Tavalisse

Generic name: fostamatinib

Drug class: Miscellaneous coagulation modifiers

Dosage form: Oral tablets (100 mg and 150 mg)

Route of administration: Oral

Dose: Initial dose: 100 mg orally twice daily; after 4 weeks, if platelet count has not increased to at least 50 × 10⁹/L, increase to 150 mg orally twice daily. Use the lowest dose necessary to achieve and maintain a platelet count of at least 50 × 10⁹/L to reduce the risk of bleeding.

Mechanism of action: Fostamatinib is a spleen tyrosine kinase (SYK) inhibitor that blocks the SYK enzyme, reducing the immune system’s destruction of platelets, thereby increasing platelet counts and decreasing the risk of bleeding.

Drug usage cases:

• Treatment of chronic immune thrombocytopenia (ITP) in adults who have had an insufficient response to previous treatments.

Drug contraindications:

• Hypersensitivity to fostamatinib or any component of the formulation.
• Active bleeding disorders.
• Severe hepatic impairment (Child-Pugh Class C).
• Uncontrolled hypertension.
• Pregnancy.
• Breastfeeding.

Side effects:

• Common: Diarrhea, hypertension, nausea, respiratory infection, dizziness, increased liver enzymes (ALT, AST), rash, abdominal pain, fatigue, chest pain, decreased white blood cell count (neutropenia).
• Serious: Severe diarrhea, liver dysfunction (e.g., jaundice, dark urine), significant hypertension, infections.

Warnings:

• Monitor blood pressure regularly; Tavalisse can cause significant increases in blood pressure.
• Monitor liver function tests monthly; Tavalisse can cause elevations in liver enzymes.
• Monitor complete blood counts regularly; Tavalisse can cause decreases in white blood cell counts.
• Discontinue Tavalisse if platelet count does not increase to at least 50 × 10⁹/L after 12 weeks of treatment.
• Use caution in patients with a history of hypertension, liver disease, or infections.
• Patients should avoid contact with individuals who have infections that may spread to others.

Use during pregnancy or breastfeeding:

Fostamatinib can harm an unborn baby. Females who can become pregnant should use effective birth control during treatment and for at least 1 month after the last dose. It is not known if fostamatinib passes into breast milk; therefore, breastfeeding is not recommended during treatment and for at least 1 month after the last dose.