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At a glance

Hydroxyurea (Hydroxycarbamide) is used in the treatment of cancer and sickle cell anemia.

Indications
  • Polycythaemia vera
  • Essential thrombocythemia
  • Sickle cell anemia
  • Resistant chronic myeloid leukemia
  • Locally advanced squamous cell carcinomas of the head and neck (in combination with chemoradiation)
Pharmacology

Hydroxyurea is converted to a free radical nitroxide (NO) in vivo and transported into cells where it quenches the tyrosyl free radical at the active site of the M2 protein subunit of ribonucleotide reductase, inactivating the enzyme. The entire replicase complex is inactivated and DNA synthesis is selectively inhibited, producing cell death in S phase. Hydroxyurea also increases fetal hemoglobin levels, leading to a reduction in vasoocclusive crises in sickle cell anemia.

Dosage

Adult Dose (Oral):

  • Polycythaemia Vera: 15-20 mg/kg once daily
  • Essential Thrombocythemia: 15 mg/kg once daily
  • Solid Tumors (Intermittent): 80 mg/kg every three days; (Continuous): 20-30 mg/kg once daily
  • Head & Neck Tumors: 80 mg/kg every three days (7 days before irradiation)
  • Chronic Myelocytic Leukemia: 20-40 mg/kg once daily
  • Sickle Cell Disease: Start 15 mg/kg/day; titrate by 5 mg/kg/day every 12 weeks (max 35 mg/kg/day)
Side effects

Common Side Effects:

  • Increased bleeding tendency
  • Loss of appetite
  • Low blood platelets
  • Nausea
  • Upset stomach
  • Vomiting
  • Diarrhea
  • Sore mouth

Others: Fever, fatigue, chills, shortness of breath, body aches, unexplained bruising

Use in pregnancy

Use in Pregnancy: Category D; unsafe during pregnancy; animal studies show fetal harm; avoid becoming pregnant while being treated.

Pregnancy Category: D — always consult a doctor before taking during pregnancy.

Precautions & warnings

Precautions:

  • Hydroxyurea may affect your ability to drive (drowsiness, dizziness)
  • Causes severe myelosuppression; regular blood tests required (WBC, RBC, platelets)
  • Long-term use associated with secondary leukemia and skin cancer
  • Protect from sun exposure
  • Embryo-fetal toxicity: can cause fetal harm in pregnant women
  • Regular monitoring of kidney, liver and heart function
  • May enhance toxicity with antiretroviral drugs
Overdose effects

Overdose: Acute mucocutaneous toxicity (soreness, violet erythema, edema on palms and soles, severe hyperpigmentation, stomatitis) has been reported.

Storage conditions

Store at or below 25°C, in a cool and dry place; keep away from light; keep out of reach of children.

Hydroxyurea (Hydroxycarbamide) — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.