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[Pharmacology](https://durgical.com/en/pharmacology/) · [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/)

# Romiplostim

A weekly injected thrombopoietin receptor agonist (a peptide on an antibody fragment) that raises platelets in chronic immune thrombocytopenia.

Updated 2026-11-01

- Class: [Thrombopoietin receptor agonists](https://durgical.com/en/pharmacology/classes/thrombopoietin-receptor-agonists/)
- Receptor: Thrombopoietin receptor (MPL, c-Mpl) on megakaryocytes
- ATC code: B02BX04

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

ⓘ The figure shows natural human thrombopoietin bound to its receptor MPL (cryo-EM); romiplostim's peptide binds the same receptor but has no sequence similarity to thrombopoietin.

**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

## Mechanism of action

Romiplostim is a peptide that binds the thrombopoietin receptor, joined to antibody fragments that prolong its half-life. Its peptide has no sequence similarity to thrombopoietin, so it does not induce antibodies against the natural hormone. Activation of MPL increases megakaryocyte growth and platelet production.

- Romiplostim binds MPL on megakaryocyte progenitors
- The receptor signals growth and maturation
- Megakaryocytes release more platelets

## Pharmacokinetics

**Absorption**
Subcutaneous injection

**Elimination**
Cleared by the reticuloendothelial system

**Half-life**
Several days; longer when platelets are low

## Indications

- Chronic immune thrombocytopenia with inadequate response to other treatments [Immune thrombocytopenia (ITP) →](https://durgical.com/en/conditions/immune-thrombocytopenia/)
- Bone marrow injury from acute radiation exposure (haematopoietic syndrome)

## Adverse effects

### Common

- Headache, dizziness
- Joint, muscle and limb pain
- Tingling in arms or legs
- Trouble sleeping

### Serious (rare, important)

- Thrombosis (leg swelling, chest pain, breathlessness)
- Bleeding when treatment stops and platelets fall again
- Severe allergic reactions

## Contraindications

- Hypersensitivity to romiplostim
- Caution in myelodysplastic syndrome, other marrow diseases and liver disease

## Key interactions

**Anticoagulants and antiplatelets**
Bleeding risk persists while platelets are low; the combination needs close review

## What is monitored

- Platelet count regularly
- Complete blood count after stopping
- Signs of thrombosis

## Administration and safety

- Weekly subcutaneous injection, usually by a health professional
- The dose is adjusted to the platelet response; a missed appointment is reported at once

## Nursing care

- Check the platelet count before each dose
- Teach bleeding precautions and to avoid injury
- Warn that platelets can fall if doses are missed or treatment stops

## Pregnancy and breastfeeding

Data in pregnancy are limited; breastfeeding is avoided during treatment.

## Memory aid

ROMIplostim = «ROutine Monday Injection»: one shot a week for platelets.

## Test yourself

Think of the answer, then tap the question to see it.

## What is romiplostim made of?

A thrombopoietin-receptor-binding peptide joined to antibody fragments.

## How is it given?

By subcutaneous injection once a week.

## What can happen if it is stopped?

Platelets fall again, with a risk of bleeding.

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

## Related drugs

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

## Related conditions

- [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: [Romiplostim Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a609008.html) (MedlinePlus (U.S. National Library of Medicine), 2025); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 33 (McGraw Hill, 2025); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 45 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=B02BX04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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