Romiplostim
Aliases: Nplate
Last verified: 2026-09-23
The short version
A "peptibody" — a peptide TPO mimetic fused to Fc; stimulates platelet production in immune thrombocytopenia (ITP).
Identity & type
- Molecular type
- peptide
- Origin
- A "peptibody" — a peptide TPO mimetic fused to Fc; stimulates platelet production in immune thrombocytopenia (ITP).
Mechanism of action
TPO receptor (c-Mpl) agonism → megakaryocyte proliferation.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. 1–10 mcg/kg SC weekly.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
1–10 mcg/kg SC weekly. Nplate: in immune thrombocytopenia raises platelets and reduces bleeding; weekly injections with platelet-level dosing.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Nplate: in immune thrombocytopenia raises platelets and reduces bleeding; weekly injections with platelet-level dosing.
Protocol — official vs community
Official / label
Nplate (immune thrombocytopenia ≥6 months, and hematopoietic acute radiation syndrome): 1 mcg/kg SC once weekly; adjust in 1 mcg/kg steps by platelet count (max 10 mcg/kg).
- 01Start 1 mcg/kg SC weekly
- 02Increase by 1 mcg/kg weekly if platelets remain <50 ×10⁹/L
- 03Platelets ≥200 ×10⁹/L for 2 consecutive weeks: reduce by 1 mcg/kg; >400 ×10⁹/L: hold
Duration: Chronic in ITP — platelet gains persist only while dosing continues; discontinuation planning is deliberate and tapered.
Dose-by-count weekly titration is the entire protocol; the hazard is overshoot into thrombocytosis and rebound worsening after abrupt stops. Hematology-managed biologic.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
Approved 2008; also for radiation myelosuppression (H-ARS, 2021).
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Thromboembolism, bone-marrow fibrosis (rare), rebound thrombocytopenia.characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials