Drug Action
Lusutrombopag is a thrombopoietin receptor agonist that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production.
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Drug reference
Lusutrombopag is a thrombopoietin receptor agonist that binds to and activates the thrombopoietin (TPO) receptor, thereby increasing platelet production.
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Thrombocytopenia [in patients with chronic liver disease undergoing invasive procedures] (under expert supervision) ▶BY MOUTH ▶Adult: 3 mg once daily for 7 days, treatment to be started at least 8 days before procedure; in clinical trials procedures were carried out between 9 to 14 days after starting lusutrombopag
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Administration before laparotomy, thoracotomy, open-heart surgery, craniotomy, or excision of organs (no clinical experience). body-weight less than 45kg (limited information available). history of splenectomy (no clinical experience). risk factors for thromboembolism CAUTIONS, FURTHER INFORMATION ▶Body-weight less than 45kg Monitor platelet count approximately 5 days after the first dose and as necessary thereafter; stop treatment if the platelet count reaches 50x109/litre or more and has increased 20x109/litre from baseline.
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NICE decisions ▶Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure (January 2020) NICE TA617 Lusutrombopag (Mulpleo ®) is recommended, within its marketing authorisation, as an option for treating severe thrombocytopenia (that is, a platelet count of below 50,000 platelets per microlitre of blood) in adults with chronic liver disease having planned invasive procedures. www.nice.org.uk/guidance/ta617 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2227 The Scottish Medicines Consortium has advised (December 2019) that lusutrombopag (Mulpleo ®) is accepted for use within NHS Scotland for the treatment of severe thrombocytopenia in adults with chronic liver disease undergoing invasive procedures.
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▶Common or very common Headache. nausea. rash ▶Frequency not known Embolism and thrombosis
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises caution in severe impairment (limited information available)— monitor platelet count approximately 5 days after the first dose and as necessary thereafter. Stop treatment if the platelet count reaches 50x109/litre or more and has increased 20x109/litre from baseline.
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Manufacturer advises monitor platelet count prior to procedure; more frequent monitoring may be required in some patients—see Cautions and Hepatic Impairment for further information.
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There can be variation in the licensing of different medicines containing the same drug. Tablet A ▶Mulpleo (Shionogi) Lusutrombopag 3 mg Mulpleo 3mg tablets | 7 tablet P £800.00 4.2a Acquired thrombotic thrombocytopenic purpura ANTITHROMBOTIC DRUGS
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3 mg once daily for 7 days, treatment to be
First-line fragment. Read the complete Indications and Dose section above.
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