ROMIPLOSTIM SHOULD BE USED ONLY IN PATIENTS WITH ITP WHOSE DEGREE OF THROMBOCYTOPENIA AND CLINICAL CONDITION INCREASES THE RISK FOR BLEEDING. NPLATE SHOULD NOT BE USED IN AN ATTEMPT TO NORMALIZE PLATELET COUNTS.
THE INITIAL DOSE FOR ROMIPLOSTIM IS 1 MCG/KG BASED ON ACTUAL BODY WEIGHT.
ADJUST THE DOSE AS FOLLOWS:
IF THE PLATELET COUNT IS < 50 X 109/L, INCREASE THE DOSE BY 1 MCG/KG.
IF PLATELET COUNT IS > 200 X 109/L FOR 2 CONSECUTIVE WEEKS, REDUCE THE DOSE BY 1 MCG/KG.
IF PLATELET COUNT IS > 400 X 109/L, DO NOT DOSE. CONTINUE TO ASSESS THE PLATELET COUNT WEEKLY. AFTER THE PLATELET COUNT HAS FALLEN TO < 200 X 109/L, RESUME ROMIPLOSTIM AT A DOSE REDUCED BY 1 MCG/KG.
USE THE ACTUAL BODY WEIGHT AT INITIATION OF THERAPY, THEN ADJUST THE WEEKLY DOSE OF ROMIPLOSTIM BY INCREMENTS OF 1 MCG/KG UNTIL THE PATIENT ACHIEVES A PLATELET COUNT > 50 X 109/L AS NECESSARY TO REDUCE THE RISK FOR BLEEDING; DO NOT EXCEED A MAXIMUM WEEKLY DOSE OF 10 MCG/KG