Introduction of Avatropag 20 mg :

Avatropag 20 mg is used in thrombocytopenia control. Each film coated tablet of Avatropag contains Avatrombopag Maleate INN which is equivalent to Avatrombopag 20 mg. Avatropag is manufactured by Ziska Pharmaceuticals Limited and exported globally by Onco Solution. Avatrombopag, as the active ingredient, represents Ziska Pharmaceuticals Limited’s dedication to offering tailored solutions to the individual needs of cancer patients globally.Thrombocytopenia presents a substantial issue in cancer treatment by raising the risk of bleeding and complicating therapy. Avatropag 20 mg helps alleviate this issue by boosting platelet synthesis in cancer patients. Avatropag’s mode of action involves activating the thrombopoietin receptor, which promotes platelet synthesis in the bone marrow and helps patients enduring rigorous cancer treatment.

Indication:

Avatropag (Avatrombopag) is mainly used in the treatment of thrombocytopenia in patients with chronic liver disease (CLD): It is recommended for treating thrombocytopenia in adult patients with chronic liver disease. Avatropag (Avatrombopag)  is also indicated for the treatment of Thrombocytopenia in Chronic Immune Patients (ITP). Avatropag (Avatrombopag)  is used to treat chronic immunological thrombocytopenia in adults who have not responded well to earlier treatments.

Pharmacology:

Avatropag, an orally accessible small molecule TPO receptor agonist, promotes megakaryocyte proliferation and differentiation in bone marrow.
Progenitor cells, which leads to enhanced platelet synthesis. The median time to peak concentration (Tmax) was 5-6 hours post-dose. Avatropag has a mean distribution volume of 180 L (25% CV). Avatrombopag binds to more than 96% of human plasma proteins. Avatropag has an average plasma elimination half-life (%CV) of 19 hours. The average clearance rate for Avatropag is 6.9 L/hr (29%). Avatrombopag  is metabolized predominantly by CYP2C9 and CYP3A4. Fecal excretion accounted for 88% of the given dosage of Avatropag, with 34% being unaltered  (Avatrombopag). Only 6% of the administered dose of Avatropag was found in urine.

Dosage and Administration of Avatropag:

Recommended Dosage for Patients with Chronic Liver Disease: Recommended Dose and Duration for Patients With Chronic Liver Disease If your platelet count is less than 40X109/L, you can take 60 mg (3 tablets) of Avatrombopag for 5 days before your procedure. Platelet count 40 to less than 50X109/L: 40 mg (2 tablets) of Avatropag for five days. Recommended dosage for patients with chronic immune thrombocytopenia: Initial Dosage Regimen: Begin taking Avatropag at a dose of 20mg (1 pill) once daily with food. Avatrombopag dose adjustments for patients with chronic immune thrombocytopenia-

Less than 50 after at least two weeks of Avatropag  x 109/L: Increase by one dose level. Wait two weeks to evaluate the efficacy of this regimen and any further dosage modifications.

Between 200 and 400 x 109/L: Reduce one dose level.

Wait two weeks to evaluate the efficacy of this regimen and any further dosage modifications.
Stop using Avatropag    if the concentration exceeds 400 x 109/L. Increase platelet monitoring to twice a week. When the platelet count is less than 150 x10 9 /L, reduce One Dose Level as per Table 3 of Avatropag and resume therapy.
If the count is less than 50 after 4 weeks of Avatropag 40 mg once daily x 109/L, the drug should be discontinued. If the count exceeds 400 after two weeks of Avatrombopag   20 mg weekly x 109/L, the medication should be discontinued.

Side Effects of Avatropag:

Common side effects of Avatropag (Avatrombopag)  for patients with chronic liver disease were pyrexia, stomach discomfort, nausea, headache, lethargy, and peripheral edema while common side effects of Avatropag for patients with chronic immune thrombocytopenia include headache, weariness, confusion, epistaxis, upper respiratory tract infection, arthralgia, gingival bleeding, petechiae, and nasopharyngitis.

Use during pregnancy and lactation:
Pregnant women should be aware of the potential risk to their fetus due to Avatropag. Females with reproductive potential should inform their prescriber of known or suspected pregnancy. Breastfeeding mothers should avoid breastfeeding while using Avatropag (Avatrombopag) for at least 2 weeks following the final dosage. Use in Children: There is no data available.

Drug interaction:

To avoid drug interactions, patients taking moderate or severe dual inhibitors of CYP2C9 and CYP3A4 should monitor platelet counts and alter the dose of Avatropag (Avatrombopag) accordingly.

Overdose:

There is no data available.

Storage Conditions:
Avatropag should be kept between 25°C and 30°C at room temperature. When a medication is no longer needed or has expired, dispose of it safely. Protect Avatropag from sunlight and humidity. Keep Avatropag and all medicines out of the reach of children.

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