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What Is Drug-induced Thrombocytopenia?
Some medications can destroy blood-clotting cells called platelets or prevent bone marrow from producing enough. This can lead to a low platelet count called thrombocytopenia.
Drugs that may cause thrombocytopenia include heparin, acetaminophen (Tylenol), and some chemotherapy drugs.
Certain medications may cause thrombocytopenia. The condition may lead to severe complications and can be life threatening.
Drug-induced thrombocytopenia occurs when medications cause a low platelet level. Platelets are blood cells that help blood clot to slow or stop bleeding. If a person's blood does not clot, they may bleed excessively.
A normal platelet count is 150,000 to 450,000 per microliter (µl) of blood. A platelet count below 150,000/µl is considered low.
Without treatment, thrombocytopenia may cause severe internal or external bleeding, which can be life threatening.
There are two types of drug-induced thrombocytopenia:
Various types of drugs can cause thrombocytopenia.
The following medications are among the most commonly reported causes of immune drug-induced thrombocytopenia:
Drugs that may cause nonimmune drug-induced thrombocytopenia include:
A person may inherit the gene responsible for thrombocytopenia from their parents, or the condition may develop for other reasons. In some cases, the causes may remain unknown.
Often, other medical conditions are the cause of thrombocytopenia. These include:
Symptoms of thrombocytopenia include:
A person can often successfully recover from drug-induced thrombocytopenia if they stop taking the medications that caused it.
A person should follow their doctor's instructions on how to stop taking medications. A doctor may advise a person to stop taking drugs in a specific order so that they can monitor how this affects a person's symptoms. They may also prescribe alternative medications.
A person should not suddenly stop taking a medication unless their doctor advises it is safe.
People usually recover within a few days of stopping the medication that triggered their thrombocytopenia. However, platelet counts can remain low in some people for several weeks.
Without treatment, thrombocytopenia can lead to severe, life threatening complications, such as excessive bleeding.
A person may be able to reduce their risk of developing drug-induced thrombocytopenia via the following steps:
A person should contact a doctor if they have symptoms of thrombocytopenia, as treatment can help prevent complications from developing.
A person should contact a doctor immediately if they experience:
Which drugs should patients avoid when diagnosed with thrombocytopenia?
A person should avoid medications that thin the blood unless their doctor advises them to take them under careful monitoring. These include NSAIDs like ibuprofen and aspirin.
Individuals should disclose their diagnosis to other healthcare professionals, as other medications that can contribute to the condition include certain antibiotics, some antidepressants, certain cancer drugs, and others.
How long does it take to recover from drug-induced thrombocytopenia?
Recovery may depend on factors such as the type of medication that caused the condition, and whether a person has co-occurring conditions. People usually recover within a few days of discontinuing the medication.
What is the most likely cause of thrombocytopenia?
The most common causes of thrombocytopenia are certain medications and other medical conditions that affect the platelets.
Various medications, including blood thinners, some antibiotics, chemotherapy drugs, and NSAIDs, can cause thrombocytopenia.
Medications may cause the condition by triggering an immune response that destroys platelets or disrupts platelet production.
A person should contact a doctor if they experience symptoms of thrombocytopenia. They should not suddenly stop taking medication unless their doctor advises that it is safe.
No Bandage Needed: Electrical Impulses To Major Nerve Help Stop Bleeding
Platelets and red blood cells mingle in a blood clot (artificially coloured).Credit: Anne Weston, EM STP, The Francis Crick Institute/Science Photo Library
Chicago, Illinois
Forget the gauze and bandages: electrical stimulation near the ear might help to reduce bleeding. Researchers hope the technique could one day be used before surgery, childbirth and other events that pose a risk of dangerously uncontrolled bleeding.
The treatment, called a 'neural tourniquet' by its creators, helps to turbocharge the activity of platelets, which are cell fragments that form blood clots, according to preliminary results presented at the 2024 Society for Neuroscience conference.
"Anybody who's worked in the emergency or operating room knows how gruesome it can be to lose somebody to bleeding," Jared Huston, a trauma surgeon at the Feinstein Institutes for Medical Research in Manhasset, New York, who co-developed the treatment, tells Nature. "Bleeding can kill you much faster than sepsis."
Bleeding's heavy tollHaemorrhage, or uncontrolled bleeding, accounts for about 60,000 deaths in the United States each year1. To try to reduce that number, Huston and his colleagues are developing a treatment that targets the vagus nerves, which are large networks of nerve fibres that link the body with the brain. Despite its name, the treatment does not work like a typical tourniquet that blocks blood flow to injured appendages. Instead, the electrical pulses help to stimulate the spleen, which stores about one-third of the body's platelets. The stimulation prods the spleen to ready platelets to form a clot.
To test the treatment, the researchers made small cuts in the ears of healthy pigs2. Compared with animals that didn't receive the treatment, treated swine lost 50% less blood, and the duration of their bleeding was 40% shorter.
The team also tested the treatment on mice with haemophilia, a condition in which the blood does not clot properly, and found similar results3. The experiment also hinted at how nerve stimulation achieves these results: it increases calcium uptake by platelets in the spleen and makes them more ready to release their innards when they reach an injured blood vessel. Both actions are key to clot formation.
Promising dataLast year, Huston and Spark Biomedical, a biotechnology firm based in Dallas, Texas, launched a trial of the treatment in 30 people. In some participants, the researchers applied mild electric currents to one of two stimulation sites near the ear; control participants received sham stimulation. The preliminary results show that the treatment modestly increases clot stability and platelet activation.
The treatment's time scale could be a problem: platelets were most highly activated 2 hours after stimulation — which might make the device impractical for use in the emergency room. Huston is still analysing data about whether the treatment could lead to excessive clotting elsewhere in the body, but he says that nerve stimulation has been used safely for decades, giving him no reason for concern.
A researcher dons a 'neural tourniquet', which has electrodes that can be positioned around and in the ear.Credit: The Feinstein Institutes for Medical Research
It's also unclear whether increased clot stability will translate into decreased bleeding in people, says Svetlana Mastitskaya, a cardiovascular neuroscientist at the University of Bristol, UK. "It would be nice to see a more visible effect of the intervention," she says.
Huston responds that bleeding time and volume are harder to study in people than in animals, because of ethical concerns about intentionally harming humans. Still, it might be possible to determine the treatment's effectiveness by studying people with haemophilia or who are about to undergo surgery.
Researchers are also testing the device in women with type 1 von Willebrand disease, who often experience excessive menstrual bleeding and lose as much as a litre of blood during menstruation, says Spark Biomedical's chief scientific officer, Navid Khodaparast. Participants receive one hour of stimulation twice a day in a bid to reduce their bleeding. Results are forthcoming, he says.
Side Effects Of Doptelet: What You Need To Know
Doptelet (avatrombopag) is a prescription drug used to treat thrombocytopenia related to certain conditions. Doptelet can cause side effects that range from mild to serious. Examples include blood clots and low blood sodium levels.
Doptelet comes as an oral tablet. It contains the active ingredient avatrombopag.
Keep reading to learn about common, mild, and serious side effects that Doptelet can cause. For a general overview of the drug, including details about its uses, see this article.
Some people may experience mild to serious side effects during Doptelet treatment. Examples of the drug's commonly reported side effects include:
While these are the most commonly reported side effects from Doptelet studies, not everyone who takes the drug will experience them. And this isn't a complete list of possible side effects Doptelet may cause. The following sections of this article contain more information on mild and serious side effects of this medication.
Mild side effects have been reported with Doptelet. These include:
In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop Doptelet treatment unless your doctor recommends it.
Doptelet may cause mild side effects other than those listed above. See the drug's prescribing information for details.
Serious side effects have been reported with Doptelet. These include:
If you develop serious side effects while taking Doptelet, call your doctor right away. If the side effects seem life threatening or you think you're having a medical emergency, immediately call 911 or your local emergency number.
* To learn more about this side effect, see the "Side effects explained" section.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you'd like to notify the FDA about a side effect you've had with Doptelet, visit MedWatch.
Allergic reaction
For some people, Doptelet can cause an allergic reaction. This side effect wasn't reported in the drug's studies but has occurred since Doptelet was approved for use.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Doptelet treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you've had a serious allergic reaction to Doptelet, they may have you switch to a different treatment.
Get answers to some frequently asked questions about Doptelet's side effects.
How do Doptelet's side effects compare to those of Promacta?
Doptelet and Promacta are both prescribed to treat thrombocytopenia related to certain conditions in adults. Both drugs belong to the same group of drugs called thrombopoietin receptor agonists. Doptelet and Promacta can cause some similar side effects and some different ones as well.
Side effects that can be caused by both Doptelet and Promacta include:
As far as different side effects, Promacta can cause cataracts. But this side effect hasn't been reported with Doptelet. On the other hand, Doptelet can cause hyponatremia (low blood sodium), which isn't a known side effect of Promacta.
If you'd like to learn more about how Doptelet and Promacta compare, talk with your doctor or pharmacist.
Can Doptelet cause liver damage as a side effect?
It's not expected to. Liver damage wasn't reported as a side effect in Doptelet's studies.
Liver damage is a rare but possible side effect of Promacta, a medication that's similar to Doptelet. But Doptelet isn't expected to cause liver damage.
Talk with your doctor if you'd like to learn more about possible side effects of Doptelet, or check out the drug's prescribing information.
Learn more about some of the side effects Doptelet may cause.
Blood clots
Blood clots were a rare side effect reported in studies of Doptelet. Blood clots may cause symptoms such as:
But in the drug's studies, this side effect was more common in people taking Doptelet to treat chronic immune thrombocytopenia. And it was less common in people with chronic liver disease scheduled to undergo a procedure.
Factors that can increase the risk of blood clots when taking Doptelet include:
What might help
If you think you're having symptoms of a blood clot during Doptelet treatment, immediately contact your healthcare professional or emergency medical services. If your symptoms feel severe or life threatening, call 911 or your local emergency number or go to the closest emergency room.
If you develop a blood clot while taking Doptelet, your doctor will likely have you stop taking this medication.
Low blood sodium
Hyponatremia (low blood sodium) was a rare side effect reported in studies of Doptelet. Low blood sodium may cause symptoms such as:
If you already have low blood sodium, treatment with Doptelet could make it worse.
What might help
During Doptelet treatment, your doctor may order blood tests to monitor your blood sodium level. If you develop this side effect, your doctor may prescribe a treatment for it. They may also have you stop taking Doptelet.
Keeping track of side effects
During your Doptelet treatment, consider taking notes on any side effects you're having. You can then share this information with your doctor. This is especially helpful when you first start a new drug or combination of treatments.
Your side effect notes can include things such as:
Sharing notes with your doctor will help them learn more about how Doptelet affects you. They can then use this information to adjust your treatment plan if needed.
Doptelet can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug is a good treatment option for you.
Talk with your doctor about your health history before starting Doptelet. Be sure to tell them if any of the following factors apply to you:
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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