Drug Interactions between anagrelide and melatonin / turmeric

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 1A2 may substantially increase the plasma concentrations of melatonin. Data from available studies suggest that melatonin is primarily metabolized by CYP450 1A2, with possible contribution from CYP450 2C19 and 2C9. Coadministration of fluvoxamine, a potent CYP450 1A2 inhibitor that also inhibits CYP450 2C19 and 2C9, increased melatonin systemic exposure (AUC) by 17-fold and maximum plasma concentration (Cmax) by 12-fold. Contraceptives containing ethinyl estradiol, which can inhibit CYP450 1A2, may lead to a 4- to 5-fold increase in melatonin concentration. The risk of this interaction may be less likely to occur with estrogen products that have limited systemic absorption (e.g., vaginal, topical products).

MANAGEMENT: Caution is advised when melatonin is used concomitantly with CYP450 1A2 inhibitors. Patients should be monitored closely for adverse effects such as excessive drowsiness, headache, lethargy, dizziness, irritability, nervousness, restlessness, anxiety, abdominal pain, and dyspepsia.

Talk to your doctor before using turmeric together with anagrelide. There is some concern that products containing turmeric or curcumin (an active component of turmeric) may affect platelet function and clotting, increasing the risk of bleeding when combined with medications that have blood thinning effects such as anagrelide. You may need more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.