Anagrelide hydrochloride
Anagrelide hydrochloride (Agrylin)
Anagrelide hydrochloride
(an- AG-greh-lyd)
Pregnancy Category: C Agrylin (Rx)

Classification: Antiplatelet drug

Action/Kinetics: May act to reduce platelets by decreasing megakaryocyte hypermaturation. Does not cause significant changes in white cell counts or coagulation parameters. Inhibits platelet aggregation at higher doses than needed to reduce platelet count. Peak plasma levels: 5 ng/mL at 1 hr. t 1/2: 1.3 hr; terminal t 1/2: About 3 days. Metabolized in liver and excreted in urine and feces.

Uses: Reduce platelet count in essential thrombocythemia. Treatment of polycythemia vera, chronic myelogenous leukemia, and other myeloproliferative diseases.

Contraindications: Lactation.

Special Concerns: Use with caution in known or suspected heart disease and in impaired renal or hepatic function. Safety and efficacy have not been determined in those less than 16 years of age.

Side Effects: CV:
CHF, palpitations, chest pain, tachycardia, arrhythmias, angina, postural hypotension, hypertension, cardiovascular disease, vasodilation, migraine, syncope, MI, cardiomyopathy, complete heart block, fibrillation, CVA, pericarditis, hemorrhage, heart failure, cardiomegaly, atrial fibrillation. GI: Diarrhea, abdominal pain, pancreatitis, gastric/duodenal ulcers, N&V;, flatulence, anorexia, constipation, GI distress, GI hemorrhage gastritis, melena, aphthous stomatitis, eructations. Respiratory: Rhinitis, epistaxis, respiratory disease, sinusitis, pneumonia, bronchitis, asthma pulmonary infiltrate, pulmonary fibrosis, pulmonary hypertension dyspnea. CNS: Headache, seizures dizziness, paresthesia, depression, somnolence, confusion, insomnia, nervousness, amnesia. Musculoskeletal: Arthralgia, myalgia, leg cramps. Dermatologic: Pruritus, skin disease, alopecia, rash, urticaria. Hematologic: Anemia, thrombocytopenia, ecchymosis, lymphadenoma. Body as a whole: Fever, flu symptoms, chills, photosensitivity, dehydration, malaise, asthenia, edema, pain. Ophthalmic: Amblyopia, abnormal vision, visual field abnormality, diplopia. Miscellaneous: Back pain, tinnitus.

Laboratory Test Alterations: Liver enzymes.

Overdose Management: Symptoms: Thrombocytopenia. Treatment: Close clinical monitoring. Decrease or stop dose until platelet count returns to within the normal range.

Drug Interactions: Evening primrose oil / Potential for antiplatelet effect Feverfew / Potential for antiplatelet effect Garlic / Potential for antiplatelet effect Ginger / Potential for antiplatelet effect Ginkgo biloba / Potential for antiplatelet effect Ginseng / Potential for antiplatelet effect Grapeseed extract / Potential for antiplatelet effect

How Supplied: Capsules: 0.5 mg

Dosage
?Capsules Essential thrombocythemia.
Initial: 0.5 mg q.i.d. or 1 mg b.i.d. Maintain for one week or more. Then, adjust to lowest effective dose to maintain platelet count less than 600,000/mcL. Can increase the dose by 0.5 mg or less/day in any 1 week. Maximum dose: 10 mg/day or 2.5 mg in single dose. Most respond at a dose of 1.5 to 3 mg/day.