Drug Interaction Report

Anagrelide and Ciprofloxacin: Interaction Details

A pharmacist-reviewed analysis of the Anagrelide and Ciprofloxacin interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Anagrelide

Agrylin Agrylin®
+

Ciprofloxacin

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 434 documented Anagrelide interactions, 376 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased anagrelide exposure and increased risk of QT interval prolongation

Interaction Deep Dive

Avoid concomitant use of ciprofloxacin and anagrelide (QT prolonging agent) due to increased risk of additive QT effects, risk factors for QT prolongation or torsade de pointes23. Coadministration of anagrelide with ciprofloxacin (a CYP1A2 inhibitor and QT prolonging drug) may increase the risk of increased anagrelide exposure and additive effects on the QT interval that can lead to serious cardiac adverse effects. If concomitant use is required, monitor for cardiovascular effects and titrate the dose as clinically indicated 1.

Why it happens (mechanism)

Inhibition of CYP1A2-mediated anagrelide metabolism; additive effects on QT interval

Common questions

Can I take Anagrelide and Ciprofloxacin together?

Increased anagrelide exposure and increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.

How serious is the Anagrelide and Ciprofloxacin interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Anagrelide or Ciprofloxacin need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (3)

  1. Product Information: AGRYLIN(R) oral capsules, anagrelide HCl oral capsules. Shire US Inc. (per FDA), Wayne, PA, 2015. DailyMed
  2. Product Information: CIPROFLOXACIN oral tablets, ciprofloxacin oral tablets. Solco Healthcare US, LLC (per Dailymed), Somerset, NJ, 2024. DailyMed
  3. Product Information: CIPROFLOXACIN HYDROCHLORIDE oral tablets, ciprofloxacin hydrochloride oral tablets. Aurobindo Pharma USA, Inc (per Dailymed), East Windsor, NJ, 2024. DailyMed
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Anagrelide

Keep reading about Anagrelide

All Anagrelide interactions (434) Anagrelide drug information
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Ciprofloxacin

Keep reading about Ciprofloxacin

All Ciprofloxacin interactions (162)
Also serious with: Metformin Brexpiprazole Foscarnet Injection Ifosfamide Injection
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Anagrelide + Activated Charcoal Danshen Piracetam Aconite Adrafinil African Wild Potato Allspice Aloe + 257 more
Ciprofloxacin + Activated Charcoal Apple Asarabacca Beer Grapefruit Siberian Cocklebur Sweet Orange Wine + 155 more

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.