[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/) › Avatrombopag

# 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.

Updated Nov 1, 2026

## Quick facts

**Group**
[Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Thrombopoietin receptor (MPL, c-Mpl) on megakaryocytes**Avatrombopag

ⓘ 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.

**Target in 3D:** Thrombopoietin receptor (MPL, c-Mpl) on megakaryocytes. PDB structure 8G04 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8G04) · Drag to rotate · pinch to zoom

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 →](https://durgical.com/en/conditions/cirrhosis/)
- Chronic immune thrombocytopenia with inadequate response to other treatments [Immune thrombocytopenia (ITP) →](https://durgical.com/en/conditions/immune-thrombocytopenia/)

## Adverse effects

### Common

- Tiredness
- Headache
- Nose or gum bleeding
- Joint pain

### Serious (rare, important)

- Thrombosis, including portal vein thrombosis in chronic liver disease (leg swelling, breathlessness, chest pain, abdominal 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

## Memory aid

«AVA = Ahead of the procedure, Via mouth, Agonist of MPL».

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/avatrombopag/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 2

- [Eltrombopag](https://durgical.com/en/pharmacology/eltrombopag/)
- [Romiplostim](https://durgical.com/en/pharmacology/romiplostim/)

## Related conditions 2

- [Cirrhosis](https://durgical.com/en/conditions/cirrhosis/)
- [Immune thrombocytopenia (ITP)](https://durgical.com/en/conditions/immune-thrombocytopenia/)

[← Back to the class: Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a618032.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=B02BX&showdescription=no) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/avatrombopag/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/avatrombopag/