Anagrelide Brand Name– Agrylin
What is Anagrelide
Anagrelide is an oral platelet reducing agent indicated for the treatment of thrombocythemia, secondary to myeloproliferative neoplasms, to reduce the elevated platelet count and the risk of thrombosis and to ameliorate associated symptoms including thrombo-hemorrhagic events.
Anagrelide therapy requires clinical monitoring, including complete blood counts, hepatic and renal function, and electrolytes.
QT prolongation and ventricular tachycardia have been reported with anagrelide
Indications
- chronic myelogenous leukemia (CML)
- polycythemia vera
- thrombocytosis
For the treatment of thrombocytosis due to myeloproliferative disorders such as essential thrombocythemia, polycythemia vera, or chronic myelogenous leukemia (CML)
NOTE: Anagrelide has been designated an orphan drug by the FDA for these indications.
NOTE: Typically, platelet counts begin to respond within 7 to 14 days at the proper dosage. The time to complete response, defined as platelet count 600,000 cells/microliter or less, ranged from 4 to 12 weeks.
In the event of dosage interruption or treatment withdrawal, platelet counts typically will start to rise within 4 days and return to baseline concentrations in 1 to 2 weeks, possibly rebounding above baseline values.
Side Effects
- abdominal pain
- alopecia
- amblyopia
- amnesia
- anemia
- angina
- anorexia
- arrhythmia exacerbation
- arthralgia
- asthenia
- atrial fibrillation
- AV block
- back pain
- bleeding
- cardiomyopathy
- chills
- confusion
- constipation
- cough
- dehydration
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- dysuria
- ecchymosis
- edema
- elevated hepatic enzymes
- eosinophilic pneumonia
- epistaxis
- eructation
- fatigue
- fever
- flatulence
- gastritis
- GI bleeding
- headache
- heart failure
- hematuria
- hypertension
- hypoesthesia
- insomnia
- interstitial lung disease
- interstitial nephritis
- lymphadenopathy
- malaise
- melena
- migraine
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- orthostatic hypotension
- palpitations
- pancreatitis
- paresthesias
- peptic ulcer
- pericardial effusion
- pericarditis
- peripheral edema
- peripheral vasodilation
- pharyngitis
- photosensitivity
- platelet dysfunction
- pleural effusion
- pneumonitis
- pruritus
- pulmonary fibrosis
- pulmonary hypertension
- QT prolongation
- rash
- renal failure (unspecified)
- rhinitis
- seizures
- sinus tachycardia
- sinusitis
- stroke
- supraventricular tachycardia (SVT)
- syncope
- thrombocytopenia
- thrombosis
- tinnitus
- torsade de pointes
- urticaria
- ventricular tachycardia
- visual impairment
- vomiting
Monitoring Parameters
- CBC
- LFTs
- platelet count
- serum creatinine/BUN
- serum electrolytes
Contraindications
- apheresis
- AV block
- bleeding
- bradycardia
- breast-feeding
- cardiomyopathy
- celiac disease
- eosinophilic pneumonia
- females
- fever
- geriatric
- heart failure
- hepatic disease
- human immunodeficiency virus (HIV) infection
- hyperparathyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- infertility
- long QT syndrome
- myocardial infarction
- pheochromocytoma
- pneumonitis
- pregnancy
- pulmonary hypertension
- QT prolongation
- renal failure
- renal impairment
- rheumatoid arthritis
- sickle cell disease
- sleep deprivation
- stroke
- systemic lupus erythematosus (SLE)
Interactions
- Abciximab
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Ado-Trastuzumab emtansine
- ADP receptor antagonists
- Alfuzosin
- Altretamine
- Aminolevulinic Acid
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Antimetabolites
- Antithrombin III
- Antithymocyte Globulin
- Apixaban
- Apomorphine
- Argatroban
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Azithromycin
- Barbiturates
- Bedaquiline
- Betrixaban
- Bexarotene
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Caffeine
- Caffeine; Ergotamine
- Capmatinib
- Carbamazepine
- Ceritinib
- Chlorambucil
- Chloroquine
- Chlorpromazine
- Cilostazol
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Cladribine
- Clarithromycin
- Clofarabine
- Clofazimine
- Clomipramine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Collagenase
- Crizotinib
- Dabigatran
- Dalteparin
- Danaparoid
- Danazol
- Dasatinib
- Defibrotide
- Degarelix
- Denileukin Diftitox
- Desflurane
- Desipramine
- Desirudin
- Desvenlafaxine
- Deutetrabenazine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dipyridamole
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Drotrecogin Alfa
- Duloxetine
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Enoxaparin
- Entrectinib
- Eptifibatide
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Estramustine
- Ezogabine
- Fingolimod
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Flecainide
- Fluconazole
- Fludarabine
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluvoxamine
- Folate analogs
- Fondaparinux
- Foscarnet
- Garlic, Allium sativum
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Ginger, Zingiber officinale
- Ginkgo, Ginkgo biloba
- Glasdegib
- Goserelin
- Granisetron
- Green Tea
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Heparin
- Histrelin
- Hydroxychloroquine
- Hydroxyzine
- Ibritumomab Tiuxetan
- Ibrutinib
- Ibutilide
- Icosapent ethyl
- Iloperidone
- Iloprost
- Imatinib
- Imipramine
- Inamrinone
- Inotersen
- Inotuzumab Ozogamicin
- Intravenous Lipid Emulsions
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Lepirudin
- Leuprolide
- Leuprolide; Norethindrone
- Levofloxacin
- Levomilnacipran
- Lidocaine
- Lidocaine; Prilocaine
- Lithium
- Lofexidine
- Lomustine, CCNU
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Macimorelin
- Maprotiline
- Mefloquine
- Meperidine; Promethazine
- Mercaptopurine, 6-MP
- Methadone
- Methoxsalen
- Methylsulfonylmethane, MSM
- Metronidazole
- Mexiletine
- Midostaurin
- Mifepristone
- Milnacipran
- Milrinone
- Mirtazapine
- Moxifloxacin
- Mycophenolate
- Nelarabine
- Nilotinib
- Nonsteroidal antiinflammatory drugs
- Norfloxacin
- Nortriptyline
- Obeticholic Acid
- Obinutuzumab
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pegaspargase
- Peginterferon Alfa-2b
- Pentamidine
- Pentosan
- Pentostatin
- Pentoxifylline
- Perphenazine
- Perphenazine; Amitriptyline
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Photosensitizing agents (topical)
- Pimavanserin
- Pimozide
- Pitolisant
- Platelet Glycoprotein IIb/IIIa Inhibitors
- Posaconazole
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Primaquine
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Purine analogs
- Quetiapine
- Quinidine
- Ranolazine
- Rasagiline
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Rilpivirine
- Risperidone
- Rivaroxaban
- Romidepsin
- Ropinirole
- Rucaparib
- Saquinavir
- Selegiline
- Selpercatinib
- Selumetinib
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Siponimod
- Sodium Hyaluronate, Hyaluronic Acid
- Solifenacin
- Sorafenib
- Sotalol
- Sulfinpyrazone
- Sunitinib
- Tacrine
- Tacrolimus
- Tamoxifen
- Telavancin
- Telithromycin
- Teriflunomide
- Tetrabenazine
- Theophylline, Aminophylline
- Thiabendazole
- Thioguanine, 6-TG
- Thioridazine
- Thrombolytic Agents
- Tinzaparin
- Tirofiban
- Tizanidine
- Tolterodine
- Topiramate
- Toremifene
- Trazodone
- Treprostinil
- Tretinoin, ATRA
- Trifluoperazine
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verteporfin
- Vilazodone
- Vorapaxar
- Voriconazole
- Vorinostat
- Vortioxetine
- Warfarin
- Zileuton
- Ziprasidone
