Agrylin Is a Prescription Medication That Lowers Dangerously High Platelet Counts

Agrylin (Anagrelide) is a platelet-reducing agent used to treat thrombocythemia caused by myeloproliferative neoplasms — blood disorders where the bone marrow produces too many platelets.

If your doctor has mentioned Agrylin, or you've been diagnosed with a condition causing high platelet counts, this guide covers everything you need to know: what it's for, how to take it, what it costs, and what to watch out for.

What Is Agrylin?

Here are the basics:

• Brand name: Agrylin
• Generic name: Anagrelide (Anagrelide Hydrochloride)
• Drug class: Platelet-reducing agent (phosphodiesterase 3 inhibitor)
• Manufacturer: Takeda Pharmaceuticals America, Inc. (originally Shire US Inc.)
• FDA approval: Approved for the treatment of thrombocythemia secondary to myeloproliferative neoplasms
• Controlled substance: No — Agrylin is not a controlled substance
• Available forms: Oral capsules in 0.5 mg and 1 mg strengths
• Generic available: Yes — generic Anagrelide is widely available

Agrylin works by inhibiting an enzyme called phosphodiesterase 3 (PDE3), which reduces the maturation of megakaryocytes — the bone marrow cells that produce platelets. The result is fewer platelets in your blood. For a deeper explanation, see our guide on how Agrylin works.

What Is Agrylin Used For?

Agrylin is FDA-approved for:

• Treating thrombocythemia secondary to myeloproliferative neoplasms — this means reducing elevated platelet counts in people whose bone marrow overproduces platelets due to conditions like essential thrombocythemia (ET), polycythemia vera, or chronic myelogenous leukemia

The goal of treatment is to lower platelet counts to reduce the risk of thrombosis (blood clots) and hemorrhage (bleeding), and to improve related symptoms.

Agrylin is also used off-label as a second-line therapy for essential thrombocythemia after Hydroxyurea has failed or isn't tolerated.

What are myeloproliferative neoplasms?

Myeloproliferative neoplasms (MPNs) are a group of blood cancers where the bone marrow makes too many blood cells. In thrombocythemia, the excess cells are platelets. While you need platelets for blood clotting, having too many can paradoxically cause both dangerous clots and abnormal bleeding.

How Is Agrylin Taken?

• Starting dose: Typically 0.5 mg four times daily or 1 mg twice daily
• Dose adjustments: Your doctor may increase the dose by no more than 0.5 mg per day per week, based on your platelet count response
• Maximum single dose: 2.5 mg
• Maximum daily dose: 10 mg
• With or without food: Agrylin can be taken with or without food
• Swallow whole: Do not crush or chew the capsules
• Spacing: Take doses at evenly spaced intervals throughout the day

Important: Agrylin carries a boxed warning against stopping the medication suddenly. Abrupt discontinuation can cause a rapid spike in platelet counts, potentially leading to life-threatening blood clots, including stroke. Always talk to your doctor before making any changes to your dose.

Who Should Not Take Agrylin?

Agrylin is contraindicated in people with:

• Severe liver impairment (Child-Pugh score C)
• Known hypersensitivity to Anagrelide or any component of the formulation

Additionally, Agrylin should not be taken with antiplatelet drugs (except low-dose Aspirin of 81 mg or less per day) during the first three months of treatment due to increased bleeding risk.

Use with caution if you have:

• Known or suspected heart disease — a cardiovascular exam including ECG is required before starting
• Mild to moderate liver or kidney impairment
• Plans to become pregnant — Agrylin is Pregnancy Category C and may cause female infertility

For a complete list of medications to avoid, read our guide on Agrylin drug interactions.

How Much Does Agrylin Cost?

The cost of Agrylin varies significantly depending on whether you use brand or generic:

• Brand Agrylin: Approximately $600–$650 for 60 capsules (0.5 mg)
• Generic Anagrelide: Approximately $40–$80 for 60 capsules (0.5 mg) with a discount card
• Average retail without discount: About $80 for generic Anagrelide

The generic version offers massive savings. If your doctor prescribes brand-name Agrylin, ask if generic Anagrelide is appropriate for you — it usually is.

Insurance Coverage

Generic Anagrelide is generally covered by most commercial insurance plans and Medicare Part D. Brand Agrylin may require prior authorization or step therapy (trying the generic first). Some plans may place the brand version on a specialty tier with higher copays.

Savings Options

If cost is a concern, several options can help:

• Discount cards: GoodRx and similar services can bring generic Anagrelide down to the $40–$80 range
• Manufacturer assistance: Takeda offers a Patient Assistance Program for eligible patients (call 1-888-CARES-55)
• Patient assistance programs: NeedyMeds, RxAssist, and RxHope connect qualifying patients with free or reduced-cost medication

For a full breakdown of savings options, see our guide on how to save money on Agrylin.

Side Effects at a Glance

The most common side effects of Agrylin include headache (43.5%), palpitations (26.1%), diarrhea (25.7%), weakness (23.1%), and nausea (17.1%). Serious side effects include heart rhythm changes, heart failure, pulmonary hypertension, and bleeding.

For a detailed breakdown, read our full guide on Agrylin side effects.

Final Thoughts

Agrylin is a well-established medication for managing high platelet counts caused by myeloproliferative neoplasms. It's been available for decades, and the generic version makes it accessible and affordable for most patients.

The keys to successful treatment are working closely with your hematologist, keeping your monitoring appointments, and never adjusting your dose on your own. If you're looking for a doctor who prescribes Agrylin or need to find it in stock, we've got guides for that too.

Need Agrylin now? Search Medfinder to find a pharmacy near you with it in stock.