# Anagrelide

Source: https://onco.cc/drugs/anagrelide/  
OnCo record `anagrelide` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Anagrelide (Agrylin) is a capsule that lowers dangerously high platelet counts in essential thrombocythaemia and other myeloproliferative neoplasms, reducing the risk of clots and bleeding.

## Summary

Anagrelide was approved by the FDA in March 1997 for thrombocythaemia secondary to myeloproliferative neoplasms, to reduce elevated platelet counts and the risk of thrombosis and to ameliorate thrombo-haemorrhagic symptoms, on open-label studies in which the majority of patients achieved platelet responses; the EU authorised Xagrid in November 2004 as second-line therapy for at-risk essential thrombocythaemia patients intolerant of or not adequately controlled by their current therapy. The UK PT-1 trial found hydroxyurea plus aspirin superior to anagrelide plus aspirin for arterial thrombosis and myelofibrotic transformation, so hydroxycarbamide remains first line and anagrelide is used in younger patients or when hydroxycarbamide fails. Palpitations, headache, fluid retention and, rarely, cardiomyopathy are the main adverse effects.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Tags: ema-list
- Brand: Agrylin / Xagrid
- Modality: Oral platelet-lowering agent (imidazoquinazoline)
- Mechanism: Inhibits megakaryocyte maturation and platelet production, probably through phosphodiesterase 3 inhibition and effects on megakaryocyte post-mitotic development; does not affect white cells.
- Approvals: US 1997: Thrombocythaemia secondary to myeloproliferative neoplasms; EU 2004: Elevated platelet counts in at-risk essential thrombocythaemia intolerant of or inadequately controlled by current therapy (Xagrid)

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Anagrelide
- EPAR (EMA): https://www.ema.europa.eu/en/medicines/human/EPAR/xagrid
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=anagrelide

## Connected records

- drugs: [Hydroxyurea (hydroxycarbamide)](https://onco.cc/drugs/hydroxyurea/)
- cancers: [Essential thrombocythaemia (ET)](https://onco.cc/cancers/essential-thrombocythaemia/), [Myeloproliferative neoplasms (PV, ET, myelofibrosis)](https://onco.cc/cancers/myeloproliferative-neoplasms/)
- companies: [Takeda](https://onco.cc/companies/takeda/)
- trials: [MAJIC-ET](https://onco.cc/trials/majic-et/), [PT-1 (Primary Thrombocythaemia 1)](https://onco.cc/trials/pt-1/), [Ropeginterferon Alfa-2b (P1101) vs. Anagrelide in Essential Thrombocythemia Patients With Hydroxyurea Resistance or Intolerance](https://onco.cc/trials/nct04285086/)
- terms: [IPSET-thrombosis score (essential thrombocythaemia)](https://onco.cc/terms/ipset-thrombosis/)

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