Donanemab-Azbt and Anagrelide: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Anagrelide
Donanemab-Azbt
No brand names on record
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.
What happens
An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage
Interaction Deep Dive
Exert caution when donanemab-azbt is coadministered with antiplatelets as it may increase risk for intracerebral hemorrhage and in particular for patients with findings on MRI that are suggestive of cerebral amyloid angiopathy. In a drug interaction study, baseline use of antithrombotic medication (antiplatelets) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications1. The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends that patients receiving standard doses of antiplatelet agents such as clopidogrel, prasugrel, or ticagrelor be considered as candidates for treatment with donanemab if other use criteria are met 2.
Why it happens (mechanism)
Additive effects on bleeding
Literature reports
2 reports — tap to read
a) The Alzheimer's Disease and Related Disorders Therapeutic Workgroup recommends that patients receiving standard doses of antiplatelet agents such as clopidogrel, prasugrel, or ticagrelor be considered as candidates for treatment with donanemab if other use criteria are met, as there was no elevated risk of amyloid-related imaging abnormalities (ARIA) in patients receiving donanemab and treated with antiplatelet agents in clinical trials 2.
b) In a study, safety was assessed in patients who received donanemab-azbt dosing regimen 1 (n=853) compared to those who received placebo (n=874), baseline use of antithrombotic medication (antiplatelets) was allowed. The incidence of ARIA with hemosiderin deposition (ARIA-H) was 30% (106/349) in patients taking donanemab-azbt with a concomitant antithrombotic medication within 30 days compared to 29% (148/504) who did not receive an antithrombotic within 30 days of an ARIA-H event. The incidence of intracerebral hemorrhage greater than 1 cm in diameter was 0.6% (2/349 patients) in patients taking donanemab-azbt with a concomitant antithrombotic medication compared to 0.4% (2/504) in those who did not receive an antithrombotic. The number of events and the limited exposure to non-aspirin antithrombotic medications limit definitive conclusions about the risk of ARIA or intracerebral hemorrhage in patients taking antithrombotic medications 1.
Common questions
Can I take Donanemab-Azbt and Anagrelide together?
An increased risk of amyloid related imaging abnormalities (ARIA), or intracerebral hemorrhage Always confirm with your pharmacist or prescriber before making any change.
How serious is the Donanemab-Azbt and Anagrelide interaction?
It is rated moderate. Can be significant — usually manageable with 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.
Questions for your pharmacist
- Does my dose of Donanemab-Azbt or Anagrelide 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 anything you'd monitor while I'm on both?
References (2)
Keep reading about Anagrelide
Keep reading about Donanemab-Azbt
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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