Hydrea-Hydroxyurea

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication

  • Hydroxyurea is used to treat patients with sickle cell anemia.
  • Hydroxyurea is also used to treat patients with certain types of leukemia [acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML)] and myeloproliferative disorder.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Hydroxyurea is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death.   Benefits Of This Medication For patients with sickle cell anemia, hydroxyurea:
  • Can help to decrease the intensity and the number of sickle cell crisis.
  • Can improve the function of the spleen (which often functions poorly in people with sickle cell anemia).
  • Can decrease the number of blood transfusions needed.
  • Can decrease the number of hospitalizations.
For patients with CML, hydroxyurea:
  • Can temporarily decrease the large number of white blood cells in the body for patients in blast crisis.
  • Can lengthen how long a person lives for patients who have CML which is in the chronic phase.
For patients with AML, hydroxyurea:
  • Can temporarily decrease the large number of white blood cells in the body for patients in blast crisis.
  Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to hydroxyurea or any of its components. 
  • Have very low platelet, red blood cell, and/or white blood cell levels. Your doctor or healthcare provider will check your platelet, red blood cell, and white blood cell levels before starting hydroxyurea treatment to make sure that it is safe to start this medication.
  Precautions To Be Aware Of Before Taking This Medication

Blood related precautions

Patients who have received previous chemotherapy and/or radiation therapy are more likely to experience very low platelet, red blood cell, and/or white blood cell levels.
  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often, and brush and floss your teeth daily.
  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
 

Organ related precautions

  • This medication can cause changes in the ability of your liver to work normally. This problem occurs more commonly in HIV positive patients who are receiving hydroxyurea in combination with didanosine (Videx®) and stavudine (Zerit®). Your doctor or healthcare provider will check your liver regularly, usually through blood tests, while you are on this medication to make sure that your liver is working properly. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  • This medication has been reported to cause inflammation of the pancreas (pancreatitis). This problem occurs more commonly in HIV positive patients who are receiving hydroxyurea in combination with didanosine (Videx®) and stavudine (Zerit®). If you experience upper abdominal pain, nausea and/or vomiting, let your doctor or healthcare provider know.
  • This medication is cleared from the body by the kidneys. In patients with severe kidney problems or older patients with decreased kidney function, hydroxyurea may not be cleared from the body as well. This can lead to high levels of this medication in the body and a greater chance of side effects. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
 

Skin related precautions

  • In patients who have had radiation therapy in the past, the skin or tissue damage from radiation therapy can become red and appear damaged again after receiving hydroxyurea. Contact your doctor or healthcare provider if your skin gets red in areas where radiation was given.
  • Inflammation and breaking of blood vessels near the surface of the skin has been reported in patients receiving hydroxyurea to treat myeloproliferative disorders. In rare cases, this problem led to gangrene, or the death of body tissue due to lack of blood flow. These conditions were reported most often in patients who had received or were receiving interferon therapy. Contact your doctor immediately if you develop any type of skin rash or red/purple dots on your skin.
 

Miscellaneous precautions

  • Patients receiving long term hydroxyurea for disorders of the blood may be at an increased risk of developing leukemia.
  • This medication has been reported to cause nerve problems in the hands and feet. This problem occurs more commonly in HIV positive patients who are receiving hydroxyurea in combination with didanosine.
  • (Videx®) and stavudine (Zerit®). Symptoms can include numbness, pain or a burning feeling in the feet or hands. Contact your doctor or healthcare provider if you experience new symptoms or if your symptoms get worse.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
  • Older patients may be more sensitive to the effects of hydroxyurea compared with younger patients and may require a lower dose of hydroxyurea.
 

Pregnancy and Breastfeeding Precautions

  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
 

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the-counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with hydroxyurea and the following medications:
  • Didanosine (Videx®)
  • Stavudine (Zerit®)
  • Fluorouracil (Adrucil®)
 

Side Effects

  • The side effects associated with hydroxyurea listed below are taken from the manufacturer package insert.
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • The incidence and type of side effects may vary depending on what type of cancer you have as well as whether hydroxyurea is being given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with hydroxyurea alone.
 

More common side effects

  • Decreased platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
 

Less common side effects

  • Loss of appetite, nausea, vomiting, sores in the mouth or on the lips, diarrhea, constipation
  • Tiredness (fatigue)
  • Skin rash, redness of the face, increased pigmentation of the skin
 

Rare side effects

This is not a complete list of the rare side effects reported with hydroxyurea. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Headache, dizziness, drowsiness, confusion, hallucinations, and seizures (convulsions) 
  • Development of a secondary leukemia (see Precautions To Be Aware Of Before Taking This Medication) 
  • Liver problems (see Precautions To Be Aware Of Before Taking This Medication) 
  • Inflammation of the pancreas (see Precautions To Be Aware Of Before Taking This Medication) 
  • Inflammation and breaking of blood vessels near the surface of the skin(which can cause red or purple dots to appear on the skin) (see Precautions To Be Aware Of Before Taking This Medication) 
  • Gangrene(see Precautions To Be Aware Of Before Taking This Medication)
  How to Take this Medication
  • This medication is taken by mouth (orally). Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. This medication can be given in different doses depending on your weight and the type of condition being treated.
  • This medication should be handled with care. To decrease exposure to hydroxyurea, you should wear disposable gloves when handling the bottles or pills. In addition, you should wash your hands before and after contact with the bottle or capsules.
  • If the powder from the capsule is spilled, wipe it up immediately with a damp disposable towel and discard in a plastic bag.
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
 

Proper Storage

  • Store this medication at room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.