What is the dosage for Doptelet?
Recommended Dosage For Patients With Chronic Liver Disease
Begin Doptelet dosing 10 to 13 days prior to the scheduled procedure. The recommended daily dose of Doptelet is based on the patient’s platelet count prior to the scheduled procedure (see Table 1). Patients should undergo their procedure 5 to 8 days after the last dose of Doptelet.
Doptelet should be taken orally once daily for 5 consecutive days with food. In the case of a missed dose, patients should take the next dose of Doptelet as soon as they remember. Patients should not take two doses at one time to make up for a missed dose, and should take the next dose at the usual time the next day; all 5 days of dosing should be completed.
Table 1: Recommended Dose and Duration in Patients with Chronic Liver Disease Scheduled to Undergo a Procedure
|Platelet Count (×109/L)||Once Daily Dose||Duration|
|Less than 40||60 mg (3 tablets)||5 days|
|40 to less than 50||40 mg (2 tablets)||5 days|
Doptelet has been investigated only as a single 5-day once daily dosing regimen in clinical trials in patients with chronic liver disease. Doptelet should not be administered to patients with chronic liver disease in an attempt to normalize platelet counts.
Obtain a platelet count prior to administration of Doptelet therapy and on the day of a procedure to ensure an adequate increase in platelet count.
Recommended Dosage For Patients With Chronic Immune Thrombocytopenia
Use the lowest dose of Doptelet needed to achieve and maintain a platelet count greater than or equal to 50×109/L as necessary to reduce the risk for bleeding. Dose adjustments are based on platelet count response. Do not use Doptelet to normalize platelet counts.
Initial Dose Regimen
Begin Doptelet at a starting dose of 20 mg (1 tablet) once daily with food.
After initiating therapy with Doptelet, assess platelet counts weekly until a stable platelet count greater than or equal to 50×109/L has been achieved, and then obtain platelet counts monthly thereafter. Obtain platelet counts weekly for at least 4 weeks following discontinuation of Doptelet.
Dose adjustments (see Table 2 and Table 3) are based on the platelet count response. Do not exceed a daily dose of 40 mg (2 tablets).
Table 2: Doptelet Dose Adjustments for Patients with Chronic Immune Thrombocytopenia
|Platelet Count (×109 /L)||Dose Adjustment or Action|
|Less than 50 after at least 2 weeks of Doptelet||
|Between 200 and 400||
|Greater than 400||
|Less than 50 after 4 weeks of Doptelet 40 mg once daily||
|Greater than 400 after 2 weeks of Doptelet 20 mg weekly||
Table 3: Doptelet Dose Levels for Titration in Patients with Chronic Immune Thrombocytopenia
|40 mg Once Daily||6|
|40 mg Three Times a Week AND 20 mg on the Four Remaining Days of Each Week||5|
|20 mg Once Daily*||4|
|20 mg Three Times a Week||3|
|20 mg Twice a Week OR 40 mg Once Weekly||2|
|20 mg Once Weekly||1|
|*Initial dose regimen for all patients except those taking Moderate or Strong Dual Inducers or Moderate or Strong Dual Inhibitors of CYP2C9 and CYP3A4.|
In the case of a missed dose, patients should take the missed dose of Doptelet as soon as they remember. Patients should not take two doses at one time to make up for a missed dose, and should take the next dose per the current regimen.
Discontinue Doptelet if the platelet count does not increase to greater than or equal to 50×109 /L after 4 weeks of dosing at the maximum dose of 40 mg once daily. Discontinue Doptelet if the platelet count is greater than 400×109 /L after 2 weeks of dosing at 20 mg once weekly.
Recommended Dosage With Concomitant Moderate Or Strong Dual Inducers Or Inhibitors Of CYP2C9 And CYP3A4 In Patients With Chronic Immune Thrombocytopenia
The recommended starting doses of Doptelet in patients with chronic immune thrombocytopenia receiving concomitant medications are summarized in Table 4.
Table 4:Doptelet Recommended Starting Dose for Patients with Chronic Immune Thrombocytopenia Based on Concomitant Medications
|Concomitant Medications||Recommended Starting Dose|
|Moderate or strong dual inhibitors of CYP2C9 and CYP3A4||20 mg (1 tablet) three times a week|
|Moderate or strong dual inducers of CYP2C9 and CYP3A4||40 mg (2 tablets) once daily|