Lusutrombopag — Drug Monograph

Brand names: Mulpleta

Drug class: Supportive Care Agent

Mechanism of Action

Oral, small-molecule thrombopoietin receptor (TPO-R / c-Mpl) agonist that binds the transmembrane domain of the receptor and activates JAK2/STAT5 signaling, stimulating megakaryocyte proliferation and differentiation to increase platelet production. Structurally related to avatrombopag; used specifically for short-course pre-procedure platelet support in chronic liver disease.

FDA Indications

• Thrombocytopenia in adults with chronic liver disease who are scheduled to undergo a procedure (FDA approved 2018)

Common Side Effects

• Headache
• Nausea
• Portal vein thrombosis (notable adverse event of interest in cirrhosis)

Clinical Pearl

Lusutrombopag is a narrowly focused agent: a fixed 3 mg × 7-day oral course purely to raise platelets before an invasive procedure in chronic liver disease, avoiding platelet transfusions. Unlike eltrombopag it has no food or cation restrictions and no hepatotoxicity boxed warning, but it has no established oncology role — for chemotherapy-induced thrombocytopenia the other TPO-RAs are used.

Related Therapies & Mechanisms

• Avatrombopag (Doptelet) — Supportive Care Agent · Supportive Care
• Defibrotide (Defitelio) — Supportive Care Agent · Supportive Care
• Dexrazoxane (Zinecard) — Supportive Care Agent · Supportive Care
• Eltrombopag (Promacta) — Supportive Care Agent · Supportive Care