hydroxyurea (Hydrea, Droxia) (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
DOSING: For treating cancer: Dose should be titrated based on individual patient response. Capsules should be swallowed whole. Hydroxyurea capsules should be handled with extreme care and disposed of properly because it causes cell damage.
For the treatment of solid tumors
For the treatment of chronic myelocytic leukemia
20 to 30 mg/kg administered orally as a single daily dose is recommended.
As hydroxyurea is mainly eliminated from the body via the kidneys, dose reductions may be necessary in patients with reduced kidney function.
For the treatment of sickle cell disease
Adults: administer 15 mg/kg by mouth once daily. Dose adjustments are made based on patient's blood counts. Patient's blood counts are monitored every two weeks. If the blood counts are in an "acceptable" range, the dose may be increased by 5 mg/kg/day every 12 weeks until a maximum tolerated dose (highest dose that does not produce toxic blood counts) or 35 mg/kg/day is reached.
Generally, use of live vaccines is contraindicated during treatment with cancer drugs because cancer drugs weaken the immune system. People with weakened immune systems have a decreased response to vaccines.
Hydroxyurea may cause a drop in platelet counts, an important type of blood cells required for forming blood clots. Use of hydroxyurea with anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelets, and thrombolytic agents increases the risk of bleeding.
Antineoplastic agents exert their benefits by killing rapidly growing cancer cells. Use of medications that stimulate cell growth is usually not recommended in patients who have been exposed to cytotoxic chemotherapy within 24 hours. Specifically, the manufacturer of pegfilgrastim (Neulasta) recommends that pegfilgrastim should not be administered to patients who have been treated with cytotoxic chemotherapy within the prior 14 days. Also, chemotherapy should not be administered within 24 hours of pegfilgrastim.
Hydroxyurea may increase blood uric acid concentration. Although no specific dose adjustments are necessary with probenecid or sulfinpyrazone (Anturane), hydroxyurea should be used cautiously with uricosuric medications.
Medically Reviewed by a Doctor on 6/9/2015
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