Various medications may be used to reduce platelets, including hydroxyurea, anagrelide, interferon and busulfan. Each medication is associated with its own side effects, and treatment needs to be tailored to each patient. No single treatment method works for all patients. Views differ on who/when to treat ET patients. Generally patients can be grouped as low risk, intermediate risk and high risk. Low risk patients are those under 60 with a platelet count under 1.5 million who do not have a history of thrombosis and do not have cardiovascular risk factors. In that case you may not even need treatment or just a daily aspirin.