Thromboreductin Dosage/Direction for Use

Doctors with experience in treatment of patients with essential thrombocythaemia should initiate treatment with Anagrelide. Anagrelide has to be dosed individually for each patient. Treatment should be started with 0.5 mg/day for one week and the dose should be increased weekly by 0.5 mg/day until the desired therapeutic effect is achieved. Normally, a therapeutic response is seen within two weeks in a dose range of 1.0 to 3.0 mg/day. The total daily dose should be administered twice a day (every 12 hours) or thrice a day (every 8 hours).
The total daily dose should not exceed 5 mg.
The therapeutic response should be controlled regularly. Upon treatment initiation, platelet counts should be measured weekly until the optimal response is reached (normalisation of platelet count or a reduction to <600,000/mL or a decrease by 50%), afterwards platelet counts should be controlled in regular intervals according to the physician's discretion.
Changing a previous therapy (e.g. Hydroxyurea or Interferon a) to Anagrelide or to a combination therapy with Anagrelide should be done in an overlapping manner.
Anagrelide is indicated for continuous use. Upon stopping treatment a relapse of platelet counts to pre-therapy values will occur within several days.
In case of therapeutic resistance to Anagrelide other therapies should be considered. During therapy, platelet counts should be measured regularly.
Caution is indicated in patients with cardiovascular diseases. Limited data are available for patients with renal and liver diseases; therefore, Anagrelide should be used in these patients only under careful risk/benefit analysis.
A limited number of elderly patients have been treated with Anagrelide. Caution is advised when treating elderly patients with cardiovascular diseases.
A limited number of children <16 years have been treated with Anagrelide. There seem to be no major dosing differences compared to treatment of adults.