Agrylin

Essential thrombocythaemia (ET) to reduce elevated platelet counts.

Initially 1 mg daily in 2 divided doses maintained for at least 1 wk. Titrate to achieve lowest effective dose required to reduce &/or maintain platelet count <600 x 10⁹/L & ideally at levels between 150 x 10⁹/L & 400 x 10⁹/L. Dosage increment must not exceed 0.5 mg daily in any 1 wk & max single dose should not exceed 2.5 mg.

Hypersensitivity. Moderate or severe renal (CrCl <50 mL/min). Moderate or severe hepatic impairment.

Avoid abrupt treatment discontinuation or substantial reduction due to risk of sudden increase in platelet count leading to potentially fatal thrombotic complications eg, cerebral infarction. Monitor for CV effects requiring further CV exam & investigation during treatment. Increased heart rate resulting in apparent increase in QTc interval of ECG. Cardiomegaly & CHF; pulmonary HTN. Patients w/ known or suspected heart disease; w/ known risk factors for QT interval prolongation eg, congenital long QT syndrome, known history of acquired QTc prolongation, medicinal products prolonging QTc interval & hypokalaemia. Evaluate signs & symptoms of underlying cardiopulmonary disease prior to initiating & during therapy. Perform LFTs (ALT & AST) before initiating treatment & at regular intervals thereafter; platelet count every 2 days during 1st wk & at least wkly thereafter until stable maintenance dose is reached; pre-treatment CV exam (including further investigation eg, echocardiography, ECG); FBC (Hb, WBC & platelet count), renal function (serum creatinine & urea) tests & electrolytes (K, Mg & Ca). Not recommended concomitant use w/ other PDE III inhibitors eg, milrinone, amrinone, enoximone, olprinone & cilostazol. Concomitant use w/ ASA in patients w/ high risk profile for haemorrhage; CYP1A2 inhibitors. Not to be used in patients w/ rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Do not drive or operate machinery if dizziness is experienced during treatment. Not recommended for moderate to severe hepatic impairment. Assess patients w/ mild hepatic & renal impairment before treatment. Women of childbearing potential should use adequate birth control measures during treatment. Not recommended during pregnancy. Discontinue breastfeeding during treatment. Ped patient. Elderly >60 yr.

Headache. Anaemia; fluid retention; dizziness; palpitations, tachycardia; nausea, diarrhoea, abdominal pain, flatulence, vomiting; rash; fatigue.

Decreased exposure w/ CYP1A2 inducers eg, omeprazole. Exacerbated effects of milrinone, enoximone, amrinone, olprinone & cilostazol. Major haemorrhages & potentiated effect of ASA. Compromised absorption of hormonal OCs. Concomitant treatment w/ CYP1A2 inhibitors eg, fluvoxamine & omeprazole; theophylline.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

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

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