Anagrelide

May be taken with or without food.

Moderate to severe hepatic and renal (CrCl <50 mL/min) impairment.

Patient with known risk factors for QT interval prolongation (e.g. congenital long QT syndrome, history of acquired QTc prolongation); hypokalaemia, suspected heart disease, class III or IV heart failure. Avoid abrupt withdrawal. Mild renal and hepatic impairment. Children. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Perform CV evaluation (including ECG) before and during treatment. Assess for signs and symptoms of cardiopulmonary disease before and during treatment. Obtain platelet count (every 2 days during 1st week of treatment and weekly thereafter until reaching maintenance dose then continue after discontinuation of treatment); CBC with differential (before and during treatment); BUN and serum creatinine (before and during treatment); liver function (before and during treatment); serum electrolytes. Monitor blood pressure, heart rate; signs and symptoms of thrombosis or bleeding, interstitial lung disease.

Significant: Serious CV events (e.g. torsades de pointes, ventricular tachycardia, cardiomyopathy, cardiomegaly, palpitation, CHF); hypotension, dizziness (high doses); pulmonary hypertension, interstitial lung disease (including allergic alveolitis, eosinophilic pneumonia, interstitial pneumonitis); renal abnormalities (e.g. haematuria, renal failure). Blood and lymphatic system disorders: Anaemia. Gastrointestinal disorders: Abdominal pain, flatulence, nausea, vomiting, diarrhoea. General disorders and administration site conditions: Fatigue. Metabolism and nutrition disorders: Fluid retention. Nervous system disorders: Headache. Skin and subcutaneous tissue disorders: Rash.
Potentially Fatal: Increased risk of thrombotic complications (e.g. cerebral infarction) if treatment is discontinued abruptly or dose is substantially reduced.

Exacerbation of inotropic effects with other PDE III inhibitors (e.g. milrinone, amrinone, enoximone, olprinone, cilostazol. Increased risk of bleeding with anticoagulants, SSRI, NSAIDs, antiplatelet agents. Increased risk of major haemorrhagic events with aspirin. Increased exposure with CYP1A2 inhibitors (e.g. fluvoxamine, enoxacin, ciprofloxacin). Decreased exposure with CYP1A2 inducers (e.g. omeprazole). May compromise absorption of oral contraceptives. Enhanced QTc-prolonging effect with drugs that prolong QTc interval (e.g. chloroquine, clarithromycin, haloperidol, methadone, amiodarone, moxifloxacin, disopyramide, pimozide, procainamide). May alter the exposure of CYP1A2 substrates (e.g. theophylline, ondansetron, fluvoxamine).

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

L01XX35 - anagrelide ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.