0.5 mg hard anagrelide capsules

Read all of this leaflet carefully before you start taking this medicine. It contains information that is important to you.

  • Save this information, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not give it to others. It may harm them, even if they show symptoms similar to yours.
  • If you get any side effects, talk to your doctor or pharmacist. This also applies to any side effects not mentioned in this information.

In this leaflet you will find information about: 
1. What Anagrelid Advanced is and what it is used for 
2. What you need to know before you take Anagrelid Advanced 
3. How to take Anagrelid Advanced 
4. Possible side effects 
5. How to store Anagrelid Advanced 
6. Contents of the packaging and other information 

1. What Anagrelid Avansor is and what it is used for

Anagrelide Avansor contains the active substance anagrelide. 
Anagrelide Avansor is a medicine that affects the development of platelets. It reduces the number of platelets produced by bone marrow and thus the number of platelets in the blood becomes more normal. Therefore, it is used to treat patients with essential thrombocythaemia. 

Essential thrombocythaemia is a condition that occurs when the bone marrow produces too many of the blood cells called platelets. A large number of platelets in the blood can cause serious problems with blood circulation and blood clotting. 

Anagrelide contained in Anagrelid Advances may also be approved for the treatment of other conditions not mentioned in this product information. Ask your doctor, pharmacist, or another healthcare professional if you have any further questions, and always follow their instructions.

2. What you need to know before taking Anagrelide Advances

Do not take Anagrelid Advanced

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

Warnings and cautions

Talk to your doctor before taking anagrelide:

  • if you have or think you may have heart problems ;
  • if you were born with prolonged QT interval (seen on ECG, electrical recording of the heart) or if there are in your family, or if you are taking other medicines that result in abnormal ECG – changes, or if you have low levels of electrolytes, for example, potassium, magnesium or calcium (see section “Other medicines and Anagrelide Advance”);
  • if you have any problems with your liver or kidneys

    Concomitant use of acetylsalicylic acid (a substance also known as aspirin and found in many medicines used to relieve pain and lower fever and also to prevent blood clots) increases the risk of major bleeding (see section “Other medicines and Anagrelide Advances”).

Children and young people

Data on the use of Anagrelid Avansor in children and adolescents are limited and this medicine should therefore be used with caution.

Other medicines and Anagrelid Advances

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

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

  • Drugs that can change the heart rhythm, e.g. sotalol and amiodarone ;
  • Fluvoxamine used to treat depression;
  • Certain types of antibiotics, such as enoxacin used to treat infections;
  • Theophylline used to treat severe asthma and respiratory problems;
  • Drugs used to treat heart disease, e.g. milrinoneenoximoneamrinoneolprinone, and cilostazol ;
  • Acetylsalicylic acid (a substance also called aspirin and found in many medicines used to relieve pain and lower fever and also to prevent blood clots);
  • Other drugs used to treat conditions that affect the platelets in the blood, e.g. clopidogrel;
  • Omeprazole used to reduce the amount of acid produced in the stomach;
  • Oral contraceptives ( birth control pills ): If you get severe diarrhea while taking this medicine, it may affect how well the oral contraceptive works, and the use of another method of contraception is recommended (eg condoms). See the instructions in the package leaflet for the contraceptive pill you are taking.

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

Ask your doctor or pharmacist if you are unsure.

Pregnancy and breastfeeding

Tell your doctor if you are pregnant or 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 use effective contraception while taking anagrelide. Talk to your doctor if you need advice on contraception. 

Tell your doctor if you are breast-feeding or if you are planning to breast-feed your baby. Anagrelide should not be taken while breast-feeding. You must stop breast-feeding if you are taking anagrelide.

Driving and using machines

Dizziness has been reported in some patients taking anagrelide. Avoid driving or using machines if you feel dizzy. 

You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention. One of the factors that can affect your ability in these respects is the use of drugs due to their effects and/or side effects. Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.

Anagrelide Avansor contains excipients

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

How to take Anagrelid Advanced

Always take Anagrelid Avansor exactly as your doctor has told you. Ask your doctor or pharmacist if you are unsure. 

Different people may take different amounts of anagrelide depending on the disease state. Your doctor will prescribe the dose that is best for you. 

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

The capsules should be swallowed whole and rinsed with water. They must not be crushed and the contents must not be dissolved in liquid. You can take the capsules with a meal or after a meal or on an empty stomach. You should preferably take the capsules at the same time each day. 

Do not take more capsules than your doctor has recommended. 

Your doctor will take blood samples at regular intervals to check that the medicine is working effectively and that your liver and kidneys are working well.

If you forget to take Anagrelid Advance

Take your capsules as soon as you remember. Take the 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. Talk to your doctor if you are worried. Serious side effects: Uncommon: Heart failure (signs of shortness of breath, chest pain, and swelling of the legs due to fluid retention), severe problems with heart rate or heart rhythm ( ventricular tachycardia, supraventricular tachycardia, or atrial fibrillation ), inflammation of the abdomen and spinal cord pain pancreatitis ), vomiting of blood or bloody or black stools, a sharp decrease in the number of blood cells 


s that can cause weakness, bruising, bleeding or infection s (pancytopenia), increased pressure in the artery are the lungs ( pulmonary hypertension, characters which include shortness of breath, swollen ankles or legs, and that the lips and skin, a bluish color tone). 
Rare: Kidney failure (little or no urination) or heart attack. 

If you notice any of these side effects, talk to 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 heavy heartbeat ( palpitation ), nausea, diarrhea, stomach pain, gas, vomiting, decrease in red blood cell count ( anemia ), fluid retention, or rash. 

Uncommon side effects: may affect up to 1 in 100 people 
Feeling weak or sick, high blood pressure, irregular heartbeat, fainting, chills or fever, indigestion, loss of appetite, constipation, bruising, bleeding, swelling ( edema), weight loss, muscle aches, joint pain, back pain, decreased or lost sensation or numbness, especially in the skin, abnormal feeling or tingling and tingling, insomnia, depression, confusion, nervousness, dry mouth, memory loss, shortness of breath, nosebleeds, severe lung infection with fever, shortness of breath, cough, mucus formation, hair loss, itchy skin or discoloration, impotence, chest pain, decreased platelet count which increases the risk of bleeding or bruising ( thrombocytopenia ), fluid accumulation around the lungs or an increase in enzymes in the liver. Your doctor may do a blood test that may show an increase in the enzyme in your liver. 

Rare side effects: may affect up to 1 in 1000 people 
Bleeding gums, weight gain, severe chest pain (angina), heart muscle disease (signs of this are fatigue, chest pain and palpitations ), heart enlargement, fluid retention around the heart, loss of coordination, speech difficulties, dry skin, migraines, visual disturbances or double vision, ringing in the ears, dizziness when getting up from sitting or lying down, increased need to urinate at night, pain, flu-like symptoms, drowsiness, dilated blood vessels, inflammation of the colon (signs of this are: diarrhea, usually with blood and mucus, stomach pain, fever), inflammation the stomach (signs of this are: pain, nausea, and vomiting), area with abnormal density in the lungs or elevated creatinine levels in the blood 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 heartbeat ( torsade de points ); 
hepatitis. Signs of this are nausea, vomiting, itching, yellowing of the skin and eyes, and discoloration of feces and urine ( hepatitis ); 
pneumonia (signs of this are fever, cough, difficulty breathing, and wheezing that causes scarring of the lungs), (allergic alveolitis, including interstitial lung disease and pneumonitis ); 
renal inflammation (tubulointerstitial nephritis).

5. How to store Anagrelid Avansor

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 can label and on the carton after EXP. The first two digits indicate the month and the last four digits indicate the year. The expiration date is the last day of the specified month. 

Store below 30 ° C. 

Store in the original package. Sensitive to light. Moisture sensitive. 

If your doctor interrupts your treatment with the medicine, you should not keep any capsules left unless your doctor tells you to. 

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. Contents of the packaging and other information

Content declaration

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

The other ingredients are: 
Capsule content: Lactose monohydrate, croscarmellose sodium, povidone (K29 / 32), lactose, microcrystalline cellulose, magnesium stearate. 

Capsule shell: Gelatin, titanium dioxide (E171).

What the medicine looks like and the contents of the pack

Anagrelide Avansor 0.5 mg is supplied as opaque, hard, capsules (size 4) with white upper and lower parts and containing a white or off-white powder. 

The capsules are supplied in jars of 42 or 100 hard capsules. 

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorisation Holder

Avansor Pharma Oy

Teknikvägen 14

02150 Espoo

Finland


Manufacturer

Synthon Hispania SL

Castello 1, Poliogono Las Salinas

08830 Sant Boi Llobregat

Spain

Muhammad Nadeem

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