Promacta not effective

Hello everyone~
I am new to this community...very glad to find this place and it makes me feel I am not alone (good feeling is very important to ITPers!!).
So here is my story:
2013 Spring: I was diagnosed when I had about 70 platelet count, and no treatment was needed.
2017 Summer: started Promacta at 25mg as my platelet dropped to low 20s. Platelet increased to 50s after the 25mg treatment.
2017 December: as I need to do a sinus surgery and sinus doctor required platelet above 70, my Hemo increase the Promacta dosage to 50mg daily and platelet count increased to 90-100
2018 Feb - Mar: after the recovery from the surgery, I reduced the Promatc back to 25mg dosage and thought the platelet count would drop to 50 which is still above safe line. HOWEVER, after I reduced the dosage the 25mg for about 2 weeks, the platelet count dropped to low 20s.
2018 April to present: I increased the Promacta to 50mg again but it was NOT responsive any more. My platelet count continues to drop to only 8 recently although I have increased the Promacta to 50mg.
Today: my Hemo suggests me increasing the Promacta to 75mg daily and see how it works.

My question here: since I increased the Promacta from 25mg to 50mg when it was effective and then decreased back to 25mg, would this kind of increasing and decreasing dosage cause Promacta non-effective?

Thanks in advance!
Renren

Not necessarily. Promacta can be weird like that sometimes. People often raise and lower the dose based on counts.

Some people have had luck with an increased dosage. I wouldn't consider it unsuccessful unless you are on 75 mg's for a few months and can't get above 20k.

I agree with Sandi.

I have been on Eltrombopag (Promacta) for 18 months and it can definitely be a bit weird at times especially with dose changes. I would go up to 75mg a day and give it a good few months to see if your count stabilises.

Renren, that is a pretty big jump. I sure hope it is temporary.

I don't know anything about sinus surgery. Did they leave some sort of artificial device implanted? Or maybe some bone removal?

Curious. When you were first diagnosed, how was your steroid response? You were like really responsive, or, took a large dose to get counts up?

Thank you for the reply. I will wait and see how the 75mg dosage work. Hope it turn out to be good result

Hi Hal9000,
No, they didn't leave any artificial device implanted...I think there is no relationship between the sinus surgery and the Platelet drop.
Yeah, I was very responsive to steroid so they concluded that I have ITP. Right now the Hemo just increased the Promacta to 75mg daily and see how it works. The steroid will cost some other infections so I hesitate to take it again. Really hope the Promacta can back to work.