Usual Adult Dose for Thrombocytopenia

Chronic Liver Disease:
Platelet count less than 40 x 10(9)/L: 60 mg orally once a day starting 10 to 13 days prior to the scheduled procedure
Platelet count 40 to less than 50 x 10(9)/L: 40 mg orally once a day starting 10 to 13 days prior to the scheduled procedure

Duration of therapy: 5 days

Comments:

• Patients should undergo their procedure 5 to 8 days after the last dose of this drug.
• Do not use this drug to normalize platelet counts.

• Platelet count less than 50 x 10(9)/L after at least 2 weeks of treatment with this drug: Increase one dose level and wait 2 weeks to assess the effects of this regimen and any subsequent dose adjustments.
• Platelet count between 200 and 400 x 10(9)/L: Decrease one dose level and wait 2 weeks to assess the effects of this regimen and any subsequent dose adjustments.
• Platelet count greater than 400 x 10(9)/L: Stop this drug and increase platelet monitoring to twice a week. When platelet count is less than 150 x 10(9)/L, decrease one dose level and reinitiate therapy.
• Platelet count less than 50 x 10(9)/L after 4 weeks at 40 mg once a day: Discontinue this drug.
• Platelet count greater than 400 x 10(9)/L after 2 weeks at 20 mg once a week: Discontinue this drug.

• Dose level 6: 40 mg once a day
• Dose level 5: 40 mg three times a week AND 20 mg on the four remaining days of each week
• Dose level 4: 20 mg once a day
• Dose level 3: 20 mg three times a week
• Dose level 2: 20 mg twice a week OR 40 mg once a week
• Dose level 1: 20 mg once a week

• Use the lowest dose needed to achieve and maintain a platelet count greater than or equal to 50 x 10(9)/L as necessary to reduce the risk for bleeding.
• Do not use this drug to normalize platelet counts.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

This drug should not be administered to normalize platelet counts.

Dose Adjustments

Chronic Immune Thrombocytopenia:
Concomitant moderate or strong dual inhibitors of CYP450 2C9 and 3A4: Initial dose: 20 mg orally 3 times a week
Concomitant moderate or strong dual inducers of CYP450 2C9 and 3A4: Initial dose: 40 mg orally once a day

Precautions

CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Administer with food.
• In case of a missed dose, the next dose should be administered as soon as possible; do not administer two doses at one time to make up for a missed dose. The next regularly scheduled dose should be administered at the usual time the next day.

• Hematologic: Platelet count (chronic liver disease: prior to starting this drug and on the day of a procedure; chronic immune thrombocytopenia: weekly until a stable platelet count greater than or equal to 50 x 10(9)/L has been achieved, monthly thereafter, and weekly for at least 4 weeks following discontinuation)

• Advise women not to breastfeed during treatment with this drug and for at least 2 weeks after the final dose.
• Advise pregnant women of the potential risk to a fetus.
• Advise females of reproductive potential to inform their prescriber of a known or suspected pregnancy.

Frequently asked questions

• What is Doptelet used for and how does it work?
• Mulpleta vs Doptelet - What's the difference?
• How do you take Doptelet before a medical or dental procedure?