Anagrelide is a 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 interferes with the development of platelets. It reduces the number of platelets produced by the bone marrow, which results in a decrease in the platelet count in the blood towards a more normal level. For this reason it is used to treat patients with essential thrombocythemia.

Essential thrombocythemia is a condition which occurs when the bone marrow produces too many of the blood cells known as platelets. Large numbers of platelets in the blood can cause serious problems with blood circulation and clotting.

In combination with acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever, as well as to prevent blood clotting, also known as aspirin), there is an increased risk of major hemorrhages (bleeding).

While on Anagrelide, you should take the exact dose prescribed by your doctor. Do not stop taking the medicine without first talking to your doctor. You should not suddenly stop taking this medicine on your own, because you may have increased risk of stroke.

Signs and symptoms of stroke may include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, sudden confusion, trouble speaking, or difficulty understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, or lack of coordination and sudden severe headache with no known cause. Please seek immediate medical help.

Anagrelide is used to decrease the number of platelets (a type of blood cell that is needed to control bleeding) in the blood of patients who have a bone marrow disorder, in which the body makes too many of one or more types of blood cells, such as essential thrombocythemia (condition in which the body makes too many platelets) or polycythemia Vera (condition in which the body makes too many red blood cells and sometimes too many platelets).

Anagrelide is in a class of medications called platelet-reducing agents. It works by slowing the production of platelets in the body.

The precise mechanism by which anagrelide reduces blood platelet count is unknown. In cell culture studies, anagrelide suppressed expression of transcription factors including GATA-1 and FOG-1 required for mega karyocytopoiesis, ultimately leading to reduced platelet production.

Always take Anagrelide exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The amount of anagrelide that people take can be different, and this depends on your condition. Your doctor will prescribe the best dose for you.

The usual starting dose of Anagrelide is 1 mg. You take this dose as one capsule of 0.5 mg twice a day, for at least a week. After this time, your doctor may either increase or decrease the number of capsules that you take to find the dose best suited to you and which treats your condition most effectively.

Your capsules should be swallowed whole with a glass of water. Do not crush the capsules or dilute the contents in a liquid. You can take the capsules with food or after a meal or on an empty stomach. It is best to take the capsule(s) at the same time every day.

Do not take more or less capsules than your doctor has recommended. Do not stop taking the medicine without first talking to your doctor. You should not suddenly stop taking this medicine on your own.

Your doctor will ask you to have blood tests at regular intervals to check that your medicine is working effectively and that your liver and kidneys are working well.

If you experience any of the following symptoms, call your doctor immediately:

Rash

Hives

Unusual bleeding or bruising

Blood in urine or stool

Black or tarry stools

Chest pain

Fluttering sensation in the chest

Fast, forceful, or irregular heartbeats

Swelling of the arms, hands, feet, ankles or lower legs

Difficulty breathing

Cough

Slow or difficult speech

Fainting

Weakness or numbness of an arm or leg

Pain, burning, or tingling in the hands or feet

Seizure

Changes in vision

Other PDE 3 inhibitors: Exacerbation of inotropic effects.

Aspirin and Drugs that Increase Bleeding Risk: Increased risk of bleeding with concomitant use.

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines.

Tell your doctor if you are taking any of the following medicines:

• Medicines that can alter your heart rhythm e.g., sotalol, amiodarone;

• Fluvoxamine, used to treat depression;

• Certain types of antibiotic, such as enoxacin, used to treat infections;

• Theophylline, used to treat severe asthma and breathing problems;

• Medicines used to treat heart disorders, for example, milrinone, enoximone, amrinone, olprinone and cilostazol;

• Acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever, as well as to prevent blood clotting, also known as aspirin);

• Other medicines used to treat conditions affecting the platelets in your blood, e.g., clopidogrel;

• Omeprazole, used to reduce the amount of acid produced in the stomach;

• Oral contraceptives: If you experience bad diarrhoea whilst taking this medicine, it may reduce how well the oral contraceptive works and use of an extra method of contraception is recommended (e.g., condom). See the instructions in the patient leaflet of the contraceptive pill you are taking.

Anagrelide or these medicines may not work properly if taken together.

If you are not sure, speak to your doctor or pharmacist for advice.

Store at 20℃ to 25℃ (68℉ to 77℉).

Excursions permitted between 15℃ and 30℃ (59℉ and 86℉).

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to anagrelide.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.