What are the precautions for Avatrombopag?

Among the warnings and precautions emerging from clinical studies of avatrombopag, thromboembolic/thromboembolic complications and embryo-fetal toxicity are relatively common. Doctors will check your patient's progress on avatrombopag regularly to make sure the drug is working properly. A blood test is needed while using this medication because clotting problems may occur. Do not take other medicines without your doctor's advice. This includes prescription or over-the-counter medicines (over-the-counter medicines) and herbal or vitamin supplements.

1. Thrombus/Thromboembolic complications: Avatrombopag is a thrombopoietin (TPO) receptor agonist. TPO receptor agonists are associated with thrombosis and thromboembolic complications in patients with chronic liver disease or chronic immune thrombocytopenia. Inclinical studies, some patients also experienced thromboembolic events (arterial or venous). Consider the potential for increased thrombotic risk when administering avatrombopag to patients with known risk factors for thromboembolism, including hereditary prothrombin conditions (e.g., factorV Leiden, prothrombin 20210A, antithrombin deficiency, or protein C or S deficiency).

Avatrombopag should not be used in patients with chronic liver disease or chronic immune thrombocytopenia to normalize platelet counts. Monitor platelet count and follow dosing guidelines to achieve target platelet count. Monitor patients receiving avatrombopag for signs and symptoms of thromboembolic events and initiate treatment promptly.

2. Embryonic-Fetal Toxicity: According to the results of animal reproduction studies, avatrombopag may cause harm to the fetus when administered to pregnant women. In animal reproduction studies, oral administration of avatropopag during organogenesis in rabbits, organogenesis and lactation in rats resulted in adverse developmental outcomes. However, these findings were observed at exposures based on AUC, which was significantly higher than the AUC observed in patients at the maximum recommended dose of 60 mg once daily. Inform pregnant women of potential risks to the fetus.

Breastfeeding women receiving avatrombopag short-term, such as before invasive surgery, should therefore interrupt breastfeeding and pump and discard breast milk during treatment and for two weeks after the last dose to minimize exposure to breastfed children. Breastfeeding is not recommended during treatment with avatropopag and for at least2 weeks after the last dose.

The original drug of avatrombopag has been launched in China and has entered the scope of Class B medical insurance, but it is only reimbursed for eligible patients. The price of a common specification of 20mg*15 tablets may be more than 7,000 yuan per box, while the original drug of avatrombopag marketed overseas is even more expensive. It is understood that there are generic drugs of avatrombopag available overseas, and their pharmaceutical ingredients are basically the same as those of the original drug. For example, the price of a box of 20mg*30 tablets in Laos pharmaceutical production specifications may be around RMB 1,000 (the price may fluctuate due to exchange rates).