Treatments and drugs

By Mayo Clinic Staff

Treatment of essential thrombocythemia depends on your risk of blood-clotting or bleeding episodes. If you're younger than 60 and have had no signs or symptoms, you may simply need periodic medical checkups.

Your doctor may prescribe medication if:

  • You're older than 60 and have had previous blood clots or TIAs
  • You have cardiovascular risk factors, such as high cholesterol, high blood pressure and diabetes


Your doctor may suggest one of the following prescription drugs, perhaps along with low-dose aspirin, to reduce your platelet count or clotting risk:

  • Hydroxyurea (Droxia, Hydrea). This drug suppresses bone marrow production of blood cells, including platelets. Its side effects are usually mild. Your doctor will monitor your blood counts and liver function. There's some concern that long-term use may slightly increase the risk of developing acute myelogenous leukemia.
  • Anagrelide (Agrylin). Unlike hydroxyurea, anagrelide isn't associated with an increased risk of leukemia, but it's not considered as effective. Side effects may include fluid retention, heart problems, headaches, dizziness, nausea and diarrhea.
  • Interferon alfa (Intron A) or pegylated interferon alpha 2a (Pegasys). This drug is given by injection. It may be more expensive and cause worse side effects than hydroxyurea or anagrelide does, but it's the best choice for some people. Side effects may include flu-like symptoms, confusion, nausea, depression, diarrhea, seizures, irritability and sleepiness.

Emergency procedure

A medical procedure called platelet pheresis is used only in emergencies, such as after a stroke or other dangerous blood clotting. It temporarily lowers your platelet count. A needle connected to a tube allows your blood to flow into a device that removes platelets, after which your blood is returned to your body.

June 24, 2015