Hydroxyurea
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Drug Status
Government Approvals
US(FDA)
WHO Essential Medicine
YES
Known Teratogen
Definite
Pharmaceutical Class
Antimetabolite
Controlled Drug Substance
NO
Hydroxyurea
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Click HereSummary
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
What is Hydroxyurea used for?
Hydroxyurea is a medication used to treat sickle cell anemia, a disease causing painful crises due to misshapen red blood cells. It helps reduce the frequency and severity of these crises. It's also used for polycythemia vera, where the body makes too many red blood cells. Sickle cell anemia is a genetic disorder where red blood cells become rigid and sickle-shaped, blocking blood flow and causing pain. Polycythemia vera is a blood cancer causing the bone marrow to produce too many red blood cells, leading to blood clots and other problems. Hydroxyurea isn't a cure for either condition and isn't suitable for everyone. Always talk to your doctor before starting any new medication, including hydroxyurea, to determine if it's right for you and to discuss potential side effects.
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.
How does one know if Hydroxyurea is working?
A large study tested hydroxyurea on 299 adults with severe sickle cell anemia (a blood disorder causing painful episodes). The study, which was carefully designed to be fair and unbiased, showed that hydroxyurea significantly helped. It reduced the number of painful episodes, hospital stays due to these episodes, and the risk of a serious complication called chest syndrome. It also meant people went longer between painful episodes. Sickle cell anemia causes misshapen red blood cells, leading to blockages and pain. Hydroxyurea helps by increasing the production of fetal hemoglobin, a type of hemoglobin that doesn't cause the sickling. The study's results strongly suggest hydroxyurea is a beneficial treatment for severe sickle cell anemia.
Directions for Use
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.
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.
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 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.
Warnings and Precautions
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.
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.
Can I take Hydroxyurea with vitamins or supplements?
There are no significant interactions reported between hydroxyurea and vitamins or dietary supplements; however, patients should inform their healthcare provider about all supplements they take to avoid potential interactions that could affect treatment efficacy or safety.
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 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.
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 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.
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.
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