information, Novartis. 4. Doptelet® (avatrombopag) full Prescribing Information, Sobi. 5. Tavalisse® (fostamatinib disodium hexahydrate) full Prescribing Information, Rigel. 6. Data on file, Amgen; Clinical Study Report 20080435; 2014.