Anagrelide (Agrylin®)

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About This Drug

Anagrelide is used to treat increased platelets, a side effect of some cancers. It is given orally (by mouth).

Possible Side Effects

  • Abnormal heart beat and/or increased heart rate
  • Chest pain
  • Nausea and vomiting (throwing up)
  • Diarrhea (loose bowel movements)
  • Excess gas and/or indigestion
  • Pain in your abdomen
  • General discomfort, a feeling of being unwell
  • Fever
  • Tiredness and weakness
  • General swelling, swelling of your legs, ankles, and/or feet
  • Decreased appetite (decreased hunger)
  • Back pain
  • Pain
  • Headache
  • Numbness, tingling and/or prickling sensation of your skin
  • Trouble breathing
  • Cough
  • Feeling dizzy
  • Rash and/or itching 

Note: Each of the side effects above was reported in 5% or greater of patients treated with anagrelide. Not all possible side effects are included above.

Warnings and Precautions

  • Severe abnormal heart beats, some of which could cause serious heart problems.
  • Increased risk of abnormal bleeding when anagrelide is taken with aspirin or medicines that increase the risk of bleeding – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Serious lung problems such as increased blood pressure in the arteries of your lungs, scarring and/ or inflammation of the lungs that causes stiffness in the lungs which makes breathing difficult.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

How to Take Your Medication

  • Take the medicine as prescribed by your doctor. Your dose may be adjusted as needed by your doctor.
  • Missed dose: If you vomit or miss a dose, contact your physician for instructions. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Storage: Store this medicine in the original container at room temperature. Protect from light.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help with excess gas, avoid gas-producing foods.
  • To help with decreased appetite, eat small, frequent meals. Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • If you are dizzy, get up slowly after sitting or lying.
  • To decrease itching, moisturize your skin several times day
  • Avoid sun exposure and apply sunscreen routinely when outdoors
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • There are no known interactions of anagrelide with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with anagrelide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • There are known interactions of anagrelide with aspirin, NSAIDS, and other medicines that increase the risk of bleeding. Ask your doctor what precautions you should take.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Headache that does not go away
  • Fatigue that interferes with your daily activities
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Feeling dizzy or lightheaded
  • Wheezing, trouble breathing, or feeling short of breath
  • Coughing up yellow, green, or bloody mucus
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Pain in your abdomen does not go away
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Swelling in legs or ankles
  • Lips or skin turn a bluish color
  • Numbness, tingling and/or prickling sensation of your skin
  • Pain that does not go away or is not relieved by prescribed medicines
  • A new rash or a rash/itching that is not relieved by prescribed medicines
  • If you think you are pregnant

Reproduction Warnings

  • Pregnancy warning:  It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while receiving this drug. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 1 week after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In women, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking.

Revised March 2019