Anagrelide | Side Effects, Dosage, Uses & More
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Generic Name:

anagrelide, Oral capsule

All Brands

  • Agrylin
SECTION 1 of 5

Highlights for anagrelide

Oral capsule
1

Anagrelide is used to treat thrombocythemia. This condition occurs when there are too many platelets in your blood. It may be caused by bone marrow diseases.  

2

This drug is available as a capsule that you take by mouth. 

3

Anagrelide is available as a brand-name drug called Agrylin. It’s also available as a generic drug.

4

The more common side effects of this drug can include headache, dizziness, and weakness. They also include stomach pain or upset, nausea, vomiting, or diarrhea.

5

Your doctor will closely monitor your blood counts to make sure the drug is working for you. They’ll adjust your dose each week until you reach a dose that lowers your platelets enough. Changing your dose slowly will also help you get used to the side effects this drug may cause. Call your doctor if you have any side effects that you can’t tolerate. They may change your dose.

IMPORTANT INFORMATION

Heart problems

This drug may cause heart problems. Call your doctor right away if you have chest pain, palpitations (a pounding heartbeat), or an irregular heartbeat.

Bleeding

This drug affects blood clotting. Taking this drug with aspirin or other medications that affect blood clotting may increase your risk of bleeding. Call your doctor right away if you have any symptoms of bleeding. These include unexplained bruising, bleeding that takes longer than normal to stop, blood in your vomit or urine, or black or bloody stools.

What is anagrelide?

Anagrelide is a prescription drug. It’s available as an oral capsule.

Anagrelide is available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Anagrelide may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Anagrelide is used to treat thrombocythemia. This condition occurs when there are too many platelets in your blood. It may be caused by bone marrow diseases.

Having too many platelets may increase your risk of blood clots or bleeding. Blood clots can lead to heart attack or stroke.

How it works

Anagrelide belongs to a class of drugs called platelet-reducing agents. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Anagrelide works by decreasing the formation or production of platelets. This reduces the number of platelets in your body.

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SECTION 2 of 5

anagrelide Side Effects

Oral capsule

More common side effects

The more common side effects of anagrelide can include: 

  • tiredness or weakness

  • dizziness

  • headache

  • nausea

  • vomiting

  • bloating

  • stomach pain

  • diarrhea

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart problems. Symptoms can include:

    • fainting
    • lightheadedness
    • chest pain
    • palpitations (pounding heartbeat)
    • irregular heartbeat
    • trouble breathing
    • swelling of your feet, ankles, legs, or hands
  • Bleeding. Your risk may be higher if you’re also taking aspirin or other drugs that affect blood clotting. Symptoms can include:

    • unexplained bruising
    • unexpected bleeding or bleeding that lasts a long time. This includes:
      • unusual bleeding from your gums
      • frequent nosebleeds
      • heavier-than-normal menstrual bleeding
    • coughing up blood
    • vomiting blood or vomit that looks like coffee grounds
    • bloody urine
    • dark or bloody stools
    • headaches
    • weakness
    • dizziness 
  • Lung damage. Symptoms can include:

    • worsening shortness of breath
    • cough
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Anagrelide may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

anagrelide May Interact with Other Medications

Oral capsule

Anagrelide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Drugs that should not be used with anagrelide

Do not take these drugs with anagrelide. When used with anagrelide, these drugs can cause dangerous effects in the body. Examples of these drugs include:

  • Chloroquine. Taking this drug with anagrelide may cause serious abnormal heart rhythms.
  • Antibiotics, such as clarithromycin and moxifloxacin. Taking these drugs with anagrelide may cause serious abnormal heart rhythms.
  • Antipsychotic drugs, such as haloperidol and pimozide. Taking these drugs with anagrelide may cause serious abnormal heart rhythms.
  • Methadone. Taking this drug with anagrelide may cause serious abnormal heart rhythms.
  • Heart rhythm drugs, such as disopyramide and amiodarone. Taking these drugs with anagrelide may cause serious abnormal heart rhythms.
  • Procainamide. Taking this drug with anagrelide may cause serious abnormal heart rhythms.

Drugs that increase the risk of side effects
  • Increased side effects from anagrelide: Taking anagrelide with certain medications raises your risk of side effects from anagrelide. This is because the amount of anagrelide in your body is increased. Examples of these drugs include:
    • Phosphodiesterase 3 (PDE3) inhibitors, such as cilostazol, and milrinone. Taking these drugs with anagrelide may cause a faster, pounding, or irregular heartbeat, or heart failure. Taking these drugs with anagrelide can also increase your risk of bleeding.
    • Aspirin. Taking this drug with anagrelide increases your risk of bleeding. 
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. Taking these drugs with anagrelide increases your risk of bleeding. 
    • Antiplatelet drugs, such as abciximab, dipyridamole, and eptifibatide. Taking these drugs with anagrelide increases your risk of bleeding. 
    • Selective serotonin reuptake inhibitors (SSRIs), such as citalopram, escitalopram, fluoxetine, paroxetine, and sertraline. Taking these drugs with anagrelide increases your risk of bleeding. 
    • Fluvoxamine. Taking this drug with anagrelide can increase your risk of heart problems and irregular heart rhythms. 
    • Ciprofloxacin. Taking this drug with anagrelide can increase your risk of heart problems and irregular heart rhythms. 

Interactions that can make your drugs less effective
  • When anagrelide is less effective: When anagrelide is used with certain drugs, it may not work as well to treat your condition. This is because the amount of anagrelide in your body may be decreased. Examples of these drugs include: 
    • Carbamazepine
    • Rifampin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Anagrelide warnings
heart conditions
People with heart conditions

Tell your doctor if you have any heart problems before you start taking this drug. This medication increases the risk of serious heart problems. These include irregular heart rhythms or heart failure. These events can be fatal (cause death).

liver problems
People with liver problems

If you have liver disease, you may not be able to clear this drug from your body well. This may increase the levels of anagrelide in your body. This can cause serious side effects that can affect your heart. These events can be fatal (cause death). People with severe liver disease shouldn’t take this drug.

Pregnant women
Pregnant women

Anagrelide is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

breast feeding
Women who are breast-feeding

It isn’t known whether anagrelide passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors
For seniors

The liver of older adults may not work as well it used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children
For children

This medication hasn’t been studied in children younger than 7 years. It shouldn’t be used in people younger than 7 years.

Allergies
Allergies

Anagrelide can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take anagrelide (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Thrombocythemia (high platelet count)

Generic: anagrelide

Form: Oral capsule
Strengths: 0.5 mg, 1 mg

Brand: Agrylin

Form: Oral capsule
Strengths: 0.5 mg
Adult dosage (ages 18–64 years)
  • Typical starting dose: 0.5 mg taken four times per day or 1 mg taken two times per day.
  • Dose increases: Your doctor will slowly adjust your dose each week until your platelet count is low enough.
  • Maximum dose: 2.5 mg per dose or 10 mg per day.
Child dosage (ages 17 years)
  • Typical starting dose: 0.5 mg taken four times per day or 1 mg taken two times per day.
  • Dose increases: Your doctor will slowly adjust your dose each week until your platelet count is low enough.
  • Maximum dose: 2.5 mg per dose or 10 mg per day.
Child dosage (ages 7–16 years)
  • Typical starting dose: 0.5 mg taken once per day.
  • Dose increases: Your doctor will slowly adjust your dose each week until your platelet count is low enough.
  • Maximum dose: 2.5 mg per dose or 10 mg per day.
Child dosage (ages 0–6 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 7 years.

Senior dosage (ages 65 years and older)

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Liver disease: If you have moderate liver disease, your doctor may start you on a dose of 0.5 mg per day. Your doctor may increase your dose after one week, if needed. If you have severe liver disease, you shouldn’t take this drug. It isn’t known if it will be safe for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Anagrelide comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your platelet levels may stay high and you may develop a blood clot. This can be fatal (cause death).

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Signs of an overdose of this drug can include:

  • low blood pressure. Symptoms can include:
    • dizziness
    • lightheadedness
    • fainting
  • very fast heart rate
  • vomiting
  • bleeding. Symptoms can include:
    • unexplained bruising
    • unexpected bleeding or bleeding that lasts a long time. This includes:
      • unusual bleeding from your gums
      • frequent nosebleeds
      • heavier-than-normal menstrual bleeding
    • coughing up blood
    • vomiting blood or vomit that looks like coffee grounds
    • bloody urine
    • dark or bloody stools
    • headaches
    • weakness
    • dizziness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once.

How to tell if the drug is working

You may not be able to tell if this drug is working. Your doctor will do blood tests to check your platelet levels and let you know if the drug is working.

Anagrelide is used for short-term treatment.

Important considerations for taking anagrelide
take anagrelide with or without food
You can take anagrelide with or without food
timing
Take this drug at the time(s) recommended by your doctor
storage
Store this drug carefully
See Details
medication is refillable
A prescription for this medication is refillable
See Details
Travel
Travel
See Details
Clinical monitoring
Clinical monitoring
See Details
Sun sensitivity
Sun sensitivity
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
prior authorization required
Insurance
See Details

Store this drug carefully

  • Store anagrelide at room temperature. Keep it between 59°F and 86°F (15°C and 30°C).
  • Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Blood counts. Your doctor will do blood tests to check your platelet levels to make sure this drug is working. This will also help your doctor decide if your dose needs to be adjusted.   
  • Electrolytes. Your doctor may do blood tests to check if your electrolytes are at normal levels. If they aren’t, this may put you at higher risk of heart problems caused by this drug. Your doctor may have you stop taking this drug.
  • Kidney function. Your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, it may mean the drug is harming them. Your doctor may have you stop taking this drug.
  • Liver function. Your doctor may do blood tests to check how well your liver is working. If your liver isn’t working well, your doctor may lower your dose or stop your treatment with this drug. 

Sun sensitivity

Anagrelide can make your skin more sensitive to the sun. This increases your risk of sunburn. Stay out of the sun if you can. If you must be in the sun, wear protective clothing and sunscreen.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does anagrelide Cost?

Oral capsule

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Lowest price for anagrelide

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These prices represent the lowest priced national pharmacies for anagrelide on GoodRx. They may be lower than your insurance.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 3, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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