Less common but serious side effects of romiplostim include blood clots and changes inside the bone marrow. Your healthcare provider will discuss how to watch for these side effects and whether any special tests are needed to monitor for these side effects. People who use romiplostim have an increased risk of developing bone marrow changes. Your doctor may check your child’s bone marrow to monitor for this. Eltrombopag is given by mouth daily. The dose may be adjusted based on platelet count. Liver function tests will also be monitored while taking this medication. People of East Asian descent require a lower starting dose and monitoring for dose adjustment. Eltrombopag should be taken 4 hours before or after antacids and multivita - mins as they may interact with these medications. Common side effects of eltrombopag include • nausea or vomiting • diarrhea • muscle aches, back pain • abnormal results on liver function tests that aren’t associated with liver toxicity • skin rash, itching • runny or stuffy nose.
Less common but serious side effects of eltrombopag include blood clots, flu- like symptoms, and liver problems. Your healthcare provider will discuss how to watch for these side effects.
Transfusions Most children with ITP make enough platelets, but they also make antibodies against their platelets. The spleen quickly destroys platelets that are coated with an antibody. These antibodies can also bind to platelets that are transfused. When transfused platelets are coated with the antibody, the spleen quickly destroys them. For this reason, platelet transfusions are used only if a child has serious bleeding. Other Medical Treatments Some children with ITP do not respond to IVIG or steroids. If your child has a low platelet count or bleeding despite these treatments, your doctor or nurse practitioner may discuss other treatments. Alternative treatments for ITP include chemotherapy (for example, vincristine, cyclophosphamide, or mercaptopurine), drugs that suppress the immune system (such as mycophenolate and cyclosporine), or a medication (like rituximab) that decreases the number of B-lymphocytes, the white blood cells that make antibodies. Complementary Therapies Some families want to try complementary or natural therapies to treat their child’s ITP. Complementary therapies may include the use of supplements, herbs, or vitamins; homeopathy; or a change in diet. These treatments have not been studied in children with ITP, and we do not know if they are helpful. We do know that some complementary therapies may be harmful because they decrease the platelet count or affect how well the platelets work to stop bleeding. Please talk to your child’s healthcare provider if you want to try complementary or natural therapies.
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