Medication Guide for Anagrelide

During treatment with anagrelide, certain adverse reactions may occur. Depending on patient response and needs, the physician may adjust the dosage of anagrelide. Understanding the dosage and administration can help patients and healthcare providers promptly identify and manage these adverse reactions, thereby preventing symptom exacerbation.

Adult Dosage for Thrombocythemia

Initial Dose: Orally, 0.5 mg four times daily, or 1 mg twice daily, for at least 7 days.

Maintenance Dose: Titrate to the lowest effective dose required to reduce and maintain platelet count below 600,000/μL (ideally to normal levels). Dose increases within any one week should not exceed 0.5 mg/day.

Dose Limitations: The daily dose should not exceed 10 mg, and the single dose should not exceed 2.5 mg.

Pediatric Dosage for Chronic Myeloid Leukemia

Initial Dose: Orally, 0.5 mg/day (recommended dose) to 0.5 mg four times daily.

Maintenance Dose: Titrate to the lowest effective dose required to reduce and maintain platelet count below 600,000/μL (ideally to normal levels). Dose increases within any one week should not exceed 0.5 mg/day.

Dose Limitations: The daily dose should not exceed 10 mg, and the single dose should not exceed 2.5 mg.

Pediatric Dosage for Thrombocythemia

Initial Dose: Orally, 0.5 mg/day (recommended dose) to 0.5 mg four times daily.

Maintenance Dose: Titrate to the lowest effective dose required to reduce and maintain platelet count below 600,000/μL (ideally to normal levels). Dose increases within any one week should not exceed 0.5 mg/day.

Dose Limitations: The daily dose should not exceed 10 mg, and the single dose should not exceed 2.5 mg.

Dosage Adjustments in Special Populations

Dosage Adjustment in Renal Impairment

Moderate Hepatic Impairment: Following a single 1 mg dose, total exposure (AUC) to anagrelide increased 8‑fold.

Severe Renal Impairment (creatinine clearance rate below 30 mL/min): Following a single 1 mg dose, no significant effect on the pharmacokinetics of anagrelide was observed.

Dosage Adjustment in Hepatic Impairment

Anagrelide is contraindicated in patients with severe hepatic impairment.

The starting dose in patients with moderate hepatic impairment should be 0.5 mg/day, maintained for at least one week (with close monitoring of cardiovascular effects during this period). Dose escalations within any one week should not exceed 0.5 mg/day.

Other Dosage-Related Information

Most patients achieve an adequate therapeutic response at doses of 1.5–3 mg/day.

Typically, with appropriate dosing, a response in platelet count begins within 7 to 14 days. For more information on the dosage and administration of anagrelide, it is recommended to consult the full prescribing information.