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Avapag 20mg (Avatrombopag)

Product Name : Avapag (Avatrombopag)
Generic Name : Avatrombopag
Formulation : Solid dosage form(Tablet)
Available Pack Size : Box of 1 bottle of 28 tablets.
Available Strengths : 20mg
Registrations : Bangladesh

Product Description

Avapag 20mg is a drug indicated in the treatment of thrombocytopenia in some patient cases. Avapag 20mg is used for adults with chronic liver disease or chronic immune thrombocytopenia with insufficient response to previous treatment. The drug is manufactured by Everest Pharma Ltd - Bangladesh, in tablet form.

Ingredients of Avapag 20mg

  • Avatrombopag: 20 mg.

Dosage forms

  • Tablets.

What is thrombocytopenia?

  • Thrombocytopenia is a condition in which a patient has a low blood platelet count (less than 150,000 platelets/mm3 of blood) leading to an increased risk of bleeding. Severe thrombocytopenia will lead to dangerous conditions such as meningeal hemorrhage, hematuria, hematemesis, spontaneous bleeding, etc.

Uses - Indications of Avapag 20mg

  • Treatment of thrombocytopenia in adult patients with chronic liver disease.

  • Treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia inadequately responsive to previous treatment.

How to use – dosage of Avapag 20mg

  • How to use: The drug is taken orally.

  • Dosage:

    • Chronic liver disease: Dosage and frequency of administration will be determined by each patient's platelet count. Dosage should begin 10 to 13 days before the procedure. Patients should undergo their procedure 5 to 8 days after the last dose of avatrombopag.

      • Platelet count (x 10^9/L) <40: Dosage 60 mg (3 20 mg tablets), once a day, taken continuously for 5 days.

      • Platelet count (x 10^9/L) > 40: Dosage 40 mg (2 20 mg tablets), once a day, taken continuously for 5 days.

    • Chronic immune thrombocytopenia: The recommended starting dose is 20 mg (1 tablet) once daily with food.

Contraindications of Avapag 20mg

  • People who are sensitive to any ingredient of the drug.

Notes when using Avapag 20mg

  • Patients with chronic liver disease are known to be at increased risk of thromboembolic events.

  • Use caution when Avapag 20mg is coadministered with moderate or strong dual CYP3A4/5 and CYP2C9 inhibitors, or with moderate or strong CYP2C9 inhibitors, as these drugs may increase avatrombopag exposure. Caution should also be exercised in patients with CYP2C9 loss-of-function polymorphisms, as they may increase avatrombopag exposure.

  • Thrombocytopenia may recur in ITP patients when avatrombopag treatment is discontinued. After discontinuation of avatrombopag, platelet counts return to baseline within 2 weeks in the majority of patients, which increases the risk of bleeding and in some cases may lead to bleeding.

  • Increased bone marrow reticulin is thought to result from stimulation of TPO receptors, leading to increased numbers of megakaryocytes in the bone marrow, which can then release cytokines. Increased reticulin can be suggested by morphological changes in peripheral blood cells and can be detected by bone marrow biopsy. Therefore, cell morphology abnormalities should be checked by peripheral blood smear and complete blood count (CBC) before and during avatrombopag treatment.

Use for pregnant or breastfeeding women

  • Consult your doctor.

For use by drivers and machine operators

  • Consult your doctor.

Side effects of Avapag 20mg

  • Some side effects that may occur when using the drug: Abdominal pain, nausea, headache, fatigue, peripheral edema, hyponatremia.


  • The serum concentration of Avatrombopag may increase when it is combined with certain drugs such as: Afatinib, Dexamethasone, Pibrentasvir, Rifamycin, Enzalutamide,...

Dealing with missed doses

  • If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Do not take double the prescribed dose.

Treatment in case of overdose

  • Consult your doctor.


  • In a cool, dry place away from direct sunlight.

  • Keep out of reach of CHILDREN.


  • Box of 1 bottle of 28 tablets.


  • Everest Pharma Ltd.