Drug reference

Hydroxyurea

Antimetabolite · Antineoplastic

Also known as Hydroxycarbamide, HYDREA

AntimetaboliteAntineoplasticATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
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Mechanism

Hydroxyurea inhibits ribonucleotide reductase by quenching the tyrosyl free radical at the active site of the M2 subunit, blocking the conversion of ribonucleotides to deoxyribonucleotides required for DNA synthesis. This produces S-phase specific cytotoxicity. In sickle cell disease, hydroxyurea's therapeutic benefit derives from its ability to reactivate fetal hemoglobin (HbF) gene expression through a mechanism involving nitric oxide generation and soluble guanylate cyclase activation, reducing sickling episodes.

Indications

Polycythaemia vera (specialist use only)Essential thrombocythaemia (specialist use only)Chronic myeloid leukaemia (specialist use only)Cancer of the cervix (specialist use only)sickle cell anemiacancerMyeloproliferative syndromes (particularly chronic myelogenous leukemia, polycythemia vera, myeloid metaplasia, essential thrombocytosis)Sickle cell disease (in adults)Thalassemia HbC and HbC/S (to induce HbF)Cervical carcinoma (with concurrent irradiation)Primary brain tumors (with concurrent irradiation)Head and neck cancer (with concurrent irradiation)Non–small cell lung cancer (with concurrent irradiation)Chronic myeloid leukaemiaPsoriasisPolycythaemia veraSome solid tumoursSickle cell disease (adults)

Dosing

Adult: Polycythaemia vera: Oral, initially 15–20 mg/kg daily, adjusted according to response; usual dose 500–1000 mg daily, dosage should be based on actual or ideal body weight, whichever is less. Essential thrombocythaemia: Oral, initially 15 mg/kg daily, adjusted according to response, based on actual or ideal body weight, whichever is less.…

Pharmacokinetics

Half-life

3.5 to 4.5 h (disappears from plasma)

Bioavailability

80% to 100% (oral)

Protein binding

Readily crosses the blood-brain barrier; significant quantities appear in human breast milk.

Excretion

From 40% to 80% of the drug is recovered in the urine within 12 h after administration.

Contraindications

Women with childbearing potential (due to teratogenicity)

Side effects

Common

Leukopenia (major toxic effect)AnemiaThrombocytopenia (occasionally)Gastrointestinal disturbancesMild dermatological reactionsStomatitis (rarely)Alopecia (rarely)Increased skin and fingernail pigmentationCutaneous reactionsPigmentation

Serious

Desquamative interstitial pneumonitis
Neurological manifestations (more rarely)
Painful leg ulcers (especially in elderly patients or those with renal dysfunction)
Myelosuppression