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Agrylin

Anagrelide (Agrylin®, Shire) is a drug used for the treatment of essential thrombocytosis (ET; essential thrombocythemia). It works by inhibiting the maturation of megakaryocytes into platelets. The exact mechanism of action is unclear, although it is known to be a potent (IC50 = 36nM) inhibitor of phosphodiesterase-III. more...

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In a 2005 head-to-head study (Harrison et al) hydroxyurea was found to be superior to anagrelide for the management of ET, with a small increase in the number of cases of myelofibrosis.

Side Effects

Headache, diarrhea, unusual weakness, nausea, dizziness may occur. If these persist or worsen, notify your doctor. Notify your doctor promptly if you develop: shortness of breath, swelling, stomach or chest pain, rash, itching, tingling sensations. Unlikely but report promptly: irregular or fast heartbeat, one-sided muscle weakness in arms or legs, black stools, fainting, mental changes, vision problems, unusual bleeding or bruising, pink-colored urine. Very unlikely but report promptly: unusual change in the amount of urine. If you notice other effects not listed above, contact your doctor or pharmacist.

Reference

  • Harrison CN, Campbell PJ, Buck G, Wheatley K, East CL, Bareford D, Wilkins BS, van der Walt JD, Reilly JT, Grigg AP, Revell P, Woodcock BE, Green AR; United Kingdom Medical Research Council Primary Thrombocythemia 1 Study. Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia. N Engl J Med 2005;353:33-45. PMID 16000354.

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Anagrelide
From Gale Encyclopedia of Cancer, by Ph.D. Michael Zuck

Definition

Anagrelide, also known by the brand name Agrylin, is used to treat patients with thrombocytosis, a condition in which patients have too many platelet cells in their blood. Platelets are a cell type formed in the bone marrow that are involved in the blood clotting process.

Purpose and Description

Anagrelide reduces the platelet count in patients with blood disorders.

Recommended dosage

Adult patients taking anagrelide should receive 0.5 mg of the drug four times daily or one mg twice daily. Based on the response to therapy, the dose of anagrelide can be increased by 0.5 mg per day every seven to 14 days if necessary. The goal is to maintain platelets at a count of less than 600,000 at the lowest dose of the drug possible to keep side effects at a minimum.

Precautions

Patients with heart disease should be given anagrelide with caution. Anagrelide should be given with caution, if at all, in patients taking drugs that affect platelet aggregations such as aspirin, clopidrogel, ticlopodine, or non-steroidal agents.

Pregnant mothers should be warned that anagrelide administration may cause fetal abnormalities. Pregnant patients should consult their physician about the current state of knowledge regarding risks and alternatives before beginning administration of anagrelide. Female patients of childbearing age should attempt to avoid pregnancy while taking this drug. Mothers who are nursing should discontinue nursing while taking this drug.

Side effects

The most common side effects of anagrelide are palpitations, fluid gain resulting in swelling, headaches, dizziness, diarrhea, stomach discomfort, mild to moderate nausea, passing gas, weakness, shortness of breath, and decreased platelets. Less common side effects of anagrelide include increased heart rate and chest pain, malaise, rash, vomiting, and decreased appetite. As with all medications, patients should contact their physician or nurse if any of these side effects occur.

Interactions

There are no proven interactions between anagrelide and other drugs. The drug sucralfate may interfere with the absorption of anagrelide. Prior to starting any over-the-counter medications, herbal medications, or new medications, patients should consult their physician, nurse, or pharmacist to prevent drug interactions.

KEY TERMS

Platelets
A cell type found in the blood important for blood clotting.

Thrombocytosis
The condition of having too many platelet cells in the blood.

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