Romiplostim (Nplate™)

Last Modified: March 11, 2012

Pronounced: roe-mi-PLOE-stim
Classification: Thrombopoietin Receptor Agonists

About Romiplostim

Romiplostim is a man-made protein medicine used to treat low blood platelet counts (thrombocytopenia) in adults with chronic idiopathic thrombocytopenic purpura (ITP). Romiplostim works by causing the cells in the bone marrow to produce more platelets. It should not be used to treat thrombocytopenia caused by other conditions and may worsen pre-existing blood cancers or myelodysplastic syndrome (MDS).

How to Take Romiplostim

Romiplostim is given as a subcutaneous injection (given under the skin) once a week in your doctor's office. The actual dose is based on your body size, starting at 1 mcg per kilogram. Your platelet count will be checked each week and the dose of medication adjusted accordingly.

Possible Side Effects of Romiplostim

There are a number of things you can do to manage the side effects of Romiplostim. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Bone Marrow Changes

Long-term use of romiplostim may cause changes in your bone marrow. These can include an increase in reticulin. Increased reticulin is unlikely to cause problems, but it is not known if this can lead to a more serious condition called bone marrow fibrosis, which is a scarring of the bone marrow, causing it to produce fewer blood cells. Your healthcare provider will monitor your blood tests for abnormalities that could signify changes in the bone marrow.

Worsening of the Platelet Count After Stopping theMedication

In clinical trials, some patients experienced lower platelet counts when the medication was stopped than they had before taking the medication. This side effect is most likely to occur shortly after stopping romiplostim and may last about 2 weeks. This lower platelet count increases the risk of bleeding, so precautions should be taken and any bruising or bleeding should be reported to your healthcare provider.

Muscle or Joint Pain/Aches and Headache

Your doctor or nurse can recommend medication and other strategies to relive pain. Also view OncoLink's page on pain management.

Blood Clots

Your healthcare provider will monitor your platelet count to attempt to prevent it from getting too high. A high platelet count can increase the risk of developing a blood clot. Blood clots can occur anywhere in the body. They occur most frequently in the calves (leg) or the lungs. People at higher risk for developing blood clots include those with a family history of blood clots, smokers, those who have an inactive lifestyle, older patients, and those with other medical problems.

Signs of a blood clot in the leg may include any of the following: leg pain, warmth, swelling of one leg more than the other. Signs of a blood clot in the lung could include: fever, shortness of breath that comes on you very quickly, racing heart, chest pain (that tends to be worse when you take a deep breath).

If you have any of these signs or symptoms of blood clots, you will need to be seen immediately so that you can be treated with blood thinners. Call your doctor or nurse.

Other Side Effects

Some less common side effects that have been reported include: dizziness, indigestion, trouble sleeping, and tingling or numbness in the hands and feet.


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