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Adults With ITP
Newly Diagnosed & Frequently Asked Questions
Nplate and Promacta
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Nplate and Promacta 5 months 3 weeks ago #72803

  • richellefleischer
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  • Diagnosed in November 2022
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Recently diagnosed, prednisone and immunoglobulin didn’t work. Nplate did and then too well (769). Tapering prednisone and Nplate too quickly, I dropped back to 2. Second hospitalization, prednisone and immunoglobulin again aren’t working.  Started Promacta on day of admission. On day 4, Hematologist added a Nplate injection as my platelets are at 1 in hopes of speeding up the response.

 I feel better as I know Nplate works. Curious if anyone has been given both. 
SRM Texas

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Nplate and Promacta 5 months 3 weeks ago #72804

  • Meredith
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I take Doptelet and NPlate together 
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Nplate and Promacta 5 months 3 weeks ago #72805

  • midwest6708
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  • ~ Janet ~ Diagnosed Sept. 2008
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At one point, I was taking NPlate with a low dose of prednisone.  My counts were wildly erratic.  During a certain one-week period, count went from 5 to 572.  That yo-yoing went on for over a year.  My highest count ever was 886, and that was on NPlate alone.

I was fortunate to have a non-official phone conversation with a noted expert on ITP and NPlate a few years ago.  I told him about my wildly swinging counts during my NPlate/prednisone time.  He said that NPlate combined with any other treatment has a synergistic result and that might be the reason for my difficulties.  Eventually, I was able to discontinue prednisone altogether.  Now I use it only when I need a  temporary, guaranteed boost in advance of invasive procedures.  

How are you doing today?

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Nplate and Promacta 5 months 3 weeks ago #72806

  • richellefleischer
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  • Diagnosed in November 2022
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Thank you! I am on high prednisone so that is probably why the Nplate is overreacting. They are trying to wean me down on the Prednisone. Problem is that they stopped the Nplate at the same time. 

Sitting in hospital waiting for Nplate to kick in again.
SRM Texas

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Nplate and Promacta 5 months 3 weeks ago #72807

  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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I cannot see the logic in stopping N Plate  whilst reducing the Pred. 
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Nplate and Promacta 5 months 3 weeks ago #72811

  • midwest6708
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  • ~ Janet ~ Diagnosed Sept. 2008
  • Posts: 402
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You don't say what your NPlate dose was, but it seems like it might've been reduced and the steroid could've been swiftly tapered.  Since your response to NPlate was both positive and negative (in a way), maybe it was just a matter of tweaking the dose...?  Or maybe the hyper-response was the double whammy effect of Promacta with it.  I don't know.  We're just armchair quarterbacks here. 

One thing I know for sure.  Patients who completely understand the disease and its treatments and who can partner with their doctors on decisions instead of being dictated to by them, are bound to be more successful at managing their condition.  Since you're probably bored to tears sitting in that hospital, be sure to read everything here on the PDSA site, specifically the material on the Patients and Caregivers tab on the homepage.

Hope you can spring yourself out of there VERY soon!   

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Nplate and Promacta 5 months 3 weeks ago #72812

  • richellefleischer
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  • Diagnosed in November 2022
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Thank you! These message boards have been incredibly helpful and definitely relieved boredom. Looks like prednisone and immunoglobulin don’t do much for me. Understand that I previously received 3 units of Nplate each time. This past Monday they started Promacta 50 mg when I was readmitted. 

I am learning a great deal. 

Thank you for all your help!
SRM Texas

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Nplate and Promacta

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