Romiplostim (Nplate)

Covered: Romiplostim (Nplate) is approved only for chronic immune thrombocytopenia (ITP) patients with a baseline platelet count <50 × 10^9/L who have had insufficient response to corticosteroids, IVIG, or splenectomy; it is excluded for thrombocytopenia due to MDS or other non‑ITP causes and should not be used to normalize platelet counts. Key requirements: start 1 mcg/kg SC weekly, adjust by 1 mcg/kg up to 10 mcg/kg/week, withhold if platelets >400 × 10^9/L and discontinue if no response after 4 weeks at max dose; prior therapy failure, baseline and ongoing platelet counts, dosing/monitoring documentation, and authorization limited to 12 months are required.

"Nplate (romiplostim) is indicated for the treatment of thrombocytopenia in individuals with chronic immune thrombocytopenia who have had an insufficient response to corticosteroids, immunoglobulins..."