anagrelide

Contraindicated in:

Hypersensitivity;
Severe hepatic impairment;
Congenital long QT syndrome
Concurrent use of other drugs known to prolong the QT interval
QTc interval ≥440 msec;
Lactation: Lactation.

Use Cautiously in:

Cardiovascular, renal or mild to moderate hepatic impairment (monitor closely during treatment);
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Pedi: Children < 7 yr (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain, edema, palpitations, COMPLETE HEART BLOCK, HF, MI, angina, atrial fibrillation, CEREBROVASCULAR ACCIDENT, orthostatic hypotension, pericardial effusion, pericarditis, tachycardia, TORSADE DE POINTES, VENTRICULAR TACHYCARDIA

Derm: alopecia, pruritus, rash

EENT: abnormal vision

GI: abdominal pain, diarrhea, flatulence, GI BLEEDING, anorexia, constipation, dyspepsia, HEPATOTOXICITY, nausea, PANCREATITIS, vomiting

GU: dysuria, ↓fertility (females), hematuria, RENAL FAILURE

Hemat: anemia

MS: weakness, arthralgia, back pain, myalgia

Neuro: dizziness, headache, malaise, paresthesia, SEIZURES

Resp: dyspnea, cough, EOSINOPHILIC PNEUMONIA, INTERSTITIAL PNEUMONITIS, pharyngitis, PULMONARY FIBROSIS, PULMONARY HYPERTENSION

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

QT-interval prolonging drugs may ↑ risk of torsade de pointes; concomitant use contraindicated
Absorption may be ↓ by sucralfate.
Fluvoxamine may ↑ blood levels.
May ↑ blood levels of theophylline.
May ↑ effects of milrinone and cilostazol.
Concurrent use with aspirin may ↑ risk of bleeding.

Availability ⬆ ⬇

(Generic available)

Capsules: 0.5 mg; 1 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 0.5 mg 4 times daily or 1 mg twice daily; may be ↑ weekly by 0.5 mg/day (not to exceed 10 mg/day or 2.5 mg as a single dose).
PO (Children ≥7 yr): 0.5 mg daily; may be ↑ weekly by 0.5 mg/day (not to exceed 10 mg/day or 2.5 mg as a single dose.

Hepatic Impairment

PO (Adults ): Initiate at 0.5 mg daily; may be ↑ weekly by 0.5 mg/day.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Decreases maturation of megakaryocytes (platelet precursors).

Therapeutic effects:

Reduction in platelet count with reduced risk of complications associated with thrombocythemia (thrombosis).

Classifications ⬆ ⬇

Therapeutic Classification: platelet-reducing agent

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed after oral administration.

Distribution: Unknown.

Metabolism/Excretion: Extensively metabolized; <1% excreted unchanged in urine.

Half-Life: 1.3 hr.

Time/Action Profile ⬆ ⬇

(↓ in platelet count)

ROUTE	ONSET	PEAK	DURATION
PO	7–14 days	4–12 wk	4 days‡

‡Increase in platelet count after discontinuation.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known. Caution patient to stand slowly.
Advise patient to notify health care professional promptly if signs and symptoms of bleeding, cardiovascular effects (chest pain, palpitations, irregular heartbeat), or pulmonary hypertension (shortness of breath, swelling in legs or ankles, lips and skin turn bluish color) occur.
Instruct patient to limit alcohol intake; may worsen side effects of anagrelide.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially anticoagulants, PDE3 inhibitors, NSAIDs, antiplatelet agents, selective serotonin reuptake inhibitors.
Rep: Advise patient to notify health care professional if pregnancy is planned or suspected, and to avoid breastfeeding during and for 1 wk after last dose. May impair female fertility.

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇