The Food and Drug Administration has approved avatrombopag (Doptelet) to treat thrombocytopenia in adults with chronic liver disease who are scheduled for a medical or dental procedure. Thrombocytopenia places these patients at an increased risk for bleeding during procedures. Avatrombopag increases platelet counts and may decrease or eliminate the need for platelet transfusions. This is the first drug approved for this use.

Avatrombopag is a thrombopoietin receptor agonist that stimulates the production of platelets. The rise in platelet counts peaks 10 to 13 days after the start of the five-day drug treatment. Platelet counts return to near baseline after 35 days. The dosing schedule reflects the pharmacokinetics of the drug. Avatrombopag should be taken once daily for five days, starting 10 to 13 days before the scheduled procedure, which should occur within five to eight days of the last dose.

Because of avatrombopag's action as a thrombopoietin receptor agonist, it has been associated with thrombotic and thromboembolic complications, including portal vein thrombosis. Its most common adverse effects, however, are pyrexia, abdominal pain, nausea, headache, fatigue, and peripheral edema.

Nurses should provide patients with information on how to self-administer the drug and on the signs and symptoms of a blood clot.

For complete prescribing information for avatrombopag, go to http://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210238s000lbl.pdf.