Hydrea (hydroxyurea) is a prescription medication primarily used in the management of certain chronic hematologic conditions, including sickle cell anemia, essential thrombocythemia, and chronic myelogenous leukemia. As an antimetabolite and ribonucleotide reductase inhibitor, it modifies disease pathology at the cellular level, reducing complications and improving quality of life for eligible patients. Its well-established efficacy and manageable safety profile make it a cornerstone in long-term therapeutic regimens under specialist supervision.

Features

• Active ingredient: Hydroxyurea
• Available in 500 mg capsule formulation
• Oral administration with high bioavailability
• FDA-approved for multiple hematologic indications
• Requires regular blood monitoring during therapy
• Prescription-only medication

Benefits

• Reduces frequency of painful vaso-occlusive crises in sickle cell disease
• Decreases transfusion requirements in myeloproliferative disorders
• Lowers elevated platelet counts in thrombocythemia to reduce thrombotic risk
• May delay disease progression in certain leukemic conditions
• Generally well-tolerated with predictable side effect profile
• Enables outpatient management of chronic conditions

Common use

Hydrea is primarily indicated for adult and pediatric patients (typically over 2 years of age) with sickle cell anemia experiencing recurrent painful crises or requiring frequent blood transfusions. It is also used in chronic myelogenous leukemia as second-line therapy and for the treatment of essential thrombocythemia. Additionally, it may be used off-label for other myeloproliferative disorders and certain solid tumors under specialist guidance.

Dosage and direction

Initial dosing is based on patient weight, typically 15 mg/kg/day as a single dose for sickle cell anemia, with adjustments based on hematologic response and toxicity. For other indications, dosing may range from 20-30 mg/kg/day. Capsules should be swallowed whole with water; do not crush or chew. Administration may be with or without food, though consistency is recommended. Dose adjustments are made gradually based on complete blood count monitoring, typically every 2 weeks initially, then monthly once stable.

Precautions

Regular monitoring of complete blood counts is essential, typically weekly during dose adjustment and monthly during maintenance therapy. Hepatic and renal function should be assessed periodically. Use effective contraception during treatment as Hydrea is teratogenic. Avoid vaccination with live vaccines during therapy. Practice good oral hygiene to minimize mucositis risk. Use sun protection due to photosensitivity potential. Report any signs of infection, unusual bleeding, or neurological symptoms promptly.

Contraindications

Hydrea is contraindicated in patients with severe bone marrow suppression (leukopenia, thrombocytopenia, or anemia), severe renal impairment (creatinine clearance <30 mL/min), or known hypersensitivity to hydroxyurea or any capsule components. It is contraindicated in pregnancy and should not be used while breastfeeding. Use with extreme caution in patients with recent radiation therapy or chemotherapy.

Possible side effect

Common side effects include myelosuppression (anemia, leukopenia, thrombocytopenia), gastrointestinal disturbances (nausea, vomiting, diarrhea, constipation), dermatological reactions (rash, skin ulceration, hyperpigmentation), and mucositis. Less frequently, neurological symptoms (dizziness, headache), hepatic enzyme elevations, and fever may occur. Rare but serious side effects include pulmonary fibrosis, vasculitic ulcers, and secondary malignancies with long-term use.

Drug interaction

Hydrea may interact with other bone marrow suppressants (including other chemotherapy agents), increasing myelosuppression risk. Concurrent use with live vaccines may diminish vaccine efficacy and increase adverse reaction risk. Antiretroviral drugs, particularly didanosine and stavudine, may have increased toxicity when combined with hydroxyurea. Monitor closely when used with other hepatically metabolized medications.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. If multiple doses are missed, contact the prescribing physician for guidance on resuming therapy, as dose adjustments may be necessary based on the treatment duration missed.

Overdose

Overdose may manifest as acute mucocutaneous toxicity, severe myelosuppression, or neurological symptoms. Symptoms may include stomatitis, nausea, vomiting, diarrhea, alopecia, and pancytopenia. Management is supportive and includes gastric lavage if recent ingestion, blood product transfusions for cytopenias, and aggressive symptomatic treatment. Hemodialysis may be considered in severe cases, though hydroxyurea clearance data are limited.

Storage

Store at room temperature (15-30°C/59-86°F) in the original container, protected from light and moisture. Keep tightly closed and out of reach of children and pets. Do not store in bathroom cabinets where humidity may affect stability. Properly dispose of expired or unused medication through take-back programs; do not flush or pour down drains.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment recommendations. Individual response to medication varies, and only a physician can determine appropriate therapy based on specific medical circumstances and monitoring.

Reviews

Clinical studies demonstrate Hydrea’s efficacy in reducing sickle cell crisis frequency by approximately 50% and transfusion requirements in appropriate patients. Many hematologists report improved quality of life and disease control in responsive patients. Some patients note manageable side effects with proper dose titration. Long-term experience supports its role as a foundational therapy in indicated conditions when monitored appropriately.