Anagrelide

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

  1. abdominal pain
  2. alopecia
  3. amblyopia
  4. amnesia
  5. anemia
  6. angina
  7. anorexia
  8. arrhythmia exacerbation
  9. arthralgia
  10. asthenia
  11. atrial fibrillation
  12. AV block
  13. back pain
  14. bleeding
  15. cardiomyopathy
  16. chills
  17. confusion
  18. constipation
  19. cough
  20. dehydration
  21. depression
  22. diarrhea
  23. diplopia
  24. dizziness
  25. drowsiness
  26. dyspepsia
  27. dyspnea
  28. dysuria
  29. ecchymosis
  30. edema
  31. elevated hepatic enzymes
  32. eosinophilic pneumonia
  33. epistaxis
  34. eructation
  35. fatigue
  36. fever
  37. flatulence
  38. gastritis
  39. GI bleeding
  40. headache
  41. heart failure
  42. hematuria
  43. hypertension
  44. hypoesthesia
  45. insomnia
  46. interstitial lung disease
  47. interstitial nephritis
  48. lymphadenopathy
  49. malaise
  50. melena
  51. migraine
  52. muscle cramps
  53. myalgia
  54. myocardial infarction
  55. nausea
  56. orthostatic hypotension
  57. palpitations
  58. pancreatitis
  59. paresthesias
  60. peptic ulcer
  61. pericardial effusion
  62. pericarditis
  63. peripheral edema
  64. peripheral vasodilation
  65. pharyngitis
  66. photosensitivity
  67. platelet dysfunction
  68. pleural effusion
  69. pneumonitis
  70. pruritus
  71. pulmonary fibrosis
  72. pulmonary hypertension
  73. QT prolongation
  74. rash
  75. renal failure (unspecified)
  76. rhinitis
  77. seizures
  78. sinus tachycardia
  79. sinusitis
  80. stroke
  81. supraventricular tachycardia (SVT)
  82. syncope
  83. thrombocytopenia
  84. thrombosis
  85. tinnitus
  86. torsade de pointes
  87. urticaria
  88. ventricular tachycardia
  89. visual impairment
  90. 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)

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