Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):ONLS
АТХ:L.01.X.X.35 Anagrelide
Pharmacodynamics:Violates the formation of platelets from megakaryocytes. Has a dose-dependent effect on the number of blood platelets. The mechanism of action of the drug is under study.
Pharmacokinetics:More than 70% of the drug after ingestion is absorbed in the gastrointestinal tract. T1 / 2: 1.3 hours.
Not cumulated in blood plasma.
Metabolised in the liver. Elimination with urine: in the form of two metabolites and about 1% of the drug - in unchanged form.
Indications:The drug is used to treat patients with high-risk thrombocythemia in the development of thromboembolic complications: over 60 years of age, with an increase in the number of platelets during three months of observation at 300,000 / μL or more, in the presence of ischemic and thrombohemorrhagic episodes in the anamnesis.
II.D37-D48.D47.3 Essential (hemorrhagic) thrombocythemia
Contraindications:Individual intolerance.
Acute renal failure (creatinine values below 50 ml / min), impaired liver function.
Carefully:It is used with caution in children over 7 years.
Be wary appoint patients who have cardiovascular pathology, as well as patients taking concomitantly acetylsalicylic acid or inhibitors of cAMP phosphodiesterase III: amrimonone, olprinol, milprinol, cilostazol, enoxime
Pregnancy and lactation:Pregnancy and lactation: recommendations for FDA - category C. When treating anagrelide it is recommended to stop breastfeeding.
Dosing and Administration:Treatment is prescribed from the starting dose, in an amount of 0.5-1.0 mg per day. After one week, dose adjustment is performed, depending on the number of platelets. Optimum - 150000-400000 / mkl.
The highest daily dose of 5 mg.
The highest single dose is 1 mg.
Side effects:General disorders: influenza-like condition, asthenia.
The system of hematopoiesis: anemia, thrombocytopenia, pancytopenia.
Nervous system: often - dizziness, headache, less often - paresthesia, amnesia, drowsiness.
Sense organs: diplopia, tinnitus.
Cardiovascular system: tachycardia, fainting. Less commonly - myocardial infarction, orthostatic hypotension.
Gastrointestinal tract: diarrhea, flatulence,bleeding gums are possible. The phenomenon of mesenchymal hepatitis is an increase in the activity of hepatic enzymes.
Allergic reactions.
Overdose:Acute attack of tachycardia, vomiting, chills, collapsoid condition.
Treatment: temporary discontinuation of the drug until the return of platelet counts to the appropriate standard.
Interaction:Food intake significantly inhibits the absorption of the drug, but its activity is not affected.
Anagrelide potentiates the action of acetylsalicylic acid - a combination of drugs is not recommended for patients with a risk of bleeding.
In some cases, intestinal disorders caused by ingestion of anagrelide worsen the absorption of oral hormonal contraceptives.
Special instructions:With the existing pathology of the heart, liver and kidneys, the benefits and risks associated with taking anagrelide should be correlated. During treatment it is recommended to monitor the patient's condition, clinical and biochemical blood tests (platelets, erythrocytes, leukocytes, ALT and AST, creatinine, urea).
After the drug has been discontinued, the platelet count rises on the fourth day and returns to normal after one and a half to two weeks.