Understanding What Medications Raise Platelets: A Pharmacological Overview

October 11, 2025 •

4 min read

According to the National Heart, Lung, and Blood Institute, certain medications are a cornerstone of treatment for low platelet counts, or thrombocytopenia. This guide explores what medications raise platelets, detailing their different mechanisms of action and common therapeutic applications.

Quick Summary

This comprehensive overview covers the primary medications used to increase platelet counts. It details the classes of drugs that stimulate production, including TPO-receptor agonists and corticosteroids, outlining their uses and functions.

Key Points

TPO-Receptor Agonists Boost Production: Drugs like eltrombopag (Promacta) and romiplostim (Nplate) directly stimulate the bone marrow to produce more platelets by mimicking natural thrombopoietin.
Corticosteroids Suppress Immunity: Corticosteroids such as prednisone are used to calm the immune system's attack on platelets, a common cause of low counts in immune thrombocytopenia (ITP).
IVIG Provides Temporary Boost: Intravenous immunoglobulin (IVIG) offers a short-term, rapid increase in platelet counts by blocking the immune destruction of platelets.
Targeted Immunomodulators Exist: For patients unresponsive to standard therapy, advanced options like rituximab or fostamatinib can target specific components of the immune system responsible for platelet destruction.
Some Meds Have Secondary Effects: Certain medications like epinephrine and specific antibiotics can have secondary, often temporary, effects on platelet levels, although they are not primarily used for this purpose.
Iron Supplements Can Influence Platelets: In cases of iron-deficiency anemia, iron supplements can correct reactive thrombocytosis, but may also be associated with increased platelet counts in some individuals.

The Pharmacological Mechanisms for Raising Platelets

Platelets are tiny, colorless cell fragments in our blood that form clots and stop or prevent bleeding. A low platelet count, known as thrombocytopenia, can increase the risk of bruising and significant bleeding. Treatment often involves identifying and addressing the underlying cause. When medication is necessary, several pharmacological approaches can be used to either boost the body's natural platelet production or reduce their destruction by the immune system.

Thrombopoietin Receptor Agonists (TPO-RAs)

Thrombopoietin is a hormone primarily produced by the liver that stimulates the bone marrow to produce platelets. For individuals with low platelet counts, often due to conditions like chronic immune thrombocytopenia (ITP) or chronic liver disease, medications known as TPO-receptor agonists are highly effective. These drugs mimic the action of thrombopoietin by binding to and activating the thrombopoietin receptor on megakaryocytes—the bone marrow cells responsible for making platelets.

Key TPO-RA Medications

Eltrombopag (Promacta/Alvaiz): An oral medication taken daily, eltrombopag is approved for chronic ITP, severe aplastic anemia, and thrombocytopenia in chronic liver disease patients undergoing procedures. Its absorption can be affected by dietary calcium, requiring careful timing relative to meals.
Romiplostim (Nplate): Administered as a once-weekly subcutaneous injection, romiplostim is also used for chronic ITP when other treatments have failed. It acts similarly to natural thrombopoietin to stimulate platelet production.
Avatrombopag (Doptelet): Another oral TPO-RA, avatrombopag is approved for chronic ITP and thrombocytopenia in patients with chronic liver disease needing a procedure. It is taken daily with food.
Lusutrombopag (Mulpleta): This medication is specifically used to treat low platelets in adults with chronic liver disease who are scheduled for a medical or dental procedure.

Corticosteroids

Corticosteroids, commonly referred to as steroids, are often used as a first-line treatment for immune thrombocytopenia (ITP). In ITP, the immune system mistakenly attacks and destroys platelets. Corticosteroids like prednisone and dexamethasone work by suppressing the immune system, thereby reducing the destruction of platelets.

Prednisone: An oral corticosteroid frequently used to quickly raise platelet counts in acute ITP. Long-term use is associated with significant side effects and is typically tapered once platelet levels stabilize.
Dexamethasone: A powerful corticosteroid sometimes used in high-dose, short-course regimens for ITP.

Intravenous Immunoglobulin (IVIG)

IVIG is a treatment made from donated blood that contains a broad spectrum of antibodies. It is administered intravenously and can temporarily increase platelet counts, particularly in immune-related conditions. IVIG works by blocking the receptors on the spleen and other immune cells that would normally destroy antibody-coated platelets. It is often used for rapid platelet increase in cases of severe bleeding or before emergency surgery.

Immunomodulatory and Other Targeted Agents

For patients with chronic or refractory ITP who do not respond adequately to initial treatments like steroids or IVIG, other immunomodulatory agents are available.

Rituximab (Rituxan): This is a monoclonal antibody that targets B-cells, a type of white blood cell involved in the autoimmune attack on platelets. By depleting B-cells, rituximab can reduce platelet destruction and increase platelet counts over time.
Fostamatinib (Tavalisse): A newer oral medication approved for chronic ITP. It prevents the destruction of platelets mediated by autoantibodies by inhibiting an enzyme involved in the immune response.

Medications with Secondary Effects

In some cases, certain medications can have a secondary, and sometimes temporary, effect of increasing platelet counts. This is not their primary use, and these effects can be highly variable depending on the individual and the specific clinical context.

Epinephrine: Also known as adrenaline, this hormone can cause a transient increase in circulating platelets.
Certain Antibiotics: Some antibiotics, like ceftazidime and aztreonam, have been associated with a potential increase in platelet count.
Iron Supplementation: In individuals with iron-deficiency anemia and reactive thrombocytosis, iron supplementation can normalize platelet counts. However, in some cases, it can cause or contribute to thrombocytosis.
Caffeine: A stimulant present in coffee and other beverages, caffeine has been suggested in some studies to have effects on platelet aggregation and could potentially influence platelet counts.

Comparison of Platelet-Increasing Medications


Medication Class	Mechanism of Action	Administration	Primary Use Cases	Key Considerations
TPO-Receptor Agonists	Mimics thrombopoietin to stimulate bone marrow platelet production.	Oral (Eltrombopag, Avatrombopag) or Subcutaneous Injection (Romiplostim).	Chronic ITP, Chronic Liver Disease-related Thrombocytopenia, Aplastic Anemia.	Regular monitoring for potential blood clots and liver enzyme changes.
Corticosteroids	Suppresses the immune system to reduce platelet destruction.	Oral (Prednisone, Dexamethasone).	First-line treatment for acute ITP.	High risk of side effects with long-term use; short-term use preferred.
Intravenous Immunoglobulin (IVIG)	Provides antibodies that temporarily block immune destruction of platelets.	Intravenous Infusion.	Emergency bleeding control in ITP or before surgery.	Short-term effect; potential for allergic reactions.
Rituximab	Targets B-cells to reduce the autoimmune attack on platelets.	Intravenous Infusion.	Chronic ITP refractory to other treatments.	Can increase risk of infections; effect may take time.
Fostamatinib	Inhibits an enzyme in the immune pathway to prevent platelet destruction.	Oral.	Chronic ITP resistant to other therapies.	Newer drug; side effect profile still being evaluated.

Conclusion

For individuals with low platelet counts, a variety of medications are available to address the issue, with the most common targeting either increased platelet production or reduced immune destruction. Thrombopoietin receptor agonists, such as eltrombopag and romiplostim, are effective at stimulating the bone marrow directly. For immune-related issues, corticosteroids and IVIG can be used to suppress the immune response, while newer agents like fostamatinib offer targeted options. It is crucial for treatment decisions to be made by a healthcare provider based on the underlying cause of the low platelet count and the patient's individual health profile. Always consult with a qualified medical professional before starting, stopping, or changing any medication to ensure safety and effectiveness. Learn more about blood disorders and treatment options from the Platelet Disorder Support Association.

Frequently Asked Questions

The primary class of medications specifically designed to raise platelet counts are Thrombopoietin Receptor Agonists (TPO-RAs), which includes drugs like romiplostim and eltrombopag.

TPO-receptor agonists work by binding to and activating the thrombopoietin receptor on megakaryocytes in the bone marrow, which stimulates the production and maturation of platelets.

Yes, corticosteroids like prednisone are often used as a first-line treatment for low platelet counts, especially when caused by an immune system disorder. They work by suppressing the immune system to reduce platelet destruction.

IVIG can temporarily increase platelet counts by introducing a broad spectrum of antibodies that block the body's immune system from destroying its own platelets. It is often used for rapid increases in emergency situations.

While some herbal products, like Carica papaya leaf extract, are anecdotally used for increasing platelet counts, particularly in dengue fever, scientific evidence is limited and inconsistent. It's crucial to consult a doctor before using any herbal treatments.

Yes, some medications, including certain antibiotics like aztreonam and ceftazidime, can cause a temporary increase in platelet count as a side effect. Hormones like epinephrine can also cause a transient rise.

Doctors select a medication based on the underlying cause of the low platelet count. For immune conditions, they may start with corticosteroids, while for production issues, TPO-RAs might be prescribed. The choice depends on the specific diagnosis, severity, and patient's response to therapy.

Side effects vary by medication. TPO-RAs can increase the risk of blood clots, while long-term corticosteroid use carries risks like infections, high blood sugar, and osteoporosis. IVIG can cause allergic reactions. The risks must always be weighed against the benefits under medical supervision.