Avatrombopag
Thrombopoietin receptor agonists
Thrombopoietin receptor agonists
An oral thrombopoietin receptor agonist that raises platelets before a procedure in chronic liver disease and in chronic immune thrombocytopenia.
Quick facts
- Group
- Thrombopoietin receptor agonists
- Target
- Thrombopoietin receptor (MPL, c-Mpl) on megakaryocytes
- Used for
- Thrombocytopenia in adults
- Key effects
- Tiredness · Headache · Nose or gum bleeding
- Monitor
- Platelet count before the procedure
- ATC
- B02BX08
No doses: the clinician sets them by the current guideline.
Mechanism of action
No structure with avatrombopag is available; the figure shows natural human thrombopoietin bound to its receptor MPL (cryo-EM). Avatrombopag is a small, non-peptide molecule that activates the same receptor.
Avatrombopag is an oral non-peptide agonist of the thrombopoietin receptor (MPL). Activating MPL on megakaryocyte progenitors increases their growth and maturation, so more platelets are released. It is more potent than eltrombopag.
- Avatrombopag activates MPL on megakaryocyte progenitors
- Megakaryocytes grow and mature
- More platelets enter the blood
Indications
- Thrombocytopenia in adults with chronic liver disease scheduled for a procedure Cirrhosis →
- Chronic immune thrombocytopenia with inadequate response to other treatments Immune thrombocytopenia (ITP) →
Adverse effects
Common
- Tiredness
- Headache
- Nose or gum bleeding
- Joint pain
Contraindications
- Hypersensitivity to avatrombopag
- Caution with previous clots or inherited clotting disorders
Key interactions
- Anticoagulants and antiplatelets
- Bleeding risk persists while platelets are low; the combination is reviewed carefully
What is monitored
- Platelet count before the procedure, and regularly in immune thrombocytopenia
- Signs of thrombosis
Administration and safety
- Tablets taken by mouth with food, at about the same time each day
- Before a procedure, a short course is timed to finish some days before it
- Do not confuse with other thrombopoietin receptor agonists (eltrombopag, lusutrombopag, romiplostim)
Pregnancy and breastfeeding
A pregnancy is reported to the doctor; breastfeeding is avoided during treatment and for a period after it.
Nursing care
- Check the platelet count and the date of the planned procedure
- Teach signs of clots and of bleeding
- Ask about previous thrombosis
- Teach to take it with food
Pharmacokinetics
- Absorption
- Oral, taken with food
- Onset and duration
- Platelets rise over days, so the course starts well before a planned procedure
Test yourself
Think of the answer, then tap the question to see it.
Which receptor does avatrombopag activate?
The thrombopoietin receptor (MPL).
Why is it started days before a procedure in liver disease?
Because platelets take days to rise.
Which serious complication is a concern in chronic liver disease?
Portal vein thrombosis.
Connections
← Back to the class: Thrombopoietin receptor agonists
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Avatrombopag: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2025); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.