Could Nplate Be Causing My Urinary Tract Infections?
In our latest question and answer, our pharmacist discusses whether or not Nplate could be causing urinary tract infections in someone taking the drug.
I’m on Nplate injections for ITP. Now, I feel like I always have a bladder infection. Could the Nplate be causing my bladder pain? Trying to come up with an answer now. Thank you so much!
Jan 14, 2023- Urinary tract infections are not listed as a common side effect of Nplate, though they have been reported as an infrequent side effect in some clinical studies. Your doctor should evaluate your symptoms and perform testing such as a urine culture to confirm whether a bladder infection is present and to identify the underlying cause. Other conditions or side effects from Nplate like muscle pain or abdominal pain could potentially feel similar to bladder infection symptoms.
Answer
Thanks so much for contacting us! Nplate (romiplostim injection) is a drug that is used to treat people with ITP (Idiopathic thrombocytopenic purpura), a condition where the body's immune system attacks and destroys platelets, which are important cells that help the blood to clot.
Nplate, which is generally considered to be a treatment option after other therapies have failed (like corticosteroids and immunoglobulins) works by attaching to a specific receptor (the TPO receptor) on the cells in the bone marrow, which sends a signal in the body to make more platelets.
Nplate Infection Side Effects
I won't go over all the side effects of Nplate here as it seems you're primarily concerned with an increase in bladder infections you've experienced. You can always review the complete side effects list on our drug information pages, or by looking through the package insert for the drug.
Interestingly enough, 'infection' is one of the most commonly reported side effects for Nplate. The following is from the prescribing information for the drug:
You can see that Nplate is commonly associated with the following infections:
- Upper respiratory tract infections
- Ear infections
- Gastroenteritis
- Sinusitis
Urinary tract infections are absent here, and it appears urinary tract infections specifically are quite uncommon.
Nevertheless, it has been reported in some clinical studies as an infrequent side effect, so you certainly have to consider the possibility that Nplate could be responsible for what you are experiencing.
It is also important to note that Nplate is associated with some other side effects, like muscle pain, neuropathy, and abdominal pain that could feel like bladder pain associated with an infection.
What To Do
Even though urinary tract infections are thought to be uncommon with Nplate (unlike other types of infection), clinical studies suggest it is possible that the medication could be causing your issues.
However, it is also important to note that bladder infections can have many causes, and it's best to consult with your doctor to determine the specific cause of your symptoms. They can evaluate you and perform appropriate testing, such as a urine culture, to confirm if it is a bladder infection and to rule out other possible causes.
You don't mention if you have been treated for a urinary infection in the past, or what antibiotics you have used, and these are important things to know for appropriate guidance.
Treatment for urinary infections can vary greatly depending on whether or not your infection is considered 'complicated', the drugs you have used in the past, and the cause of your infections.
Again, please speak with your doctor so you can be appropriately evaluated and treated.
Final Words
Thanks so much for reaching out and I hope you found this information helpful.
References & sources
- Comparative treatment-related adverse event cost burden in immune thrombocytopenic purpura — PubMed
- Use of Romiplostim to Facilitate Platelet Engraftment in Allogeneic Hematopoietic Transplantation — ASH Publications
- Safety and feasibility of romiplostim treatment for patients with persistent thrombocytopenia after allogeneic stem cell transplantation — PubMed
- Romiplostim in adult patients with newly diagnosed or persistent immune thrombocytopenia (ITP) for up to 1 year and in those with chronic ITP for more than 1 year: a subgroup analysis of integrated data from completed romiplostim studies — PubMed
- Nplate Prescribing Information — Amgen
Glossary — Terms in This Answer
- ITP (Idiopathic thrombocytopenic purpura)
- A condition where the body's immune system attacks and destroys platelets, the cells that help blood clot.
- Platelets
- Small cells in the blood that help it clot and stop bleeding.
- Corticosteroids
- Medications that reduce inflammation and suppress the immune system.
- Immunoglobulins
- Proteins made by the immune system that can help protect against disease or reduce immune system attacks.
- TPO receptor
- A specific target site on bone marrow cells where Nplate attaches to stimulate platelet production.
- Gastroenteritis
- Inflammation of the stomach and intestines, typically causing nausea, vomiting, or diarrhea.
- Neuropathy
- Disease or dysfunction of one or more peripheral nerves, often causing weakness or pain.
- Urine culture
- A laboratory test that grows and identifies bacteria from a urine sample to diagnose urinary tract infections.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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