Anadmak Capsule 0.5 mg (Anagrelide Hydrochloride)

Adult dose

In adults, the initial dose is 0.5mg 4 times daily or 1.0mg twice daily, administered under close observation and maintained for at least 1 week. In both adults and children, the dose should be the lowest effective dose needed to reduce the platelet count to 600,000/μL or below, while keeping the platelet count within the normal range as far as possible. If the dose is increased, the increment should be no more than 0.5mg/day, and the increased dose should not be increased further within 1 week. The maintenance dose does not differ between adult and pediatric patients. Do not exceed 2.5mg as a single dose or 10mg as the total daily dose. To monitor the effect of this medicine and prevent the onset of thrombocytopenia, measure the platelet count every 2 days during the first week of treatment and at least once weekly after the maintenance dose is reached. Generally, the platelet count begins to decrease within 7～14 days at the appropriate dose. When a complete response is defined as a platelet count of 600,000/μL or below, the time to achieve this is 4～12 weeks. Most patients will show an adequate response at doses of 1.5～3.0mg/day. Closely monitor patients with a history of heart disease, renal failure, or hepatic impairment, or in whom these conditions are suspected.

Child dose

The initial dose in children should range from 0.5mg/day to 0.5mg 4 times daily; based on limited data, an initial dose of 0.5mg/day is recommended for children.

This medication should not be administered to patients with severe liver dysfunction due to the potential for significantly increased blood concentration in patients with moderate or greater liver impairment. Additionally, it should not be given to patients with genetic disorders that prevent the digestion of lactose, as this medication contains lactose which can pose a problem. In patients with or suspected of having heart conditions, this medication should be used with caution, as it can increase heart rate and myocardial contractility, which may burden the heart. Cardiac function tests should be conducted before and during treatment, and heart condition should be closely monitored. In patients with reduced liver function, dosage adjustments may be necessary, and liver function and heart condition should be monitored carefully. Similar caution is required for patients with interstitial lung disease or pulmonary hypertension. During treatment with this medication, side effects such as headache, palpitations, edema, nausea, diarrhea, and so on may occur frequently, so patients should consult a doctor if symptoms are severe. Suddenly discontinuing this medication may result in a rapid increase in platelet count, leading to a risk of thrombosis; therefore, discontinuation should always be done under a doctor's directive. Regular blood tests and liver and kidney function tests should be performed to detect and manage adverse reactions early. Caution is required when this medication is used in conjunction with other heart-related medications or with drugs like aspirin that may increase the risk of bleeding. The combination should be carefully considered, especially in patients at high risk of bleeding. Pregnant women or those who may become pregnant should not use this medication. If pregnancy occurs during treatment, it should be immediately discontinued and a doctor consulted. Women who are nursing should be cautious, as this medication may be excreted in breast milk; therefore, discontinuation of breastfeeding or the medication is recommended. There is limited experience with the use of this medication in pediatric patients, but adverse reactions may appear similarly to those in adults, thus caution is needed. It can be administered to elderly patients; however, there may be a higher incidence of cardiac-related adverse reactions, requiring careful monitoring. In case of overdose, there is a risk of bleeding due to reduced platelets and toxic reactions affecting the cardiovascular and central nervous systems, which should be treated under medical supervision immediately. This medication should be kept out of the reach of children, and it is safest not to transfer it to other containers.

Headache, palpitations, fluid retention, nausea, diarrhea, anemia, pancytopenia, thrombocytopenia, bleeding, petechiae, edema, weight loss, weight gain, dizziness, depression, forgetfulness, confusion, insomnia, paresthesia, hypesthesia, neuroasthenia, dry mouth, migraine, stuttering, drowsiness, abnormal coordination, cerebral infarction, diplopia, visual disturbances, tinnitus, tachycardia, ventricular tachycardia, congestive heart failure, atrial fibrillation, supraventricular tachycardia, arrhythmia, hypertension, syncope, myocardial infarction, cardiomyopathy, cardiac hypertrophy, pericardial effusion, angina pectoris, orthostatic hypotension, vasodilation, Prinzmetal angina, Torsade de Pointes, pulmonary hypertension, pneumonia, pleural effusion, dyspnea, epistaxis, pulmonary infiltrates, interstitial lung disease including pneumonia and allergic alveolitis, diarrhea, vomiting, abdominal pain, nausea, gastric intestinal air retention, gastrointestinal bleeding, pancreatitis, loss of appetite, dyspepsia, constipation, gastrointestinal disorders, colitis, gastritis, gum bleeding, elevated liver enzymes, hepatitis, rash, alopecia, pruritus, skin discoloration, dry skin, arthralgia, myalgia, low back pain, erectile dysfunction, renal failure, nocturia, tubulointerstitial nephritis, fatigue, chest pain, fever, chills, malaise, weakness, flu-like symptoms, asthenia, increased blood creatinine, thrombosis, urinary tract infection symptoms, chest discomfort, right ear pain, visual impairment, photosensitivity dermatitis, leukocytosis, neuropathy, anal bleeding, increased ALP, acute renal failure, cytopenia, generalized weakness, vomiting, epistaxis, bleeding, thrombocytopenia, malaise, pain, chest discomfort, generalized weakness, sinus tachycardia, decreased mobility, loose stools, loss of appetite

This medication may be degraded by air or light; therefore, it should be stored in a tightly closed container in a place protected from light. A storage temperature of 15 to 25 degrees Celsius is recommended.

Appearance

White hard capsule filled with white powder

Package unit

30 capsules/bottle, 100 capsules/bottle