Kelirae, in my humble opinion, one (preferred?) option would be to go back and retry Promacta. I understand that could be a problem due to liver/lifestyle issues.
Since you eventually became sensitive to Nplate, I don't see why that can't happen with Promacta. Like with Nplate when you started it, it may initially take a higher than normal dose of Promacta to get counts up. Or, it may not, and a typical dose of Promacta will end up working right off the bat. Who knows? My guess is that Promacta will work right of the bat.
Since you've been away, some newly diagnosed here have found that Promacta will not work at the normal 75mg max dose, but will work at higher doses. For example. Some hematologists, with ITP specialty, are now willing to prescribe up to 150mg dose.
If liver enzymes are the issue, it would seem Doptelet is an alternative. It is likely to send counts much higher than you want, however. One 20mg Doptelet pill is equivalent to 80mg of Promacta. LOL, it gives me a headache just thinking about that much Promacta.
On a side note. You initially had a steroid response, many years ago. I would venture to say. Even though you lost steroid response long ago does not necessarily mean that today you still have no steroid response.
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