Posted on December 2nd, 2008 by
Class: Supportive care
Generic Name: Anagrelide (eh-NA-gre-lide)
Trade Name: Agrylin®
For which conditions is this drug approved?
Anagrelide is FDA approved for the treatment of high blood platelet levels (polycythemia) associated with myeloproliferative disease (disease in which higher than normal levels of one or more types of blood cells are produced).
It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action?
Anagrelide is classified as a phospholipase A2 inhibitor. Anagrelide is believed to reduce the number of platelets by blocking the enzyme called phospholipase A2, which is at least partially responsible in the maturation process of platelets.
How is anagrelide typically given (administered)?
Anagrelide is given orally and may be taken with food or on an empty stomach. The dose may be changed based on the patient’s platelet count.
How are patients typically monitored?
Patients will usually have scheduled meetings with their healthcare provider while they are being treated with anagrelide. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.
During treatment with anagrelide, patients will have their platelet levels closely monitored. Patients will also have their heart function monitored, as anagrelide may cause abnormalities with the pumping action of the heart. Patients experiencing anxiety, cold sweating, increased heart rate, severe pain in the chest and/or the jaw, neck, back, or arms, or shortness of breath should contact their healthcare provider immediately.
What are the common (occur in 30% or more of patients) side effects of treatment with anagrelide?
What are the less common (occur in 10% to 29% of patients) side effects of treatment with anagrelide?
• Heart rhythm abnormalities (palpitations)
• Abdominal pain
• Dizziness, drowsiness
• Difficulty breathing
What are the possible late side effects of treatment with anagrelide?
Although uncommon, treatment with anagrelide may cause damage to the heart that affects its pumping action. Patients will be monitored for this condition.
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Maintain adequate rest and nutrition.
• Eat small meals frequently to help alleviate nausea
Are there any special precautions patients should be aware of before starting treatment?
• Patients should tell their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, infection, heart disease, kidney disease, liver disease, lung disease, thyroid disease, etc.) as they may worsen with this drug.
• Patients should inform their physician if they have ever had convulsions or seizures.
• Patients should inform their physician about any other medication they are taking (whether prescription or over the counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Patients who miss an oral dose should not double up the dose, but instead should contact their physician. • Patients should keep tablets out of the reach of children and return any unused tablets to the pharmacy for safe disposal if treatment is terminated.
When should patients notify their physician?
• Anxiety, cold sweats, increased or uneven heart rate, severe pain in the chest and/or the jaw, neck, back, or arms, or shortness of breath
• Persistent or severe headache
• Persistent or severe abdominal pain
• Swelling of face
• Black tarry stools
• Blood in urine
• Unexplained bleeding (bruises, bloody nose)
• Swelling of the feet or ankles
• Sudden weight gain
• Difficulty breathing
• Noticeable changes in heart rate or rhythm
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
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