Thrombocytopenic purpura
Treatment of acquired thrombotic thrombocytopenic purpura (TTP)
Caplacizumab
Caplacizumab 10mg powder and solvent for solution for injection vials
Dose as per specialist.
Rituximab
Rituximab 100mg/10ml solution for infusion vials
Dose as per specialist.
Prescribing Notes:
- Caplacizumab is approved for the treatment of adults experiencing an episode of acquired thrombotic thrombocytopenic purpura (aTTP), in conjunction with plasma exchange and immunosuppression.
History Notes
20/04/2023
East Region Formulary content agreed.
Treatment of idiopathic thrombocytopenic purpura (ITP)
For initial management with corticosteroids and in some cases, immunoglobulins refer to local or national guidance.
Eltrombopag
Eltrombopag 25mg tablets
Dose as per specialist.
Eltrombopag 50mg tablets
Dose as per specialist.
Prescribe biosimilars by brand.
Rituximab
Rituximab 100mg/10ml solution for infusion vials
Dose as per specialist.
Avatrombopag
Doptelet 20mg tablets
Dose as per specialist.
Romiplostim
Romiplostim 125microgram powder for solution for injection vials
Dose as per specialist.
Romiplostim 250microgram powder and solvent for solution for injection vials
Dose as per specialist.
Prescribing Notes:
- The order of second line choices in this pathway is not intended to guide on place in therapy. The place in therapy is directed by a specialist prescriber experienced in the management of the condition, use is in line with relevant local or national guidance.
- For use of immunoglobulins in management of ITP refer to Scottish IVIG guidelines.
- Eltrombopag is approved for restricted use by a hospital specialist for the following indications:
- In chronic immune (idiopathic) thrombocytopenic purpura (ITP) splenectomised patients who are refractory to other treatments (e.g. corticosteroids, immunoglobulins).
- As second-line treatment for adult non-splenectomised patients where surgery is contraindicated. Use is restricted to patients with severe symptomatic ITP or a high risk of bleeding.
- Treatment of thrombocytopenia in patients with chronic hepatitis C virus infection. Where the degree of thrombocytopenia is the main factor preventing the initiation or limiting the ability to maintain optimal interferon-based therapy.
- Avotrombopag is approved for the treatment of primary chronic immune thrombocytopenia (ITP) in adult patients who are refractory to other treatments (e.g. corticosteroids, immunoglobulins). Restricted to use in patients with severe symptomatic ITP or a high risk of bleeding.
- Romiplostim is approved for restricted use by a hospital specialist for the following indications:
- Severe symptomatic ITP or patients with a high risk of bleeding for chronic immune (idiopathic) thrombocytopenic purpura (ITP) splenectomised patients who are refractory to other treatments (e.g. corticosteroids, immunoglobulins).
- Second line treatment for non-splenectomised patients where surgery is contra-indicated. Restricted to use in patients with severe symptomatic ITP or at high risk of bleeding.
- Other immunosuppressants may also be used for treatment for ITP as guided by the haematologists as per local and National guidance.
History Notes
26/02/2026
Prescribing information updated, ERFC November 25.
05/06/2025
Addition of Avatrombopag SMC2345, ERWG May 25
20/04/2023
East Region Formulary content agreed.