Indication: Avatrombopag (Avatrombopag INN) is indicated for managing thrombocytopenia in adults with chronic liver disease who are preparing for a medical or dental procedure.

Pharmacology: Administered orally, Avatrombopag acts as a thrombopoietin receptor agonist, enhancing platelet production by stimulating megakaryocyte growth and differentiation through interaction with the thrombopoietin receptor’s transmembrane domain, thereby activating intracellular signaling pathways.

Dosage and Administration: The recommended dose of Avatrombopag is 40 mg once daily for 5 consecutive days, commencing 10 to 13 days before the scheduled procedure. It should be taken with food for optimal absorption.

Interactions: Avatrombopag may interact with drugs metabolized by CYP2C9 and CYP3A4. Avoid concurrent use with potent CYP2C9 inhibitors or inducers and use caution with medications that may increase bleeding risks.

Side Effects: Common adverse effects of Avatrombopag include headache, fatigue, nausea, diarrhea, upper respiratory tract infections, and peripheral edema. Severe reactions may include thromboembolic events, hepatotoxicity, and cataracts.

Precautions and Warnings:

• Patients, especially those with known thromboembolic risk factors, should be closely monitored for signs of thrombosis.
• Regular liver function tests are recommended due to reported cases of hepatotoxicity.
• Ophthalmic monitoring is advisable as Avatrombopag may lead to cataract formation.
• Caution is advised for patients with chronic liver disease, who may have an increased risk of portal vein thrombosis when using Avatrombopag.

Overdose Effect: In the event of overdose, supportive care is recommended. There is no specific antidote for Avatrombopag overdose, hence close monitoring for signs of adverse reactions is crucial, with appropriate treatment administered as needed.