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How is Nplate (romiplostim) administered?

Medically reviewed by Philip Thornton, DipPharm. Last updated on March 28, 2025.

Official answer

by Drugs.com

Nplate (romiplostim) is a once-weekly subcutaneous (under the skin) injection that is administered by a healthcare provider. It is used to treat thrombocytopenia in certain patients with immune thrombocytopenia (ITP) who have not responded adequately to corticosteroids, immunoglobulins, or splenectomy.

How is Nplate prepared?

Healthcare providers prepare Nplate by reconstituting the powder contained in a vial. The process includes:

  • Using Water for Injection, USP, alone or combined with 0.9% Sodium Chloride Injection, USP.
  • Gently swirling and inverting the vial to dissolve the powder (do not shake).

How will I receive Nplate?

Your healthcare provider will use a syringe to draw up the required dose of Nplate from the vial containing the reconstituted powder. It will then be injected under your skin (subcutaneously) at one of three recommended injection sites:

  • Front of the middle thighs
  • Stomach (abdomen), except for the 2 inch (5 cm) area around the belly button
  • Outer upper arms

A syringe with 0.01 mL graduations is used for precise dosing, as Nplate doses may be very small.

What Is the Usual Nplate Dosage?

  • Starting dose for ITP: 1 mcg per kg of body weight, adjusted gradually until a platelet count of ≥ 50x10⁹/L is achieved and maintained.
  • Maximum weekly dose: 10 mcg per kg.
  • During dose adjustment, platelet counts are checked before each injection.
  • Once a stable dose is established, monthly blood tests are required.
  • For pediatric patients, body weight is reassessed every 12 weeks to ensure accurate dosing.

Once your healthcare provider has determined what your regular dose of Nplate should be a blood test is only required once a month. Blood tests are also required for at least two weeks after treatment with Nplate is stopped to check your platelet counts aren’t dropping too low.

Is Nplate Used for Radiation Exposure?

Yes. Nplate (10 mcg per kg) can be administered as a one-time treatment to improve survival in individuals acutely exposed to myelosuppressive radiation doses (Hematopoietic Syndrome of Acute Radiation Syndrome, HS-ARS).

This FAQ provides general information about Nplate, but does not replace professional medical advice. Always follow your healthcare provider’s instructions and review the full prescribing information before starting treatment.

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