Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI9M2O7K8)
  Drug Name Anagrelide Drug Info Cilostazol Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antithrombotic Agents Vasodilator Agents
  Structure

 Mechanism of Anagrelide-Cilostazol Interaction (Severity Level: Moderate)
     Additive hypotensive effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Anagrelide Cilostazol
      Mechanism 1 Hypotensive effects
Phosphodiesterase 3  Inhibitor 		Hypotensive effects
Phosphodiesterase 3  Inhibitor
      Key Mechanism Factor 1
Factor Name Phosphodiesterase 3 Structure Sequence
Protein Family Cyclic nucleotide phosphodiesterase family
Protein Function
Cyclic nucleotide phosphodiesterase with specificity for the second messengers cAMP and cGMP, which are key regulators of many important physiological processes (PubMed:1315035, PubMed:8695850, PubMed:8155697, PubMed:25961942). Has also activity toward cUMP (PubMed:27975297). Independently of its catalytic activity it is part of an E2/17beta-estradiol-induced pro-apoptotic signaling pathway. E2 stabilizes the PDE3A/SLFN12 complex in the cytosol, promoting the dephosphorylation of SLFN12 and activating its pro-apoptotic ribosomal RNA/rRNA ribonuclease activity. This apoptotic pathway might be relevant in tissues with high concentration of E2 and be for instance involved in placenta remodeling (PubMed:31420216, PubMed:34707099).
    Click to Show/Hide
      Mechanism Description
  • Additive hypotensive effects by the combination of Anagrelide and Cilostazol 
     Increased risk of bleeding Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Anagrelide Cilostazol
      Mechanism 2 Risk of bleeding
Antiplatelet  		Risk of bleeding
Antiplatelet 
      Key Mechanism Factor 2
Factor Name Bleeding
Factor Description Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
      Mechanism Description
  • Increased risk of bleeding by the combination of Anagrelide and Cilostazol 

Recommended Action
      Management Caution is advised if anagrelide is coadministered with other inotropes or inhibitors. The risk of potentially additive cardiovascular adverse effects should be considered.

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