What is a Patient Information Leaflet and why is it useful?

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged.

Below is a text only representation of the Patient Information Leaflet. The original can be viewed in PDF format using the link above.

The text only version may be available from RNIB in large print, Braille or audio CD. For further information call RNIB Medicine Leaflet Line on 0800 198 5000. The product code(s) for this leaflet is: PL 08553/0603 .

Anagrelide Dr. Reddy's 0. 5 mg Capsules, Hard

Package leaflet: Information for the patient

Anagrelide 0.5 mg Capsules, Hard

Anagrelide

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet. You may need to read it again.
  • If you have further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Anagrelide is and what it is used for
2. What you need to know before you take Anagrelide
3. How to take Anagrelide
4. Possible side effects
5. How to store Anagrelide
6. Contents of the pack and other information

1. What Anagrelide is and what it is used for

Anagrelide capsules contain the active substance anagrelide. Anagrelide is a medicine which interferes with the development of platelets. It reduces the number of platelets produced by the bone marrow, which results in a decrease in the platelet count in the blood towards a more normal level. For this reason it is used to treat patients with essential thrombocythaemia.

Essential thrombocythaemia is a condition which occurs when the bone marrow produces too many of the blood cells known as platelets. Large numbers of platelets in the blood can cause serious problems with blood circulation and clotting.

2. What you need to know before you take Anagrelide

Do not take Anagrelide

  • if you are allergic to anagrelide or any of the other ingredients of this medicine (listed in section 6). An allergic reaction may be recognised as a rash, itching, swollen face or lips, or shortness of breath
  • if you have moderate or severe liver problems
  • if you have moderate or severe kidney problems.

Warnings and precautions

Talk to your doctor before taking Anagrelide:

  • if you have or think you might have a problem with your heart
  • if you were born with or have family history of prolonged QT interval (seen on ECG, electrical recording of the heart), or you are taking other medicines that result in abnormal ECG changes or if you have low levels of electrolytes e.g. potassium, magnesium or calcium (see section “Other medicines and Anagrelide”)
  • if you have any problems with your liver or kidneys.

In combination with acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever, as well as to prevent blood clotting, also known as aspirin), there is an increased risk of major haemorrhages (bleeding) (see section “Other medicines and Anagrelide”).

Children and adolescents

There is limited information on the use of Anagrelide in children and adolescents and therefore this medicine should be used with caution.

Other medicines and Anagrelide

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines.

Tell your doctor if you are taking any of the following medicines:

  • medicines that can alter your heart rhythm; e.g. sotalol, amiodarone
  • fluvoxamine, used to treat depression
  • certain types of antibiotic, such as enoxacin, used to treat infections
  • theophylline, used to treat severe asthma and breathing problems
  • medicines used to treat heart disorders, for example, milrinone, enoximone, amrinone, olprinone and cilostazol
  • acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever, as well as to prevent blood clotting, also known as aspirin)
  • other medicines used to treat conditions affecting the platelets in your blood, e.g. clopidogrel
  • omeprazole, used to reduce the amount of acid produced in the stomach
  • oral contraceptives: If you experience bad diarrhoea whilst taking this medicine, it may reduce how well the oral contraceptive works and use of an extra method of contraception is recommended (e.g. condom). See the instructions in the patient leaflet of the contraceptive pill you are taking.

Anagrelide or these medicines may not work properly if taken together.

If you are not sure, speak to your doctor or pharmacist for advice.

Pregnancy and breastfeeding

Tell your doctor if you are pregnant or are planning to become pregnant. Anagrelide should not be taken by pregnant women. Women who are at risk of becoming pregnant should make sure that they are using effective contraception when taking Anagrelide. Speak to your doctor if you need advice with contraception.

Tell your doctor if you are breastfeeding or if you are planning to breastfeed your baby. Anagrelide should not be taken while breastfeeding. You must stop breastfeeding if you are taking Anagrelide.

Driving and using machines

Dizziness has been reported by some patients taking Anagrelide. Do not drive or use machines if you feel dizzy.

Anagrelide capsules contain lactose

Lactose is an ingredient in this medicine. If you have been told that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Anagrelide

Always take Anagrelide exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The amount of Anagrelide that people take can be different, and this depends on your condition. Your doctor will prescribe the best dose for you.

The usual starting dose of Anagrelide is 1 mg. You take this dose as one capsule of 0.5 mg twice a day, for at least a week. After this time, your doctor may either increase or decrease the number of capsules that you take to find the dose best suited to you and which treats your condition most effectively.

Your capsules should be swallowed whole with a glass of water. Do not crush the capsules or dilute the contents in a liquid. You can take the capsules with food or after a meal or on an empty stomach. It is best to take the capsule(s) at the same time every day.

Do not take more capsules than your doctor has recommended.

Your doctor will ask you to have blood tests at regular intervals to check that your medicine is working effectively and that your liver and kidneys are working well.

If you take more Anagrelide than you should

If you take more Anagrelide than you should, or if someone else has taken your medicine, tell a doctor or pharmacist immediately. Show them the pack of Anagrelide.

If you forget to take Anagrelide

Take your capsules as soon as you remember. Take your next dose at the usual time. Do not take a double dose to make up for a forgotten dose.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. If you are worried, speak to your doctor.

Serious side effects:

Uncommon:

  • heart failure (signs include shortness of breath, chest pain, swelling of the legs due to fluid build-up)
  • severe problem with the rate or rhythm of the heart beat (ventricular tachycardia, supraventricular tachycardia or atrial fibrillation)
  • inflammation of the pancreas which causes severe abdominal and back pain (pancreatitis)
  • vomiting blood or passing bloody or black stools
  • severe reduction in blood cells which can cause weakness, bruising, bleeding or infections (pancytopenia)
  • pulmonary hypertension (signs include shortness of breath, swelling in legs or ankles, and lips and skin can turn bluish colour)

Rare:

  • kidney failure (when you pass little or no urine)
  • heart attack

If you notice any of these side effects, contact your doctor immediately.

Very common side effects: may affect more than 1 in 10 people

  • headache

Common side effects: may affect up to 1 in 10 people

  • dizziness, tiredness
  • rapid heartbeat, irregular or strong heartbeat (palpitations)
  • feeling sick (nausea), diarrhoea, stomach pain, wind, being sick (vomiting)
  • reduction in red blood cell count (anaemia)
  • fluid retention or rash

Uncommon side effects: may affect up to 1 in 100 people

  • a feeling of weakness or feeling unwell
  • high blood pressure, irregular heart beat
  • fainting, chills or fever
  • indigestion, loss of appetite, constipation
  • bruising, bleeding, swelling (oedema)
  • weight loss
  • muscle aches, painful joints, back pain
  • decreased or loss of feeling or sensation such as numbness, especially in the skin
  • abnormal feeling or sensation such as tingling and ‘pins and needles’
  • sleeplessness, depression, confusion, nervousness
  • dry mouth
  • loss of memory
  • breathlessness, nosebleed, serious lung infection with fever, shortness of breath, cough, phlegm
  • hair loss, skin itching or discolouration
  • impotence
  • chest pain, reduction in blood platelets, which increases the risk of bleeding or bruising (thrombocytopenia)
  • accumulation of fluid around the lungs or an increase in liver enzymes. Your doctor may do a blood test which may show an increase in your liver enzymes

Rare side effects: may affect up to 1 in 1,000 people

  • bleeding gums, weight gain
  • severe chest pain (angina pectoris), heart muscle disease, (signs include fatigue, chest pain and palpitations), enlarged heart, accumulation of fluid around the heart
  • loss of coordination, difficulty in speaking
  • dry skin
  • migraine, visual disturbances or double vision, ringing in the ears, dizziness on standing up, (especially when getting up from a sitting or lying position)
  • increased need to pass water at night, pain, ‘flu-like’ symptoms, sleepiness, widening of blood vessels
  • inflammation of the large bowel (signs include: diarrhoea, usually with blood and mucus, stomach pain, fever), inflammation of the stomach (signs include: pain, nausea, vomiting)
  • area of abnormal density in the lung
  • increased creatinine level in blood tests, which may be a sign of kidney problems

The following side effects have been reported but it is not known exactly how often they occur:

  • potentially life-threatening, irregular heart beat (torsade de pointes)
  • inflammation of the liver, symptoms include nausea, vomiting, itching, yellowing of the skin and eyes, discolouration of stool and urine (hepatitis)
  • lung inflammation (signs include fever, coughing, difficulty breathing, wheezing; which causes scarring of the lungs) (allergic alveolitis, including interstitial lung disease, pneumonitis)
  • inflammation of the kidneys (Tubulointerstitial nephritis).

Reporting of side effects

If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme website www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Anagrelide

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and bottle label after EXP. The expiry date refers to the last day of that month.

Do not store above 30°C. Store in the original package in order to protect from moisture. After first opening use within 100 days, keep the bottle tightly closed and store at dry conditions.

If your doctor stops your medicine, do not keep any leftover capsules unless your doctor tells you to. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Anagrelide capsules contain

The active substance is anagrelide. Each capsule contains 0.5 mg anagrelide (as anagrelide hydrochloride).

The other ingredients are:

Capsule contents: povidone K-30 (E-1201); crospovidone Type A (E-1202); lactose anhydrous; lactose monohydrate; microcrystalline cellulose (E-460) and magnesium stearate.

Capsule shell: gelatin (E-441) and titanium dioxide (E-171).

What Anagrelide capsules look like and contents of the pack

Anagrelide is supplied as opaque white hard gelatine capsules, size n°4 (14.4 mm), containing white or almost white fine powder.

The capsules are provided in bottles containing 100 hard capsules.

Marketing Authorisation Holder

Dr. Reddy’s Laboratories (UK) Ltd.
6 Riverview Road
Beverley
East Yorkshire
HU17 0LD
United Kingdom

Manufacturer

J.Uriach y Compañía S.A.
Avda. Camí Reial, 51-57
Palau-Solità i Plegamans
08184 Barcelona
Spain

This leaflet was last revised in 11/2017

The reference medicinal product containing anagrelide has been authorised under “exceptional circumstances”. This means that because of the rarity of this disease it has been impossible to get complete information on this medicinal product.

The European Medicines Agency will review any new information on this medicine every year and this leaflet will be updated as necessary.