Blood Disorders How Thrombocytopenia Is Treated By Julie Scott, MSN, ANP-BC, AOCNP Julie Scott, MSN, ANP-BC, AOCNP LinkedIn Oncology Certified Nurse Practitioner and freelance healthcare writer with over a decade of medical oncology and hematology experience. Learn about our editorial process Published on July 26, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Douglas A. Nelson, MD Medically reviewed by Douglas A. Nelson, MD LinkedIn Douglas A. Nelson, MD, is a board-certified oncologist and hematologist who previously served for 13 years as a physician in the US Air Force. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Observation Medication Avoidance Prescription Medications Platelet Transfusion Surgical Options Lifestyle Changes Thrombocytopenia is a diagnosis of having too few platelets in the blood. Someone with thrombocytopenia may not have any symptoms, but sometimes people with thrombocytopenia may experience bleeding that is difficult to stop, bruising, tiny pinpoint red spots on the skin, or blood in the urine or stool. Treating thrombocytopenia depends upon its severity and the condition that is causing it. If thrombocytopenia requires treatment, this is often done by fixing the underlying disorder. Verywell / Dennis Madamba Observation If thrombocytopenia is mild and is not causing any symptoms, it may not require any treatment. Continued monitoring of platelet counts and reporting any symptoms of bleeding or bruising may be the only intervention that is required. Medication Avoidance If thrombocytopenia is due to a reaction after taking a medication, stopping that medication may be the only treatment required. It may also be necessary to avoid or use with caution other medications that affect platelet function. Some of the most common medications that may need to be discontinued or avoided include: HeparinAspirinIbuprofenNaproxenBlood thinners such as warfarin, Eliquis, or XareltoPlavix Prescription medications should never be discontinued without the guidance or instruction of the healthcare provider who prescribed it. Prescription Medications Depending upon the underlying cause leading to the development of thrombocytopenia, multiple prescription medication treatments may be prescribed. Steroids Steroids are often given when thrombocytopenia occurs due to an autoimmune disorder or abnormal destruction of platelet cells by the immune system. Giving steroids decreases the immune system’s reaction and keeps the immune system from attacking the platelets. Steroids can be given through an intravenous infusion or can be taken orally in pill form. They are typically tapered down over a few days or weeks as platelet counts improve. Immune Globulin Immune globulin (IVIG) is an intravenous infusion that can be given to slow down the immune system’s destruction of platelets. IVIG may be given in combination with steroids or as second-line therapy if steroids alone don’t work well enough to increase platelet counts. Antibody Therapy An antibody infusion called Rituxan can be infused to help improve platelet counts. Rituxan works by helping the immune system stop destroying platelets abnormally. This infusion can be given weekly for a few weeks to improve platelet counts. Platelet-Boosting Medications Instead of decreasing the immune system’s destruction of platelets, these medications work by increasing platelet production in the bone marrow. Examples of these medications include Promacta (eltrombopag) and Nplate (romiplostim). Platelet Transfusion Giving an infusion of donated platelets may be necessary for instances of severe thrombocytopenia and bleeding or with a need for emergent surgery. A unit of platelets can increase platelet counts by 30,000 to 60,000 per deciliter of blood. However, platelets should not be transfused in thrombocytopenia caused by the medication Heparin, as a platelet transfusion can lead to greater complications. Surgical Options If nonsurgical treatments such as steroids, immune globulin infusions, and antibody infusions are not effective in increasing platelet counts, a splenectomy may be needed. During a splenectomy, a surgeon removes the spleen from the body. The spleen is the location that platelets are removed from the body when being attacked by the immune system, and removing the spleen may significantly improve platelet counts. However, there are risks associated with surgery, and a splenectomy increases the risk of future infections. Lifestyle Changes Dietary Changes Sometimes low platelet counts can be associated with low vitamin B12 or folate levels. Increasing these nutrients in the diet may improve platelet counts. Avoiding Alcohol If low platelet counts are caused by heavy alcohol use, avoiding alcohol completely may be necessary. Talk to your healthcare team to discuss prevention of withdrawal symptoms if alcohol use has been a chronic problem. Decreasing Bleeding Risk If platelets are low, certain activities may increase the risk of bleeding. Taking proper precautions to prevent injury may be necessary. Some of these may include: Wearing a helmet when riding a bike or scooterWearing a seatbelt when riding in a carAvoiding high-contact sports if the spleen is enlarged or if platelets are lowWearing gloves when working with sharp objects A Word From Verywell Having low platelet counts may come with a lot of worry about the potential risk of bleeding. However, having low platelet counts doesn’t always come with problems. If platelets are low enough and require some form of treatment, multiple options are available, from oral and intravenous medications, to surgical options. Talk to your healthcare team about what options are best for you in treating thrombocytopenia. Be sure to seek emergency treatment if you have low platelets and are experiencing bleeding or are having difficulty stopping bleeding. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Heart, Lung, and Blood Institute. Thrombocytopenia. University of California San Francisco. Immune thrombocytopenia treatments. Mayo Clinic. Immune thrombocytopenia. Sharma S, Sharma P, Tyler LN. Transfusion of blood and blood products: indications and complications. AFP. 2011;83(6):719-724. Chaturvedi S, Arnold DM, McCrae KR. Splenectomy for immune thrombocytopenia: down but not out. Blood. 2018;131(11):1172-1182. doi:10.1182/blood-2017-09-742353