Lancashire and South Cumbria
Formulary
 
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9 Nutrition and blood
09-01-04 Drugs used in autoimmune thrombocytopenic purpura

Anagrelide
Formulary

Capsules 500 micrograms

Specialist initiation only.

Effective contraception required during treatment.

Link  MHRA: Xagrid (anagrelide hydrochloride): Risk of thrombosis, including cerebral infarction, if treatment discontinued abruptly. [also applicable to generic forms]

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Avatrombopag Doptelet®
Formulary

Tablets 20mg

Specialist initiation only.

Link  NICE TA626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
Link  NICE TA853: Avatrombopag for treating primary chronic immune thrombocytopenia

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Caplacizumab  Cablivi®
Formulary

Solution for injection 10mg

Specialist initiation only.

Link  NICE TA667: Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura

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Eltrombopag Revolade®
Formulary

Tablets 25mg, 50mg

Specialist initiation only.

Ensure effective contraception during treatment.

Link  MHRA: Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results
Link  NICE TA293: Eltrombopag for treating chronic immune thrombocytopenia

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Fostamatinib  TAVLESSE ®
Formulary

Film coated tablets, 100mg, 150mg

Specialist initiation only.

Manufacturer advises effective contraception during and for at least 1 month after stopping treatment in females of childbearing potential.

Link  NICE TA835: Fostamatinib for treating refractory chronic immune thrombocytopenia

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Lusutrombopag Mulpleo®
Formulary

Film coated tablets 3mg

Specialist initiation only.

Link  NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

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Romiplostim Nplate®
Formulary

Injection 250 micrograms

Specialist initiation only.

Link  NICE TA221: Romiplostim for the treatment of chronic immune thrombocytopenia

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Rituximab
Formulary

Off-label use for the treatment of idiopathic thrombocytopenia in adults.

For use as an alternative 2nd line treatment in adults with ITP following failure of corticosteriod treatment or when corticosteroids and thrombopoietin receptor agonists are contraindicated

Treatment requires initiation and continuation and continuation by specialist haematology services.

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Link  LSCMMG: Rituximab Intravenous Infusion For treatment of Idiopathic Thrombocytopenia Purpura (ITP) in adults NMR
Link  MHRA: Rituximab: screen for hepatitis B virus before treatment

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