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Anagrelide
General information
Anagrelide was developed as an inhibitor of platelet aggregation and acts by inhibiting phosphodiesterase. It was later found to reduce the platelet count, in doses lower than those required to inhibit platelet aggregation, by interfering with megakaryocyte differentiation and proliferation. It is used for the treatment of essential thrombocythemia.
The uses, adverse effects, and interactions of anagrelide have been reviewed [ ]. Its common adverse effects include headache, anemia, palpitation, fluid retention, tachycardia, abdominal pain, flatulence, vomiting, rash, fatigue, and nausea. Diarrhea has been attributed to lactose in the capsule formulation. The adverse effects occur within 2 weeks of starting treatment and abate with time (i.e. they are probably early adverse effects with tolerance).
Drug studies
Observational studies
In a long-term study of 39 young patients with essential thrombocythemia treated with anagrelide, 20 had adverse effects: tachycardia (n = 9), gastric distress (n = 6), anemia (n = 4), headache (n = 2), capillary leak syndrome (n = 2), acute fluid retention (n = 1), alopecia (n = 1), and a rash (n = 1) [ ].
In a prospective study of 97 patients the most frequent adverse effects after 1 month were headache (n = 24), diarrhea (n = 8), and bouts of palpitation (n = 8) [ ].
In a prospective study in 120 patients with myeloproliferative disease the adverse effects were bouts of palpitation (n = 84), headache (n = 62), nausea (n = 42), diarrhea or flatulence (n = 38), edema (n = 260), and fatigue (n = 280) [ ].
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