Switching from NPlate to Revolade (Promacta)

I would appreciate hearing of anyone's experiences in switching from NPlate to Revolade (Promacta). I am nervous to stop the NPlate as I suffered severe bleeding when I tried to go off before but I have weekly migraines from the NPlate that started a year and a half into treatment and so my hemo wants to switch me over. Thanks in advance!

About 6 months ago, I switched from Nplate to Promacta, not because of side effects, but because my counts had very wide swings. They could go dangerously high (over 900,000) on Nplate.

After switching, my counts began to decrease, and after 5 months, my counts never rose above 50,000, so I was put back on Nplate. Still on on Nplate now, and my counts still swing widely, from 10,000 up to 400,000, but this is my best option, so far.

My hemo has another ITP patient who switched, simply for convenience, and has had no problems maintaining safe counts on either drug, so "go figure".

Good luck!

I have just switched to Promacta from Nplate. Last week I had only taken 2 doses of Promacta so I still received Nplate but a lower dose than I had gotten the week before. This is first week of being on Promacta and not receiving Nplate. So far I'm doing okay. I'm not quite as tired as I was on both Nplate and Promacta last week. I switched to Promacta under the advise of my hematologist and not because of side effects from Nplate. Nplate did take my count from 2 to 275 this week (was on both Nplate and Promacta), it was 169 just on Nplate alone at the highest. I was only on Nplate for about a month or so.

After switching, my counts began to decrease, and after 5 months, my counts never rose above 50,000, so I was put back on Nplate. Still on on Nplate now, and my counts still swing widely, from 10,000 up to 400,000, but this is my best option, so far.
My hemo has another ITP patient who switched, simply for convenience, and has had no problems maintaining safe counts on either drug, so "go figure".

I'm not sure what you mean by 'safe count'. 50k IS a safe count. And 50k is precisely the count Promacta was designed to keep you around. It was not designed to bring counts up to or beyond 'normal' levels. Doctors and patients should not expect otherwise.
The PDF information sheet from Glaxo says; DOSAGE AND ADMINISTRATION: (2nd line)
"Adjust the daily dose to achieve and maintain a platelet count ≥50k in order to reduce the risk of bleeding."

Honestly, I prefer taking a drug that keeps me at a known count, than one which may swing widely.
I also prefer only having to visit my hematologist twice a year.
But everyone has different preferences with ITP and treatment. YMMV

.

Hi, weirdjack

Yes 50K is the "safe" target, but since they cannot find a dose that keeps me "stable" at or near 50K, they figure I will be OK as long as my counts don't go above 400,000.

Looks like maybe consensuses here to dyan is that, as far as needing to switch because of the migraines is "give it a try".

Thanks for the replies and information. I would prefer to be around the 50 count but am at present at 600. My doctor is reluctant to lower the NPlate so we'll see what the Promacta does as we switch over. Thanks!