romiplostim at a glance
Medicine class
Thrombopoietin-receptor agonist biologic
Main licensed use
Primary ITP that is refractory to previous treatments
Administration
Injection under the skin; selected trained adults may self-inject
Monitoring
Regular platelet counts and other blood tests are essential
What is romiplostim used for?
The selected products are licensed for primary ITP that has not responded adequately to previous treatments.
Adults with primary ITP, whether or not the spleen has been removed.
Children aged one year and over with chronic primary ITP, using the selected powder-only vial product.
How does romiplostim work?
Romiplostim is an Fc-peptide fusion protein that activates the thrombopoietin receptor, also called c-Mpl. This stimulates platelet-forming cells in the bone marrow, increasing platelet production and helping reduce bleeding associated with ITP.
romiplostim preparations and strengths
Injection
Route: Parenteral
Strengths: 125 micrograms, 250 micrograms
How to take romiplostim
Romiplostim is injected under the skin after the powder has been correctly reconstituted. It is normally given under specialist supervision. Selected adults may self-inject only after training and approval by their clinical team.
Follow the supplied preparation and injection instructions exactly.
Do not shake the vial vigorously.
Do not use a solution containing particles or discolouration.
Use each vial once and discard leftover solution and injection equipment safely.
romiplostim side effects
Common or expected effects
- Headache
- Upper respiratory tract infection
- Dizziness
- Nausea, diarrhoea, abdominal discomfort or constipation
- Rash, itching or bruising
- Joint, muscle, back, bone or limb pain
- Tiredness or flu-like symptoms
- Injection-site reactions
Get urgent medical advice
- Severe allergic reaction, including angioedema
- Blood clots, including deep-vein thrombosis, pulmonary embolism or myocardial infarction
- Very high or falling platelet counts, causing clotting or bleeding
- Bone-marrow reticulin changes or fibrosis
- Worsening thrombocytopenia and bleeding after treatment stops
romiplostim in pregnancy
Human pregnancy information is limited, and romiplostim is not recommended during pregnancy. Discuss pregnancy plans, contraception or pregnancy during treatment promptly with the specialist team so maternal bleeding risk and potential fetal exposure can be assessed.
romiplostim while breastfeeding
It is unknown whether romiplostim enters human milk, and a risk to the infant cannot be excluded. A specialist should weigh the benefits of breastfeeding against the benefit of treatment before deciding whether breastfeeding or romiplostim should be interrupted.
romiplostim interactions
Formal interaction studies have not been performed. Tell the specialist team about all prescribed, non-prescribed and complementary products.
Anticoagulants and antiplatelet medicines
Bleeding risk may increase if platelet counts are low, particularly after romiplostim is stopped; clinical review and platelet monitoring are needed.
Corticosteroids, danazol or azathioprine
These may be used alongside romiplostim, but reducing or stopping them can alter platelet counts and requires monitoring.
Common questions about romiplostim
Answers are fully visible for fast scanning and source review.
Is romiplostim a steroid or an immunosuppressant?
No. It is a thrombopoietin-receptor agonist that stimulates platelet production rather than acting as a corticosteroid or broadly suppressing immunity.
Does romiplostim cure immune thrombocytopenia?
It usually controls low platelet counts rather than curing the underlying immune condition. Platelet counts commonly fall again after treatment stops.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.