Avamax

Composition

Avatrombopag 20mg Tablet: Each tablet contains Avatrombopag 20 mg.

Pharmacology

Mechanism of Action: Avatrombopag is an orally bioavailable, small molecule TPO receptor agonist that stimulates proliferation and differentiation of megakaryocytes from bone marrow progenitor cells resulting in an increased production of platelets. Avatrombopag does not compete with TPO for binding to the TPO receptor and has an additive effect with TPO on platelet production.

Indication

It is indicated in: Treatment of Thrombocytopenia in Patients with Chronic Liver Disease (CLD): Avatrombopag is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure. Treatment of Thrombocytopenia in Patients with Chronic Immune Thrombocytopenia (ITP): Avatrombopag is indicated for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.

Dosage & Administration

Avatrombopag should be started 10–13 days before the scheduled surgical procedure, and the procedure should be performed 5–8 days after the last dose is taken.

Avatrombopag should be taken once daily for 5 consecutive days with food. The dose of avatrombopag is determined based on the patient’s platelet count prior to the surgical procedure.

If a patient misses a dose of avatrombopag, it should be taken as soon as possible. However, two doses should never be taken together.

The full 5-day course must be completed.

Recommended Dose and Duration

Platelet count < 40 × 10⁹/L:

• Dose: 60 mg once daily (3 tablets)

• Duration: 5 days

Platelet count ≥ 40 × 10⁹/L but < 50 × 10⁹/L:

• Dose: 40 mg once daily (2 tablets)

• Duration: 5 days

For Patients with Chronic Immune Thrombocytopenia (ITP):

Use the lowest effective dose of avatrombopag to achieve a platelet count of ≥ 50 × 10⁹/L, or higher if needed, to reduce the risk of

bleeding.

The dose may be increased or decreased based on changes in platelet count.

Avatrombopag should not be used to normalize platelet counts.

Initial dose: 20 mg of avatrombopag once daily with food.

Take the medication only as directed by a registered physician.

Contraindications

It is contraindicated in patients with hypersensitivity to Avatrombopag or any component of this product.

Precautions & Warnings

Avatrombopag is a thrombopoietin (TPO) receptor agonist, and TPO receptor agonists are associated with thrombotic and thromboembolic complications in patients with chronic liver disease or chronic immune thrombocytopenia. Platelet counts and the signs and symptoms of thromboembolism should be monitored, and immediate medical attention should be sought if needed.

Side Effect

In patients with chronic liver disease, common reactions include fever or a feverish feeling, abdominal pain, nausea, headache, fatigue, and swelling of the legs. In patients with chronic immune thrombocytopenia, common reactions include headache, fatigue, constipation, nosebleeds, upper respiratory tract infection, joint pain, gum bleeding, red spots under the skin, and inflammation of the nasal passages

Use in Pregnancy & Lactation

Pregnancy: Based on findings from animal reproduction studies, Avatrombopag may cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to a fetus.

Drug Interaction

Moderate or strong dual inhibitors of CYP2C9 and CYP3A4: These increase the AUC of avatrombopag, resulting in an increased risk of avatrombopag toxicity. Therefore, when used together, the initial dose should be reduced.

Moderate or strong dual inducers of CYP2C9 and CYP3A4: Concurrent use decreases the AUC of avatrombopag, resulting in reduced effectiveness of avatrombopag. Therefore, when used together, the initial dose should be increased.

Packing

Avatrombopag 20mg Tablet: Each box contains 28 Tablets and one packet silica gel in a HDPE container.

Keep away from light & moisture below and store 30°C temperature, Keep all medicine out of the reach of children. Packing Avatrombopag 20mg Tablet: Each box contains 28 Tablets and one packet silica gel in a HDPE container