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Anagrelide Side Effects

For the Consumer

Applies to anagrelide: oral capsule

Along with its needed effects, anagrelide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking anagrelide:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain
  • congestion
  • cough
  • difficult or labored breathing
  • dryness or soreness of the throat
  • fast, irregular, pounding, or racing heartbeat or pulse
  • fever
  • hoarseness
  • rapid weight gain
  • runny nose
  • tender, swollen glands in the neck
  • tightness in the chest
  • trouble with swallowing
  • voice changes
Less common
  • Anxiety
  • blurred vision
  • burning while urinating
  • chills
  • cold sweats
  • confusion
  • decreased urine output
  • dehydration
  • difficult or painful urination
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • extreme fatigue
  • general feeling of discomfort or illness
  • headache
  • irregular breathing
  • joint pain
  • large, flat, blue, or purplish patches in the skin
  • loss of appetite
  • muscle aches and pains
  • nausea or vomiting
  • noisy breathing
  • pale skin
  • redness of the face, neck, arms, and occasionally, upper chest
  • severe pain or pressure in the chest or the jaw, neck, back, or arms
  • sudden severe headache or weakness
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • trouble sleeping
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • weight gain
Incidence not known
  • Abdominal or stomach pain or tenderness
  • clay colored stools
  • dark urine
  • decreased appetite
  • dry cough
  • general feeling of tiredness or weakness
  • rapid breathing
  • skin rash or itching
  • yellow eyes or skin

Some side effects of anagrelide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Acid or sour stomach
  • back pain
  • belching
  • diarrhea
  • excess air or gas in the stomach or intestines
  • full feeling
  • general feeling of discomfort or illness
  • heartburn
  • hives or welts
  • indigestion
  • lack or loss of strength
  • pain
  • passing gas
  • stomach discomfort, upset, or pain
Less common
  • Burning feeling in the chest or stomach
  • change in vision
  • confusion
  • constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • depression
  • difficulty with moving
  • double vision
  • hair loss or thinning of the hair
  • hearing loss
  • impaired vision
  • increased sensitivity of the skin to sunlight
  • leg cramps
  • loss of memory
  • muscle pain or stiffness
  • problems with memory
  • redness or other discoloration of the skin
  • seeing double
  • severe sunburn
  • sleepiness or unusual drowsiness
  • stuffy nose
  • swelling or inflammation of the mouth
  • swollen joints

For Healthcare Professionals

Applies to anagrelide: oral capsule

Nervous system

Very common (10% or more): Headache (43.5%), asthenia (23.1%), dizziness (15.4%), pain (15%)
Common (1% to 10%): Fever
Frequency not reported: Migraine, syncope, somnolence, confusion, insomnia, nervousness, amnesia[Ref]


Very common (10% or more): Palpitations (26.1%)
Common (1% to 10%): Chest pain, tachycardia
Frequency not reported: Arrhythmia, cardiovascular disease, angina pectoris, heart failure, postural hypotension, thrombosis, vasodilation
Postmarketing reports: Torsades de pointes, ventricular tachycardia[Ref]


Very common (10% or more): Diarrhea (25.7%), nausea (17.1%), abdominal pain (16.4%), flatulence (10.2%)
Common (1% to 10%): Vomiting, anorexia, dyspepsia, constipation, gastritis, aphthous stomatitis, pharyngitis, hemorrhage, eructation, dehydration[Ref]


Very common (10% or more): Edema (20.6%)
Common (1% to 10%): Peripheral edema
Frequency not reported: Tinnitus, flu symptoms, chills[Ref]


Frequency not reported: Anemia, thrombocytopenia, ecchymosis, lymphadenopathy[Ref]


Very rare (less than 0.01%): Cholestatic liver failure
Frequency not reported: Elevated liver enzymes[Ref]


Common (1% to 10%): Back pain
Frequency not reported: Arthralgia, myalgia, leg cramps[Ref]


Very common (10% or more): Dyspnea (11.9%)
Frequency not reported: Pharyngitis, cough, rhinitis, epistaxis, respiratory disease, sinusitis, pneumonia, bronchitis, pleural effusion, pulmonary hypertension, pulmonary infiltrates, asthma, allergic alveolitis[Ref]


Common (1% to 10%): Rash (including urticaria)
Frequency not reported: Skin disease, alopecia, pruritus[Ref]


Frequency not reported: Photosensitivity, amblyopia, abnormal vision, visual field abnormality, diplopia[Ref]


A 30-year-old man developed erectile dysfunction after 2 months of treatment with anagrelide which disappeared 2 weeks after stopping the drug. A definitive cause could not be determined.[Ref]

Frequency not reported: Dysuria, hematuria[Ref]


Very rare (less than 0.01%): A 60-year-old woman developed shortness of breath, palpitations, and chest pain after 1 week of treatment leading to respiratory failure and intubation by week 5. Patient recovered after treatment with methylprednisolone.
Frequency not reported: Severe hypersensitivity pneumonitis[Ref]

The authors of the case report of severe hypersensitivity pneumonitis suggest that patients receiving anagrelide therapy, alone or in combination with hydroxyurea, may benefit from monitoring with serial chest X-rays, pulmonary function testing, and echocardiography to detect the development of cardiomyopathy or hypersensitivity pneumonitis.[Ref]


Postmarketing reports: Tubulointerstitial nephritis.


Frequency not reported: Depression


1. "Product Information. Agrylin (anagrelide)." Roberts Pharmaceutical Corporation, Eatontown, NJ.

2. Lin S, Howell DN, Tuttle-Newhall JE, Heneghan MA "Cholestatic liver failure secondary to anagrelide." Am J Gastroenterol 98(9S) (2003): S153

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

4. Braester A, Laver B "Anagrelide-induced erectile dysfunction." Ann Pharmacother 36 (2002): 1291

5. Raghavan M, Mazer MA, Brink DJ "Severe hypersensitivity pneumonitis associated with anagrelide." Ann Pharmacother 37 (2003): 1228-31

Some side effects of anagrelide may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.