After 7 weeks treatment of IVIG and Prednisone, it could not keep my 12 years old son's platelets in a safe range for longer than a week or two. His count is back below 10K now. Our hemo finally prescribed Promacta 50mg today. However, I just read the Promacta web site, it says that for East Asian, the starting dosage should be lowered to 25mg. We are East Asian. Should we ask our hemo to change the prescription to 25mg? Or it is ok to start with 50mg? Also my son's liver function test is slightly elevated. Hemo said it is because of Prednisone and it is safe to start Promacta. Should we be concerned? Thanks for any information.
Diagnosis of ITP in 2014. Ex renal specialist nurse. I retired in Nov 2019 after 46 years on the front line. I firmly believe in empowering patients to be involved as much as possible in their care; always question medics about the evidence base they use.
50mg tablets can be cut, though they crumble fairly easily. I found that putting the pill and the pill slitter in the refrigerator for a while (an hour?) before hand reduces crumbling significantly. Split the pill quickly, before moisture builds up, after taking it out of the frig. If you've never done that sort of thing, learn on other pills first.
An alternative is to take the 50mg every other day. That can work well (except with row 1 folks). Also, skipping two days, for a one third dose, doesn't work nearly as well. Effectiveness may go down to ~20% instead of the desired one third.
I talked with our hematologist and he said lower dose is just a recommendation. Since my son's platelets are less than 10K and we want to have a rapid response, he think 50mg is right dose to start. Promacta is finally on the way and scheduled to be delivered next Monday. Fingercrossed that it could work the way it suppose to. Happy Thanksgiving everyone and thanks so much for all the help we are getting here.
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