rifampin will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In patients with CLD, avatrombopag rapidly increased platelet levels and significantly reduced the need for platelet transfusions or rescue procedures. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inducer requires an increased avatrombopag starting dose. Blood. 2016;2016:1802932. doi: 10.1155/2016/1802932. Modify Therapy/Monitor Closely. Monitor Closely (1)carbamazepine will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avatrombopag increases platelet count but not platelet activation in patients with thrombocytopenia resulting from liver disease. Accessed 17 Sep 2021. The recurrence of severe thrombocytopenia on discontinuation of avatrombopag appeared to be dose dependent, because all 9 subjects were in the higher (10-mg and 20-mg) dose groups. Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Partial splenic artery embolization can be effective but platelet counts tend to decline over time, and nearly all patients will experience post-embolization syndrome requiring hospitalization, with rates of serious complications ranging between 15 and 30% [37]. Exposure increased in a dose-proportional manner up to a dose of 80mg. swelling, pain, or tenderness in your legs. Avatrombopag was generally well tolerated in patients with ITP. The efficacy of avatrombopag as treatment for thrombocytopenia associated with CLD prior to an elective procedure has been established in the phase III ADAPT program, comprising the global ADAPT-1 and ADAPT-2 studies [20]. 4.2) has been investigated. The overall incidence of treatment-emergent adverse events in avatrombopag recipients was similar to that in placebo recipients in both the avatrombopag 60mg/day (low baseline platelet count; 56.0% and 58.2%, respectively) and avatrombopag 40mg/day (high baseline platelet count; 51.3% and 50.8%, respectively) treatment cohorts. Int J Hematol. Epub 2016 Oct 9. 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility . Markham, A. Avatrombopag: A Review in Thrombocytopenia. 2017;13(5):28691. Modify Therapy/Monitor Closely. Blood. Patients should undergo procedure 5 to 8 days after the last avatrombopag dose. Avatrombopag is a thrombopoietin receptor (TPOR; MPL) agonist, with possible megakaryopoiesis stimulating activity. Avatrombopag was approved by the FDA on May 21, 2018 for thrombocytopenia (low platelets) in adults with chronic liver disease who are scheduled to undergo a procedure 14. Avoid coadministration with sensitive CYP3A substrates. Dugosz-Danecka M1, Zdziarska J1, Jurczak W1. Patients who had a durable response in the double-blind phase had response at 60.1% of the extension phase visits. Comparative efficacy and safety of avatrombopag versus lusutrombopag in patients with chronic LIVER disease and severe thrombocytopenia undergoing invasive procedures: a systematic literature review and network meta-analysis [abstract no. REVOLADE (eltrombopag) has a unique mechanism of action (MOA) that complements, rather than competes with endogenous thrombopoietin, stimulating an immunomodulatory response to promote platelet production in immune thrombocytopenia (ITP) and deliver a trilineage response in severe aplastic anaemia (SAA). Modify Therapy/Monitor Closely. In the double-blind, placebo-controlled, phase 3 trial, investigators set out to examine the safety and efficacy of avatrombopag in patients with chemotherapy-induced thrombocytopenia who are. Available data indicate the risk of bleeding in patients with platelet counts 50109/L undergoing invasive procedures is minimal; however, the risk of bleeding in patients with more severe thrombocytopenia (platelet count 20109/L) is unclear. Avatrombopag, eltrombopag, and lusutrombopag have a similar half-life and excretion mechanism, while romiplostim differs, likely due to its peptibody structure. Most Terrault N, Chen YC, Izumi N, et al. Use Caution/Monitor. Coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose to 20 mg PO TID. Avoid or Use Alternate Drug. Alternatives to platelet transfusion include one-off procedures such as splenectomy, partial splenic artery embolization, radiofrequency ablation of the spleen, TIPS and administration of TPO-RA inhibitors prior to surgery [36]. Tell your doctor if any of these symptoms are severe or do not go away: extreme tiredness headache nosebleeds or gum bleeding joint pain Some side effects can be serious. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose. by | Nov 7, 2022 | sovereign vs non-sovereign bonds | interior designer boston | Nov 7, 2022 | sovereign vs non-sovereign bonds | interior designer boston PubMed The trial comparing avatrombopag with eltrombopag, however, was terminated before completion because of enrolment challenges related to the requirement for endoscopy and availability of eltrombopag, and no conclusions could be drawn [17]. Avatrombopag thus represents a convenient and effective second-line treatment for patients with chronic ITP and can prevent bleeding events in patients with CLD scheduled to undergo a procedure, offering a useful alternative to other available treatments in both indications. Avatrombopag does not compete with TPO for binding to the TPO receptor and has an additive . Clin Gastroenterol Hepatol. Incidence, prevalence, and clinical significance of abnormal hematologic indices in compensated cirrhosis. Instituto Grifols SA. Immune thrombocytopenia (ITP), an acquired autoimmune disorder resulting from immune-mediated platelet destruction and impaired platelet production, is estimated to affect two to five persons per 100,000 [2]. 2018;93(7):92130. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose. Put a plan in place to protect yourself from smoke inhalation. Discover Part 6 of the Quality Data series: ATP-binding cassette sub-family G member 2, Thrombocytopenia Associated With Liver Disease, Predicted MS/MS Spectrum - 10V, Positive (Annotated), Predicted MS/MS Spectrum - 20V, Positive (Annotated), Predicted MS/MS Spectrum - 40V, Positive (Annotated), Predicted MS/MS Spectrum - 10V, Negative (Annotated), Predicted MS/MS Spectrum - 20V, Negative (Annotated), Predicted MS/MS Spectrum - 40V, Negative (Annotated). Avatrombopag is greater than 96% bound to human plasma proteins. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Platelet count <50,000/mm3 after 4 weeks of avatrombopag at 40 mg once daily: Discontinue avatrombopag. Importantly, most patients (93.8%) who responded to avatrombopag had platelet counts 50109/L on the day of the procedure compared to 38.0% of placebo recipients [6]. The mean plasma elimination half-life (%CV) of avatrombopag is approximately 19 hours (19%) Label. Refer to drug monograph for specific recommendations. In both indications avatrombopag can be considered a useful alternative to other available treatments. Changes resulting from comments received were made on the basis of scientific and editorial merit. Eur J Haematol. Avatrombopag is approved for the treatment of primary chronic immune thrombocytopenia (ITP) and to prevent bleeding caused by surgery in patients with low platelet levels caused by chronic liver disease (CLD). Biomed Res Int. Platelet count 200,000/mm3 to 400,000/mm3: Decrease dose one dose level; wait 2 weeks to reassess for subsequent dosage adjustments. 2022 Springer Nature Switzerland AG. 1). This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. Fukushima-Shintani M, Suzuki K, Iwatsuki Y, et al. Your list will be saved and can be edited at any time. Treatment for ITP should aim to improve platelet count such that the risk of bleeding is reduced with minimal treatment-related adverse events [5]. amobarbital will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. CYP2C9 polymorphisms: CYP2C9*2 and CYP2C9*3 loss-of-function polymorphisms result in reduced CYP2C9 enzymatic activity. The patients are diagnosed as hepatitis associated with very sever/sever aplastic anemia (V/SAA) or V/SAA with abnormal liver function before treatment. Avatrombopag, an alternate treatment option to reduce platelet transfusions in patients with thrombocytopenia and chronic liver disease-integrated analyses of 2 phase 3 studies. Avatrombopag is primarily metabolized by cytochrome P450 (CYP) 2C9 and CYP3A4 Label. Accessed 17 Sep 2021. Avatrombopag is a thrombopoietin receptor agonist that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production. Article Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Piatek CI, Jamieson B, Vredenburg M. Characterization of thromboembolic events occurring during the avatrombopag immune thrombocytopenia (ITP) clinical development program [abstract no. This has led to interest in alternative approaches such as TPO-RAs, which offer a convenient, non-invasive means of increasing platelet levels [6]. Pooled safety data from the two phase III trials described above (Sect 4.1) and two phase II trials (a double-blind, placebo-controlled, dose-finding trial and an open-label extension trial) included data from a total of 128 patients treated with avatrombopag 2.540mg once daily for 29.1 (median) weeks who had one post-dose safety assessment, and 22 placebo recipients. Thrombocytopenia associated with chronic liver disease. Only 6% of the administered dose was found in urine Label. InChI=1S/C29H34Cl2N6O3S2/c30-20-15-23(41-17-20)24-27(37-12-10-35(11-13-37)21-4-2-1-3-5-21)42-29(33-24)34-26(38)19-14-22(31)25(32-16-19)36-8-6-18(7-9-36)28(39)40/h14-18,21H,1-13H2,(H,39,40)(H,33,34,38), 1-(3-chloro-5-{[4-(4-chlorothiophen-2-yl)-5-(4-cyclohexylpiperazin-1-yl)-1,3-thiazol-2-yl]carbamoyl}pyridin-2-yl)piperidine-4-carboxylic acid, OC(=O)C1CCN(CC1)C1=C(Cl)C=C(C=N1)C(=O)NC1=NC(C2=CC(Cl)=CS2)=C(S1)N1CCN(CC1)C1CCCCC1, Use our structured and evidence-based datasets to. Coadministration of a single 20mg dose of avatrombopag with the dual CYP2C9 and CYP3A inducer rifampin was associated with a 0.5-fold decrease in AUC and an approximate halving of t, although this did not have a clinically relevant effect on platelet count [14]. Wojciechowski P, Wilson K, Pochopien M, et al. Blood 2017) Doptelet (avatrombopag) approved in the EU for treatment of ITP. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. 2014;123(25):388794. Use Caution/Monitor. Gastroenterology. Monitor for signs/symptoms of thromboembolism. Platelet count >400,000/mm3 after 2 weeks of avatrombopag at 20 mg once weekly: Discontinue avatrombopag. The chemical name of avatrombopag maleate is 4-piperidinecarboxylic acid . . Modify Therapy/Monitor Closely. Int J Hepatol. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. 12.1 Mechanism of Action 12.2 Pharmacodynamics 12.3 Pharmacokinetics 12.5 Pharmacogenomics 13 NONCLINICAL TOXICOLOGY . Refer to drug monograph for specific recommendations. PubMed Central If not feasible, avoid use of abametapir. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inducer requires an increased avatrombopag starting dose. The dosage could range from 20mg/week to 60mg/day. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inducer requires an increased avatrombopag starting dose. Avoid or Use Alternate Drug. In the high baseline platelet count cohorts, close to 90% of avatrombopag recipients achieved the primary endpoint compared to 38% (ADAPT-1) and 33% (ADAPT-2) of placebo recipients (p<0.0001) [Table 2]. Consider increasing CYP3A substrate dose if needed. TPO-RAs approved for use in ITP include avatrombopag, eltrombopag and romiplostimlusutrombopag is not approved in this indication. 2018 May 17. pii: S0016-5085(18)34545-1. doi: 10.1053/j.gastro.2018.05.025. tucatinib will increase the level or effect of avatrombopag by P-glycoprotein (MDR1) efflux transporter. Accessed 17 Sep 2021. Blood clots like numbness or weakness on one side of the body; pain, redness, tenderness, warmth, or swelling in the arms or legs; change in color of an arm or leg; chest pain; shortness of breath; fast heartbeat; or coughing up blood. Blood. chest pain. Aliment Pharmacol Ther. Modify Therapy/Monitor Closely. The excretion of Allopurinol can be decreased when combined with Avatrombopag. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. Twenty-two patients in the avatrombopag group and one in the placebo group completed the study, with 7 and 15, respectively, discontinuing because of lack of efficacy. This review summarises the pharmacological properties of avatrombopag and its therapeutic efficacy and tolerability in ITP, and as treatment for thrombocytopenia in patients with CLD scheduled to undergo a procedure. <50 x 109/L following at least 2 weeks of PROMACTA . Refer to drug monograph for specific recommendations. Proliferation of haematopoietic and megakaryocytic progenitor cells was also greater with the combination than with avatrombopag or rhTPO alone, indicating an additive effect early in the maturation process. Below is the link to the electronic supplementary material. In: International Society for Pharmacoeconomics and Outcomes. Dose level 4: 20 mg once daily (initial dose for all patients except those taking moderate or strong dual inhibitors or inducers of CYP2C9 and CYP3A4). In patients with ITP the recommended starting dose of avatrombopag is 20mg once daily then titrated to achieve a stable platelet count between 50 and 150109/L, with platelet levels assessed at least once weekly; consult local prescribing information for details of dose titration and discontinuation of treatment criteria [7, 8]. See monograph for details. After 26 weeks, patients who did not go on to participate in a subsequent open-label extension stage (described below) entered a dose tapering phase (4 weeks) with a further 4 weeks follow-up. levoketoconazole will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Drug created at October 20, 2016 21:09 / Updated at December 04, 2021 06:47. Avatrombopag does not lead to increased platelet activation 10. Refer to drug monograph for specific recommendations. Obtain platelet count weekly for 4 weeks following discontinuation of therapy. Afdhal N, McHutchison J, Brown R, et al. Indicated for thrombocytopenia in adults with chronic liver disease who are scheduled to undergo a procedure, Initiate 10-13 days before the scheduled procedure, Patients should undergo their procedure 5-8 days after the last dose, Indicated for thrombocytopenia in adults with chronic immune thrombocytopenia (ITP) who have had an insufficient response to a previous treatment, Use lowest dose needed to achieve and maintain a platelet count 50 x10, Initial dose: 20 mg PO qDay; not to exceed 40 mg PO qDay, Dose level 5: 40 mg 3x/week AND 20 mg on the 4 remaining days each week, Dose level 2: 20 mg 2x/week OR 40 mg qWeek, Moderate or strong dual inhibitors of CYP2C9 and CYP3A4: Start avatrombopag 20 mg 3x/week, Moderate or strong dual inducers of CYP2C9 and CYP3A4: Start avatrombopag 40 mg qDay, Mild-to-moderate (CrCl 30 mL/min): No dose adjustment required; minimally excreted by the kidneys, Severe (CrCl <30 mL/min) or hemodialysis: Unknown, Child-Turcotte-Pugh grades A, B, or C or MELD score 4-23: No clinically meaningful effects on the pharmacokinetics, Obtain platelet count before initiating therapy and on the day of a procedure, After initiating, assess platelet count weekly until 50 x10, Obtain platelet counts weekly for at least 4 weeks following discontinuation, Dova Pharmaceuticals, Inc; 240 Leigh Farm Road,Suite 245; Durham, North Carolina 27707, Thrombopoietin (TPO) receptor agonists associated with thrombotic and thromboembolic complications in patients with chronic liver disease or chronic ITP, Portal vein thrombosis reported with chronic liver disease in patients treated with thrombopoietin (TPO) receptor agonists (ADAPT-1 and ADAPT-2 clinical trials), Consider the potential increased thrombotic risk when administering to patients with known risk factors for thromboembolism, including genetic prothrombotic conditions (eg, factor V Leiden, prothrombin 20210A, antithrombin deficiency, or protein C or S deficiency), Not to be administered to patients with chronic liver disease or chronic immune thrombocytopenia in an attempt to normalize platelet counts; thromboembolic events (arterial or venous) reported, Monitor platelet counts and follow dosing guidelines to achieve target platelet counts; monitor patients receiving therapy for signs and symptoms of thromboembolic events and institute treatment promptly, Avatrombopag is a CYP2C9 and CYP3A4 substrate; it inhibits organic anion transporter (OAT) 3 and breast cancer resistance protein (BCRP), Coadministration with a moderate or strong dual CYP2C9 and CYP3A4 inhibitor increases avatrombopag AUC, which may increase the risk of avatrombopag toxicities, If starting a moderate or strong dual CYP2C9 and CYP3A4 inhibitor during treatment, monitor platelet counts and adjust avatrombopag dose as necessary, Coadministration with a moderate or strong dual CYP2C9 and CYP3A4 inducers decreases avatrombopag AUC, which may reduce efficacy of avatrombopag, If starting a moderate or strong dual CYP2C9 and CYP3A4 inducer during treatment, monitor platelet counts and adjust avatrombopag dose as necessary, In animal reproduction studies, administration resulted in adverse developmental outcomes when administered during organogenesis in rabbits and during organogenesis and the lactation period in rats, These findings were observed at exposures based on AUC substantially higher than AUC observed in patients at a dose of 60 mg qDay, Advise pregnant women of the potential risk to a fetus, Interrupt breastfeeding and pump and discard breast milk in lactating women receiving avatrombopag for brief periods (eg, before an invasive procedure) during treatment and for 2 weeks after the last dose in order to minimize exposure to a breastfed child, In the case of a missed dose, administer next dose as soon as possible, Do not take 2 doses at one time to make up for a missed dose; take the next dose at the usual time the next day. provider for the most current information. Part of Springer Nature. Adv Ther. Michelson AD, Smolensky Koganov E, Forde EE, et al. Portal vein thrombosis has occurred (rarely) in patients with chronic liver disease who received avatrombopag. World J Radiol. Adverse reactions occurring with a frequency of 10% included headache (31% with avatrombopag vs 14% with placebo), fatigue (28% vs 9%), contusion (26% vs 18%), epistaxis (19% vs 18%), upper respiratory tract infection (15% vs 5%), arthralgia (13% vs 0%), gingival bleeding (13% vs 0%), petechiae (11% vs 9%) and nasopharyngitis (10% vs 0%). Avoid or Use Alternate Drug. Serious - Use Alternative (1)lonafarnib will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)enzalutamide will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When treating ITP, reduce starting dose of avatrombopag to 20 mg PO 3 times weekly when used concomitantly with mifepristone; in patients starting mifepristone while receiving avatrombopag, monitor platelet counts and adjust avatrombopag dose as necessary; coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose. ceritinib will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The preparation of this review was not supported by any external funding. As a result, based on its mechanism of action, safety, and flexible dosing, avatrombopag is a rational choice for the prevention and management of thrombocytopenia associated with niraparib therapy. Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Monitor Closely (1)amiodarone will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If unavoidable, reduce CYP3A substrate dose according to product labeling. 2013;98(1):1023. This medication is used by people with chronic liver disease and a certain blood disorder (low platelet count) who are scheduled to have a medical or dental procedure. 1):234. In G-CSFmobilized human peripheral blood CD34+ cells cultured with a combination of avatrombopag and rhTPO, megakaryocyte proliferation was 200% greater than that seen with rhTPO alone. Avatrombopag mechanism of action: ATP-Binding Cassette (ABC . [5] It is a thrombopoietin receptor agonist. Management: Management of this interaction varies based on avatrombopag indication. See monograph for details. Mechanism of action Avatrombopag is an orally bioavailable, small molecule thrombopoietin (TPO) receptor agonist that stimulates proliferation and differentiation of megakaryocytes from bone marrow progenitor cells resulting in an increased production of platelets. Find information on Avatrombopag (Doptelet) in Davis's Drug Guide including dosage, side effects, interactions, nursing implications, mechanism of action, half life, administration, and more. ritonavir will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When treating ITP, reduce starting dose of avatrombopag to 20 mg PO 3 times weekly when used concomitantly with mifepristone; in patients starting mifepristone while receiving avatrombopag, monitor platelet counts and adjust avatrombopag dose as necessary; coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inhibitor requires a decreased avatrombopag starting dose. Poordad F, Terrault NA, Alkhouri N, et al. commonly, these are "preferred" (on formulary) brand drugs. Avatrombopag is a substrate of cytochrome P450 (CYP) 2C9 and CYP3A. 2009;82(4):24754. Human megakaryocyte colonies generated with avatrombopag had similar morphologic features to those generated with rhTPO. Google Scholar. Avatrom bopag significantly increased the chance of achieving durable platelet response and reducing the use of concomitant ITP medication vs placebo, and significantly reduced the incidence of any bleeding events compared with placebo, eltrombopag, and romiplostim. Expert Rev Clin Immunol. We review the mechanism of action, safety and efficacy of fostmatinib in 2 randomized controlled trials in North America, Australia and Europe (FIT1 . Use our structured and evidence-based datasets to unlock new insights and accelerate drug research. Dosage adjustment for concomitant therapy with moderate or strong dual inhibitors or inducers of CYP2C9 and CYP3A4 in chronic liver disease-associated thrombocytopenia: No dosage adjustment necessary. Refer to drug monograph for specific recommendations. The patient ultimately was taken off fostamatinib and it was demonstrated that avatrombopag 40 mg/day monotherapy was quite effective in achieving and maintaining high platelet values. 2020;2020:5421632. Avatrombopag is metabolized primarily by cytochrome P450 (CYP) 2C9 and CYP3A, with unchanged drug and metabolites excreted mostly in faeces (88%), and no metabolites detected in plasma. 2020. https://www.nice.org.uk/guidance/ta626. Pharmacother. avatrombopag (doptelet ) is an orally administered second generation thrombopoietin receptor agonist (tpo-ra) approved for the treatment of primary chronic immune thrombocytopenia (itp) in adult patients who are refractory or have an unsatisfactory response to other treatments, as well as for the treatment of thrombocytopenia in adult patients When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inducer requires an increased avatrombopag starting dose. Similarly, clinical trials in patients with low platelet levels because of CLD showed that giving avatrombopag prior to surgery reduced the need for platelet transfusions or rescue procedures for bleeding. Background: Avatrombopag is a novel oral, nonpeptide thrombopoietin receptor agonist (TPO-RA). Fostamatinib for the treatment of adult persistent and chronic immune thrombocytopenia: results of two phase 3, randomized, placebo-controlled trials. 2021. https://clinicaltrials.gov/. [, FDA approves avatrombopag for thrombocytopenia in adults with chronic liver disease [, Avatrombopag, a Novel Thrombopoietin Receptor Agonist, Increases Platelet Counts without Increasing Platelet Activation in Patients with Thrombocytopenia Due to Chronic Liver Disease [, NCI Drug Dictionary: Avotrombopag maleate [, NEJM Journal Watch: FDA Approval of Avatrombopag [, Avatrombopag Gains FDA Approval for Patients with Chronic Liver Disease [, SLC22A8 - solute carrier family 22 member 8 (human) [, Nomoto M, Ferry J, Hussein Z: Population Pharmacokinetic/Pharmacodynamic Analyses of Avatrombopag in Patients With Chronic Liver Disease and Optimal Dose Adjustment Guide With Concomitantly Administered CYP3A and CYP2C9 Inhibitors. carbamazepine will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Satapathy S, Jamieson B. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Serious - Use Alternative (1)ritonavir will increase the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The drug was generally well tolerated in both indications. The biology of thrombopoietin and thrombopoietin receptor agonists. Feces (88%; 34% as unchanged drug); urine (6%). Refer to drug monograph for specific recommendations. US National Institutes of Health. Al-Samkari H, Nagalla S. Efficacy and safety evaluation of avatrombopag in immune thrombocytopenia: analyses of a phase III study and long-term extension. Controlled studies in pregnant women show no evidence of fetal risk. Although a small proportion of patients are able to tolerate prolonged low-dose corticosteroid therapy, alternative subsequent treatment options are required for most. Maximum plasma concentrations (Cmax) and the area under the plasma concentration-time curve (AUC) were not affected to a clinically important extent when avatrombopag was given with high or low fat food; however, between and within subject variability in Cmax and AUC was reduced by 50% and it is thus recommended that the drug is administered with food [8, 13].
Welsh Postcode Example, Publix Remoulade Sauce, Figuarts Zero Official Website, Prayer Points From Psalm 133, 40 Year-old Actresses 2022, Berkshire Pork Vs Kurobuta, Gcash Interest Rate Calculator,