Nplate didn't has any effect

[hamid_80386]

My wife had an inject of Nplate 5 days ago

Her platelets count was 76 before inject

Now after 5days of inject she has 72 count of platelete

It seem Nplate didn't has any effect on my wife, what is reason?

She had treatment with ivig and rituximub in the past, and those drugs didn't has complete effect too

[Morgan]

I had two injections of Nplate a week apart and my platelets rose from 23 to normal. This was in preparation for an operation so it worked for me, I have no need of medication at the moment and only have a test yearly now. Your wife's count is higher than most with ITP so why does she need Nplate, does she have another condition or suffer bad symptoms.

[hamid_80386 in reply to Morgan]

No Morgan, my wife didn't has problem other than ITP, but Rituximab injection didn't effect for her, and in 4 injection her platelets goes to 35, 35, 25, 8

And after 5 Injection of IVIG her platelets was (after 3 day 276) (after 10 day 176) (after 17 days 76)

So it is possible her platelets goes to under 35 after Nplate,

hematologist said if Nplate dosn't has effect we must prepare for splenectomy!

[Kyriak51]

Hi, Nplate is startedat 1mcgper kg, if your wief’s wt. was 60kg or 132 lbs she should have 60mcg of Nplate weekly injections, if no response the dose should have been increased by1 mcg/kg until a positive resulted seen. My first injection wason10/01/09 (count was 8 thousand), it was not until 12/09/09 that my count increased to 125 thousand (manual count) or 30 thousand auto count on an increased dose of 2mcg/kg. Nplate is NOT a one dose drug!! What country are you from that your doctors DO NOT follow the dosing for Nplate use? The maximum dose is10mcg/kg your doctors should have increased the dose! As for rituximb, it has only a 50% response rate and didn’t work for me, nor did IVIg.

I have been on weekly Nplate injections since I started to maintain my counts between 30 to 80 thousand which is adequate for a fairly active lifestyle. Learn as much as you can about ITP so you can advocate for your wife, the more you know the better the care she will receive. This site has an excellent educational section, check it out. Be well Georgia

[hamid_80386 in reply to Kyriak51]

Thanks friend,

My wife's plt increase to 325 after 6days, doctors says just monitor it and if plt count reduce under 200 we take another inject.

But a question, if Nplate must inject 1mcg per kg, why vials are 250mcg and 500mcg? It is very expensive vial in my country

Are we have an ITP sick with 250kg weight? or 500kg?

Or can we keep used ampoule for later? and use a vial for example for 4 times? does it not be damaged if exposed to air?

[rjsmyth in reply to Kyriak51]

There is a definite tipping point with NPLATE. For example a 250mg (one phial) dose may have little or no effect whereas 1000th (4x250mg phials) may send platelets skywards. The whole purpose of Nplate is not to normalise your count but to obtain a safe count of around 50. As you have said dosage depends on weight. At 110kg I am on the maximum dose which currently gets my count around the magic 50 but not without some side effects.

[virginiabranscom in reply to rjsmyth]

Are you on weekly injections? Do your counts fluctuate wildly for no reason?! Mine do.

[hamid_80386]

my wife's plt increase to 310 after 6 days

but it only stilled for 6 day and her platelets down to 57 again