Nplate (Romiplostim)
Complete patient guide for uses, dosage, side effects, and safety information
Quick Facts
What Is Nplate Used For?
Nplate contains romiplostim and is used to treat a blood disorder called immune thrombocytopenia (ITP). This condition causes your body to have fewer platelets than normal, which can lead to serious bleeding problems.
Primary Uses
Nplate is used to increase the number of platelets in your blood and prevent bruising and bleeding in adults and children with ITP. ITP occurs when your immune system mistakenly attacks and destroys your platelets.
How It Works
Nplate works by stimulating your bone marrow to produce more platelets. Platelets are blood cells that help your blood clot properly. With more platelets, you’re less likely to bruise easily or bleed for long periods after an injury.
Good to know: Nplate helps control your ITP condition and prevent bleeding, though it does not cure the condition completely.
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How to Take Nplate
Nplate is given as an injection under your skin (subcutaneous injection) once a week. It should be administered by an experienced healthcare professional, a trained caregiver, or you can learn to inject it yourself if you’re an adult.
Dosage Instructions
Your doctor will determine your exact dose, typically between 1 to 10 micrograms per kilogram of your body weight. The dose is personalized based on your weight and platelet count. Your doctor will adjust your dose to maintain safe platelet levels long-term. If injecting at home, use a syringe with graduations in 0.01 mL units since doses may be very small.
What If You Miss a Dose?
If you miss a dose of Nplate, contact your doctor immediately. Your doctor will discuss when you should have your next dose. Don’t try to make up for missed doses on your own.
Important: Self-administration is not recommended for children. Children should receive their Nplate injection from an experienced doctor or nurse.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Headache
- Joint or muscle aches and pains
- Dizziness
- Difficulty sleeping
- Pain
- Runny or blocked nose
- Throat inflammation
- Cough
- Diarrhea
- Rash
- Fever
- Bruising
- Infections
- Tiredness
- Swelling of limbs, hands, or feet
- Nausea and vomiting
- Abdominal pain
- Constipation
Seek immediate medical attention if you experience:
- Signs of allergic reaction (chest tightness, difficulty breathing, swelling of face, lips, tongue, rash)
- Blood clots in veins or lungs
- Bone marrow problems
- Signs of heart attack (chest pain spreading to neck and shoulders)
- Severe swelling of face, lips, mouth, or throat causing difficulty swallowing or breathing
Important Warnings
There are several important warnings and precautions you should know about before taking Nplate.
Who Should Not Take Nplate
Do not use Nplate if you are allergic to romiplostim or any ingredients in the medication. Also avoid it if you’re allergic to other medicines produced by DNA technology using E. coli bacteria.
Medical Conditions to Discuss
Tell your doctor if you have: planned surgery, liver problems, kidney problems, cancer or blood cancer, history of blood clots (or family history), if you take birth control pills, use hormone replacement therapy, smoke, recently had surgery or injury, are overweight, are 65 or older, or are bedridden.
Pregnancy and Breastfeeding
Nplate is not recommended during pregnancy unless your doctor advises it. Tell your doctor immediately if you become pregnant while taking Nplate. For breastfeeding, Nplate is not recommended as it’s unknown if the drug passes into breast milk.
Blood Clot Risk: Your risk of blood clots may be increased, especially if you have certain risk factors. Discuss your complete medical history with your doctor.
Drug Interactions
Some medications may interfere with how Nplate works. Always tell your healthcare provider about all medicines you’re taking.
Dose Adjustments: Your doctor may need to adjust doses of other ITP medications when you start Nplate, and some may be reduced or stopped.
- Blood clot prevention medicines
- Immune system suppressants like azathioprine and corticosteroids
- Danazole (synthetic hormone)
- Immunoglobulins (blood products for infection prevention)
- Any other ITP treatments
Alcohol & Driving
Nplate may affect your ability to drive or operate machinery safely, and there are some precautions regarding alcohol use.
Alcohol
There is no specific information available about the effects of using Nplate with alcohol. Discuss alcohol use with your doctor.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Nplate affects you. Nplate may cause temporary bouts of dizziness in some people, which could impair your ability to drive or use machinery safely.
Storage
Store Nplate vials in the refrigerator between 2°C and 8°C. Do not freeze. Keep away from moisture and sunlight, and out of reach of children. After dissolving the powder, use the solution as soon as possible. If you can’t use it immediately, it can be stored in the refrigerator for up to 24 hours. Do not freeze the dissolved solution. Do not shake or vigorously agitate the vial. Don’t use if the solution is cloudy, discolored, or contains clumps or flakes.
Overdose Information
If you think you’ve used too much Nplate, seek urgent medical attention immediately. You may not experience physical symptoms, but your platelet counts could rise to very high levels, increasing blood clot risk. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital emergency department. Always bring the medicine carton with you.
Frequently Asked Questions
Nplate should be taken every week to keep your platelet counts in a safe range. Your doctor will monitor your blood regularly to check your platelet levels and may adjust your dose accordingly.
Yes, Nplate can be used to treat both adults and children with ITP. However, it’s not recommended for children under 1 year old, and self-administration is not recommended for children – they should receive injections from experienced healthcare professionals.
Do not stop using Nplate unless your doctor tells you to. If you stop taking Nplate, your low platelet count is likely to return, putting you at risk of bleeding. Your doctor will monitor your platelet count if you need to stop treatment.
There is no specific information available about the effects of using Nplate with alcohol. You should discuss alcohol use with your doctor.
Store Nplate powder in the refrigerator between 2°C and 8°C. Don’t freeze it. After dissolving the powder, use it as soon as possible, or store the solution in the refrigerator for up to 24 hours. Don’t use if the solution is cloudy or contains particles.
If you miss a dose of Nplate, contact your doctor immediately. Your doctor will discuss when you should have your next dose. Don’t try to make up for missed doses on your own.
Long-term use of Nplate may cause changes in your bone marrow, including increased reticulin (mild bone marrow changes). Your doctor will monitor you with regular blood tests and may perform bone marrow tests if needed.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.