Does the combination of Romiplostim (Romiplostim) and Levetiracetam (Keppra) cause thrombocytopenia?

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Last updated: March 4, 2025View editorial policy

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From the Research

Romiplostim and Keppra (levetiracetam) together do not typically cause thrombocytopenia. In fact, romiplostim is a medication specifically used to treat thrombocytopenia by stimulating platelet production in patients with chronic immune thrombocytopenia, as shown in a study published in 2019 1. Keppra, an antiepileptic medication, has been associated with thrombocytopenia in rare cases as a side effect, but this is uncommon. If a patient is experiencing low platelet counts while taking these medications together, it's essential to consider other potential causes of thrombocytopenia rather than assuming it's from this drug combination. The underlying condition being treated with romiplostim is likely the primary cause of low platelets. Regular blood count monitoring is recommended for patients on either medication, especially during the initial treatment period, as suggested by a study in 2020 2. If thrombocytopenia develops or worsens while on these medications, consult with a healthcare provider immediately to evaluate the cause and determine appropriate management. Some studies have evaluated the safety and efficacy of romiplostim in patients with thrombocytopenia, including a study published in 2017 3, which found that romiplostim can improve platelet counts in about 50% of patients with low- or intermediate 1-risk myelodysplastic syndromes and thrombocytopenia. However, the most recent and highest quality study, published in 2020 2, provides the most relevant evidence for the use of romiplostim in patients with immune thrombocytopenia. Key points to consider include:

  • Romiplostim is a thrombopoietin receptor agonist that stimulates platelet production
  • Keppra has been associated with thrombocytopenia in rare cases
  • Regular blood count monitoring is essential for patients on either medication
  • The underlying condition being treated with romiplostim is likely the primary cause of low platelets
  • Consult with a healthcare provider immediately if thrombocytopenia develops or worsens while on these medications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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