Carbamazepine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Drug reference
avatrombopag
Thrombopoietin receptor agonist (oral) · Hematopoietic Agent
START
CLD procedure: 40–60 mg PO once daily ×5 d (start 10–13 d pre-procedure)
TYPICAL MAX
60 mg/day (CLD); 40 mg/day (chronic ITP)
STOP IF
Thromboembolism, hepatotoxicity, or platelet count overshoot
WATCH
Platelet count weekly initially; portal vein/thrombosis signs
CDSCO approvedATC B02BX08
KDIGO 2024 + manufacturer label
- ONSET
- 1h · absorption
- PEAK
- 6h · Tmax
- t½
- 19h · t½
- DURATION
- 1d · once-daily
EXCRETION
Mainly faecal; ~6% renal
route + CYP
INTERACTIONS
11 major
SEVERE in our sources
PREGNANCY
Limited data; use only if benefit outweighs risk.
FDA category + note
Top interactionssee all 12 →
- CarbamazepineSevereDatabaseDDInter
- CarfilzomibSevereDatabaseDDInter
- DabrafenibSevereDatabaseDDInter
- EnzalutamideSevereDatabaseDDInter
Mechanism
Small-molecule TPO-receptor agonist on megakaryocytes (binding distinct from TPO and eltrombopag), stimulating megakaryocyte proliferation/maturation and increasing platelet production.
Indications
Thrombocytopenia in adults with chronic liver disease scheduled for an invasive procedureChronic immune thrombocytopenia (after inadequate response to prior therapy)
Dosing
- Adult
- CLD-procedure: platelet 40 to <50 ×10⁹/L → 40 mg PO once daily ×5 days; <40 ×10⁹/L → 60 mg PO once daily ×5 days; start 10–13 days before procedure. ITP: 20 mg PO once daily, titrate by platelet response; max 40 mg/day.
- Pediatric
- Not established.
- Renal adjustment
- No dose adjustment for any eGFR.
- Hepatic adjustment
- No specific adjustment for procedural dosing; caution in decompensation.
- Geriatric
- No specific adjustment.
- Max dose
- 60 mg/day (CLD procedural); 40 mg/day (chronic ITP)
Pharmacokinetics
Onset
Platelet rise over 4–8 days
Peak effect
Platelet count peak ~10–13 days
Duration
~24 h (once-daily)
Half-life
~19 h
Bioavailability
High oral (take with food)
Protein binding
>96%
Metabolism
Hepatic CYP2C9 and CYP3A4
Excretion
Mainly faecal; ~6% renal
Contraindications
- Hypersensitivity
- Caution: hepatic decompensation, portal vein thrombosis history, malignancy with bone marrow involvement
Side effects
Common
HeadacheFatiguePetechiae/contusionNauseaPyrexia
Serious
- Thromboembolic events (especially in CLD)
- Hepatotoxicity / portal vein thrombosis (CLD)
- Rebound thrombocytopenia on discontinuation (ITP)
- Bone marrow reticulin formation (long-term)
Pregnancy & lactation
Pregnancy
Limited data; use only if benefit outweighs risk.
Lactation
Limited data; caution.
Drug interactions
Carfilzomib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Dabrafenib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Enzalutamide
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Fluconazole
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Fosphenytoin
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Imatinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Other Tpo Mimetics
Severe
Database
Additive platelet stimulation
Do not co-prescribe
Source: Kimi deep-research + Cla
Phenytoin
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Rifampicin
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Rifapentine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Anticoagulants
Moderate
Database
Modified bleeding/thrombosis balance
Reassess need; monitor platelets/clot risk
Source: Kimi deep-research + Cla
Related guidelines
Ask House about avatrombopag
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Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20