Hydroxyurea

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Drug Status

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Government Approvals

US(FDA)

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WHO Essential Medicine

YES

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Known Teratogen

Definite

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Pharmaceutical Class

Antimetabolite

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Controlled Drug Substance

No

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Drug Ingredient

Hydroxyurea

Summary

  • Hydroxyurea is used to treat several conditions. It's used for sickle cell anemia, a disease causing painful crises due to misshapen red blood cells. It's also used for polycythemia vera, a condition where the body makes too many red blood cells. It can also help manage certain types of leukemia, which are cancers of the blood-forming tissues.

  • Hydroxyurea works by interfering with the growth of cells. It inhibits DNA synthesis in rapidly dividing cells, which affects both cancer cells and abnormal red blood cells in sickle cell anemia. This action slows down or stops the growth of these cells, helping manage symptoms associated with both cancer and sickle cell disease.

  • The starting dose of Hydroxyurea depends on whether you're an adult or child. Adults begin with 15 mg per kilogram (kg) of body weight while children start with 20 mg/kg. The dose can be increased every two months or sooner if needed by 5 mg/kg up to a maximum of 35 mg/kg per day.

  • Common side effects of Hydroxyurea include infections and low white blood cell counts. It can also cause headaches, gastrointestinal side effects like nausea or diarrhea, and sleep problems. More serious side effects can include liver damage and pancreatitis, especially when taken with certain other medications.

  • Individuals who are allergic to Hydroxyurea or have severe liver or kidney disease should avoid using this medication. Caution is also advised for patients with a history of HIV or those undergoing radiation therapy or chemotherapy. Always consult your healthcare provider before starting treatment.

Indications and Purpose

How does Hydroxyurea work?

Hydroxyurea is a medicine that slows or stops the growth of cancer cells. It also helps prevent the sickled shape of red blood cells in sickle cell anemia. Antimetabolite means it interferes with cell growth. For some cancers, it might be taken every three days, but the dose and how often you take it depends on your condition and how your body reacts. It's crucial to follow your doctor's instructions exactly. Sickle cell anemia is a blood disorder where red blood cells are abnormally shaped, causing blockages and pain.

Is Hydroxyurea effective?

Hydroxyurea works by inhibiting DNA synthesis in rapidly dividing cells, which affects both cancer cells and abnormal red blood cells in sickle cell anemia. This action slows down or stops the growth of these cells, helping manage symptoms associated with both cancer and sickle cell disease effectively. By targeting this critical pathway in cellular metabolism, hydroxyurea plays a vital role in treating these conditions.

What is Hydroxyurea?

Hydroxyurea is a medication that interferes with cell growth. It's used to treat several conditions: * **Cancer:** It slows down or stops the growth of cancer cells. * **Sickle cell anemia:** It helps prevent the formation of abnormally shaped red blood cells (sickle cells) that cause pain and block blood flow. Sickle cells are crescent-shaped red blood cells that don't carry oxygen efficiently. * **Polycythemia vera:** This is a blood disorder where the bone marrow makes too many red blood cells. Hydroxyurea helps lower their number. * **Certain leukemias:** Leukemias are cancers of the blood-forming tissues, and Hydroxyurea can help manage some types. Antimetabolite means it interferes with the way cells use substances needed for growth and reproduction.

Directions for Use

For how long do I take Hydroxyurea?

The duration of hydroxyurea treatment depends on the specific condition being managed. For sickle cell anemia, treatment is often long-term and may continue indefinitely to prevent complications. In cancer treatment, hydroxyurea may be used as part of a combination therapy regimen, with duration determined by clinical response and monitoring of blood counts. Regular follow-up appointments are crucial to assess treatment effectiveness and adjust dosages as needed.

How do I take Hydroxyurea?

Hydroxyurea can be taken with or without food; however, it is usually recommended to take it at the same time each day to maintain consistent levels in the bloodstream. The capsules should be swallowed whole, and if a patient has difficulty swallowing, the tablets can be dissolved in a small amount of water before consumption. Patients should wear gloves when handling hydroxyurea capsules or tablets to avoid skin contact, as it is a cytotoxic drug.

How long does it take for Hydroxyurea to start working?

Hydroxyurea typically begins to work within a few days to weeks after starting treatment, although clinical improvement may take longer, especially in cancer therapy. Patients receiving hydroxyurea for sickle cell anemia often report fewer painful crises within weeks of initiating therapy. Monitoring blood counts regularly helps assess how well the medication is working and whether adjustments are necessary.

How should I store Hydroxyurea?

Hydroxyurea capsules should be stored at room temperature away from moisture and heat sources; they should not be stored in bathrooms due to humidity exposure. Proper storage practices help maintain medication integrity and prevent degradation.

What is the usual dose of Hydroxyurea?

Hydroxyurea is a medication with a starting dose depending on whether you're an adult or child. Adults begin with 15 mg per kilogram (kg) of body weight, while children start with 20 mg/kg. "Kilogram" is a unit of weight, roughly 2.2 pounds. The doctor uses your actual weight or your ideal weight—whichever is lower—to calculate the dose. The dose can be increased every two months or sooner if needed, by 5 mg/kg, up to a maximum of 35 mg/kg per day. This increase is only done if your blood counts (the number of red and white blood cells) are healthy. Blood counts are checked every two weeks to make sure the medicine is safe.

Warnings and Precautions

Can Hydroxyurea be taken safely while breastfeeding?

While limited data exists on hydroxyurea during breastfeeding, it is generally recommended that nursing mothers consult their healthcare provider before using this medication due to potential risks from exposure through breast milk.

Can Hydroxyurea be taken safely while pregnant?

The safety of hydroxyurea during pregnancy has not been fully established but the evidence of fetal harm in animal studies has been found. Pregnant women should only use hydroxyurea if clearly needed and after discussing potential risks with their healthcare provider. Effective contraception should be used during treatment to prevent pregnancy. 

Can I take Hydroxyurea with other prescription drugs?

Hydroxyurea can be very dangerous when taken with certain HIV/AIDS medications (antiretroviral drugs), especially didanosine and stavudine. This combination significantly raises the risk of serious side effects like pancreatitis (inflammation of the pancreas) and liver damage (hepatotoxicity). In the worst cases, it can even be fatal. Therefore, these drugs should never be taken together.Additionally, hydroxyurea interferes with certain blood tests. It can cause falsely high readings for uric acid (a waste product from the breakdown of purines), urea (a waste product from protein breakdown), and lactic acid (produced during muscle activity). Doctors need to be aware of this when interpreting these test results for someone taking hydroxyurea. 

Is Hydroxyurea safe for the elderly?

Hydroxyurea needs careful use in older people. They might be more sensitive to it and need smaller doses because their kidneys may not work as well as younger people's. This means they could have more side effects.Doctors need to choose the right dose very carefully and regularly check how well the kidneys are working to prevent problems. 

Is it safe to drink alcohol while taking Hydroxyurea?

Drinking alcohol while taking hydroxyurea can increase the risk of liver toxicity and enhance certain side effects like dizziness or drowsiness; therefore, it’s advisable for patients undergoing treatment for bacterial infections to limit alcohol consumption during this time period significantly for optimal recovery outcomes without complications arising from concurrent use.

Is it safe to exercise while taking Hydroxyurea?

Exercising while taking hydroxyurea is usually safe, but patients should be cautious and listen to their bodies. Some side effects, such as dizziness or fatigue, may affect physical activity levels. It's important to consult with a healthcare provider about an appropriate exercise regimen tailored to individual health status and treatment response. If any unusual symptoms occur during exercise, patients should stop and seek medical advice promptly.

Who should avoid taking Hydroxyurea?

Individuals who are allergic to hydroxyurea or have certain medical conditions such as severe liver or kidney disease should avoid using this medication due to potential risks. Additionally, caution is advised for patients with a history of human immunodeficiency virus (HIV) or those undergoing radiation therapy or chemotherapy. It’s essential for patients to inform their healthcare provider about their complete medical history before starting treatment.