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anagrelide (Rx)Brand and Other Names:Agrylin

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 0.5mg
  • 1mg
more...

Thrombocythemia

Indicated for essential thrombocythemia and for thrombocythemia secondary to myeloproliferative disorders to decrease risk thrombosis and thrombo-hemorrhagic event

0.5 PO q6hr or 1 mg q12hr; increase PRN not more frequently than 0.5 mg/day/week

Not to exceed 10 mg/day or 2.5 mg/dose

Platelet count responds typically in 7-14 days; time to complete response is 4 to 12 weeks

Polycythemia Vera (Orphan)

Orphan indication sponsor

  • Roberts Pharmaceutical Corp; Meridian Center II, 4 Industrial Way West; Eatontown, NJ 07724-2274

Hepatic Impairment

Moderate: Start with 0.5 mg/day for at least 1 week; increase PRN no more frequently than 0.5 mg/day/week

Severe: Contraindicated

Monitor

Platelet count

Dosage Forms & Strengths

capsule

  • 0.5mg
  • 1mg
more...

Thrombocythemia

0.5 mg/day to 0.5 mg PO q6hr; adjust dose PRN no more frequently than 0.5 mg/day/week

Platelet count responds typically in 7-14 days; time to complete response is 4 to 12 weeks

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Interactions

Interaction Checker

anagrelide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache (44%)

            Palpitations (26%)

            Diarrhea (26%)

            Asthenia (23%)

            Edema (21%)

            Nausea (17%)

            Abdominal pain (16%)

            Dizziness (15%)

            General pain (15%)

            Dyspnea (12%)

            1-10%

            Flatulence (10%)

            Vomiting (10%)

            Fever (9%)

            Edema (9%)

            Rash (8%)

            Chest pain (8%)

            Anorexia (8%)

            Tachycardia (8%)

            Pharyngitis (7%)

            Malaise (6%)

            Cough (6%)

            Paresthesia (6%)

            Back pain (6%)

            Pruritus (6%)

            Confusion (1-5%)

            Depression

            Migraine

            Myalgia

            Nervousness

            Photosensitivity

            Arthralgia

            Vision abnormalities

            Angina

            Arrhythmia

            Cardiovascular disease

            Heart failure

            Hemorrhage

            Hypertension

            Postural hypotension

            Syncope

            Thrombosis

            Vasodilation

            Bronchitis

            Rhinitis

            Sinusitis

            Constipation

            Dyspepsia

            Gastritis

            Anemia

            Elevated liver enzymes

            Flu symptoms

            Leg cramps

            Dehydration

            Postmarketing Reports

            Interstitial lung diseases, including allergic alveolitis, eosinophilic pneumonia and interstitial pneumonitis

            Hepatotoxicity

            Tubulointerstitial nephritis

            Supraventricular tachycardia (SVT)

            Hypoesthesia

            Torsades de pointes

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            Warnings

            Contraindications

            Severe hepatic impairment

            Cautions

            Caution in heart disease, renal impairment, mild-moderate hepatic impairment

            Torsades de pointes and ventricular tachycardia reported; obtain pretreatment cardiovascular exam, including EKG, in all patients

            Hepatic impairment increases anagrelide exposure and could increase risk of QTc prolongation; monitor patients with hepatic impairment for QTc prolongation and other cardiovascular adverse reactions

            Increases QTc interval and heart rate in healthy volunteers; should not be used in patients with known risk factors for QT interval prolongation, such as congenital long QT syndrome, a known history of acquired QTc prolongation, medicinal products that can prolong QTc interval and hypokalemia

            In patients with cardiac disease, use only when benefits outweigh risks

            In patients with heart failure, bradyarrhythmias, or electrolyte abnormalities, consider periodic ECG monitoring

            Orthostatic hypotension reported with higher doses; minimal BP changes observed following 2 mg/dose

            Coadministration with aspirin increases risk for major hemorrhagic event

            Interstitial lung diseases (including allergic alveolitis, eosinophilic pneumonia and interstitial pneumonitis) reported to be associated with use of anagrelide in post-marketing reports; most cases presented with progressive dyspnea with lung infiltrations; time of onset ranged from 1 week to several years after initiating anagrelide; discontinue anagrelide if it occurs and evaluate; symptoms may improve after discontinuation

            Monitor platelets, Hgb, WBC, LFTs, Cr, BUN for at least first 2 weeks

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Phosphodiesterase 3 (PDE3) inhibitor; inhibits nucleotide PDE and the release of arachidonic acid from phospholipase A2; reduces also platelet production by disrupting the maturation phase of megakaryocytes

            Pharmacokinetics

            Onset of action: Within 7-14 days (initial); 4-12 weeks (complete)

            Peak plasma time: 1 hr

            Duration: 6-24 hr

            Metabolism: Extensive; partially through CYP1A2

            Half-life: 1.3 hr

            Excretion: Urine (<1%)

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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