Nplate (romiplostim) can cause side effects that range from mild to serious. More common side effects include joint pain and dizziness. If side effects from Nplate become difficult to tolerate, talk with your doctor about coping tips or other treatment options.
Nplate injection is used in adults and certain children to:
- treat immune thrombocytopenia (an immune condition that causes problems with blood clotting due to a low level of platelets). Nplate is prescribed when other types of treatments have been ineffective.
- increase survival after radiation exposure that has affected the bone marrow (where platelets are made)
The active ingredient in Nplate is romiplostim. (An active ingredient is what makes a drug work.) Nplate is a
To learn more about Nplate, including its uses, dosage, and cost, read this Nplate overview.
Nplate can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult for you to tolerate.
Nplate’s commonly reported side effects include:
- insomnia (trouble sleeping)
- joint pain
- muscle pain
- dizziness
- abdominal pain
- nausea
- pins and needles feeling in your hands and feet
- indigestion (upset stomach)
For more information about some of these side effects, see the “Tips for managing side effects” section.
Mild side effects have been reported with Nplate. These include:
- muscle pain
- headache
- joint pain
- abdominal pain
- nausea
- pins and needles feeling in your hands and feet
- dizziness
- insomnia (trouble sleeping)
- indigestion (upset stomach)
In most cases, these side effects should be temporary, and some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. Do not stop Nplate treatment unless your doctor recommends it.
Nplate may cause mild side effects other than those listed. See the drug’s prescribing information for details.
For more information about some of these side effects, see the “Tips for managing side effects” section.
Nplate may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Nplate’s prescribing information.
If you develop serious side effects while taking Nplate, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported include:
- blood clots
- worsening of platelet counts from low response to Nplate
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Nplate and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
Allergic reactionFor some people, Nplate can cause an allergic reaction.
In general, symptoms of an allergic reaction can be mild or serious.
What might helpIf you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Nplate treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Nplate, they may have you switch to a different treatment.
Nplate may cause some different side effects in children. The drug is used in children ages 1 year and older to treat immune thrombocytopenia that doesn’t respond to other medications. It’s also prescribed for children who have been exposed to radiation that’s affected their bone marrow.
Some common side effects in children include:
- bruising
- mouth and throat pain
- fever
- upper respiratory infection
- skin rash
Here are answers to some commonly asked questions about Nplate’s side effects.
Can Nplate cause long-term side effects?
While most side effects of Nplate are temporary, a few long-term side effects were reported in studies of people using the drug. Long-term side effects refer to those that may last a long time or start or continue after treatment ends. Possible long-term side effects of Nplate include:
- risk of blood clots
- bone marrow problems
With bone marrow problems, Nplate may cause scarring or hardening of the tissue inside bone marrow. Nplate may also cause high platelet levels, which may lead to blood clots. Blood clots can cause long-term health problems.
Your doctor will monitor your blood levels during your Nplate treatment. If they notice blood clots or any problems with your bone marrow, they’ll determine whether it’s safe for you to continue treatment.
If you have questions about long-term side effects of this drug, ask your doctor for more information.
How long do side effects of Nplate typically last?
How long Nplate’s side effects last will vary from person to person. In general, most side effects are temporary and should last only a few days or weeks after starting or stopping treatment with Nplate.
However, Nplate may cause side effects that lead to long-term complications. For details, see “Can Nplate cause long-term side effects?”
Talk with your doctor if you have questions about how long Nplate’s side effects could last.
Does Nplate cause weight gain?
It’s possible. Changes in weight weren’t typically reported as a side effect in studies of Nplate. However, Nplate may cause edema (swelling), which can increase body weight.
If you experience unexplained weight gain during your treatment with Nplate, talk with your doctor. They’ll help determine whether Nplate or another factor is the cause.
Will I experience side effects from stopping Nplate?
You most likely won’t experience side effects from stopping Nplate. If you do experience side effects, the most common one is an increased risk of bleeding. Nplate is used to increase the level of platelets in your blood, so your platelet level may drop when you stop taking it.
Your doctor will monitor your blood levels and suggest a different treatment to manage your condition, if necessary. Talk with them if you have concerns about possible side effects that may occur from stopping Nplate.
While taking Nplate, you may be able to take steps to make side effects easier to manage.
If you have problems with side effects, they do not go away, or they become worse, talk with your doctor or pharmacist. They can discuss options for managing side effects or other available treatment options.
Insomnia
Insomnia (trouble sleeping) was commonly reported by people using Nplate in studies. This is usually a mild side effect that goes away after a few days to weeks.
What might help
If you experience bothersome or ongoing insomnia with Nplate treatment, talk with your doctor. They can suggest ways to help manage this side effect. This may include tips such as:
- limiting caffeinated drinks before bedtime
- avoiding rich, heavy, or spicy meals late in the day
- maintaining good sleep habits
But if your insomnia is severe or affecting your quality of life, your doctor may suggest other ways to manage your condition.
Dizziness
Dizziness was a common side effect reported in Nplate studies, but it was usually mild and manageable. Keep in mind there may be other causes of dizziness, such as your condition or other drugs you take.
What might help
Take extra care when standing up from sitting to avoid falls. Because you may experience dizziness when starting Nplate, be careful driving or operating machinery until you know how the drug affects you.
Dizziness may be temporary and ease with continued treatment. But if it’s ongoing or severe, talk with your doctor. They can suggest ways to help manage this side effect and determine whether you should continue with Nplate treatment.
Joint pain
Joint pain is a common side effect of Nplate. People in the drug’s studies reported joint pain and other types of pain, including muscle and shoulder pain, and pain in their extremities.
Joint pain may be caused by other health conditions, such as osteoarthritis or rheumatoid arthritis. Tell your doctor if you have problems with your joints or muscles before starting Nplate treatment.
What might help
If you have joint pain with Nplate treatment, talk with your doctor. They can suggest ways to ease mild pain. Suggestions may include:
- stretching
- moderate exercise
- maintaining a moderate weight
- getting a massage
If your joint pain is ongoing or severe, your doctor may suggest other ways to manage it. In some cases, they may recommend that you stop Nplate treatment.
Keeping track of side effectsDuring your Nplate treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start treatment with a new drug or combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were using when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how your symptoms affected your daily activities
- what other medications you were taking
- any other information you feel is important
Taking notes and sharing them with your doctor will help them learn more about how Nplate affects you. They can then use this information to adjust your treatment plan if needed.
Nplate may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug is a good treatment option for you. Talk with your doctor about your health history before starting Nplate. Factors to consider include those that follow.
Blood clots: Treatment with Nplate increases the level of platelets in your blood, which helps with clotting. But sometimes the drug can cause a dangerously high level of platelets and increase your risk of blood clots. This can increase your risk of heart attack and stroke. There isn’t enough information to know the ideal platelet level for balancing the risks of blood clots and bleeding. Your doctor will monitor you during your treatment to be sure Nplate continues to be safe for you.
Allergic reaction: If you’ve had an allergic reaction to Nplate or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.
Loss of response to Nplate: Nplate can sometimes stop working to improve or maintain the level of platelets in the body. This may happen because your immune system has inactivated the drug. Your doctor will monitor you during your treatment. If they suspect your body is not responding to the drug, they’ll likely order blood tests. If tests confirm the drug is no longer effective, your doctor will discuss other treatment options with you.
Myelodysplastic syndromes: If you have myelodysplastic syndromes (MDS), your doctor won’t prescribe Nplate for you. MDS is a group of conditions that interfere with your body’s ability to make healthy blood cells. Nplate can cause MDS to turn into acute myeloid leukemia (AML). Some people with MDS in the drug’s studies developed this kind of blood cancer during Nplate treatment.
Doctors only recommend Nplate for immune thrombocytopenia which is caused by your immune system and to increase platelet counts after radiation exposure that’s affected the bone marrow. They do not recommend the drug for thrombocytopenia caused by MDS or for other causes of low platelet counts.
Alcohol and Nplate
There are no known interactions between Nplate and alcohol. But drinking alcohol can cause some side effects similar to those of Nplate, including indigestion (upset stomach) and dizziness. If you drink alcohol, check with your doctor regarding how much (if any) is safe during your treatment.
Pregnancy and breastfeeding with Nplate
It’s not known whether Nplate treatment is safe during pregnancy or while breastfeeding. If you’re pregnant or planning to become pregnant, talk with your doctor about the safety of Nplate.
It’s not known whether the drug passes into breast milk. Your doctor will likely suggest not breastfeeding while you’re receiving Nplate treatment. This is to avoid possible risks to a child from side effects of the medication.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.