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Hydroxyurea is a mono hydroxyl-substituted urea (hydroxy carbamate) antimetabolite. Hydroxyurea selectively inhibits ribonucleoside diphosphate reductase, an enzyme required to convert ribonucleoside diphosphates into deoxyribonucleoside diphosphates, thereby preventing cells from leaving the G1/S phase of the cell cycle. This agent also exhibits radiosensitizing activity by maintaining cells in the radiation-sensitive G1 phase and interfering with DNA repair. (NCI04)
An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. Hydroxyurea is an antimetabolite that is used in the treatment of cancer and to stimulate fetal hemoglobin production in sickle cell disease. Hydroxyurea is associated with a low rate of transient serum enzyme and bilirubin elevations during therapy and has been implicated in rare cases of clinically apparent acute liver injury with jaundice. Hydroxyurea is an antimetabolite used to treat the sickle cell anemia crisis.
Hydroxyurea is a member of the class of areas that is urea in which one of the hydrogens is replaced by a hydroxy group. Antineoplastic is used in the treatment of chronic myeloid leukemia as well as for sickle-cell disease. It has a role as a DNA synthesis inhibitor, an EC 1.17.4.1 (ribonucleoside-diphosphate reductase) inhibitor, an antineoplastic agent, a genotoxin, an antimetabolite, a teratogenic agent, a radical scavenger, an immunomodulator and an antimitotic. It is a member of the area and a one-carbon compound.
Mechanism of Action
Hydroxyurea is converted to a free radical nitroxide (NO) in vivo, and transported by diffusion 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, including ribonucleotide reductase, is inactivated and DNA synthesis is selectively inhibited, producing cell death in S phase and synchronization of the fraction of cells that survive. Repair of DNA damaged by chemicals or irradiation is also inhibited by hydroxyurea, offering potential synergy between hydroxyurea and radiation or alkylating agents. Hydroxyurea also increases the level of fetal hemoglobin, leading to a reduction in the incidence of vasoocclusive crises in sickle cell anemia. Levels of fetal hemoglobin increase in response to the activation of soluble guanylyl cyclase (sGC) by hydroxyurea-derived NO.
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The exact mechanism of the antineoplastic activity of hydroxyurea has not been fully determined. Some studies indicate that hydroxyurea interferes with the synthesis of DNA without interfering with the synthesis of RNA or protein. Although hydroxyurea may have multiple sites of action, it appears likely that the drug inhibits the incorporation of thymidine into DNA; in addition, it may directly damage DNA. Hydroxyurea can destroy the tyrosyl free radical that is formed as the catalytic center of ribonucleoside diphosphate reductase, the enzyme that catalyzes the reductive conversion of ribonucleotides to deoxyribonucleotides; this conversion is a critical and probably rate-limiting step in the synthesis of DNA. The drug is an S-phase inhibitor and may cause cells to arrest at the G1-S border, decrease the rate of cell progression into the S phase, and/or cause cells to accumulate in the S phase as a result of inhibiting DNA synthesis. Animal studies indicate that the cytotoxic effects of hydroxyurea are limited to those tissues with high rates of cellular proliferation and the effects are evident only in those cells that are actively synthesizing DNA.
Hydroxyurea has dose-dependent synergistic activity with cisplatin in vitro. In vivo Hydroxyurea showed activity in combination with cisplatin against the LX-1 and CALU-6 human lung xenografts, but minimal activity was seen with the NCI-H460 or NCI-H520 xenografts. Hydroxyurea was synergistic with cisplatin in the Lewis lung murine xenograft. Sequential exposure to Hydroxyurea 4 hours before cisplatin produced the greatest interaction.
Indications
- Antineoplastic Agents; Antisickling Agents; Enzyme Inhibitors; Nucleic Acid Synthesis Inhibitors
- Hydroxyurea is indicated to reduce the frequency of painful crises and to reduce the need for blood transfusions in adult and pediatric patients, 2 years of age and older, with sickle cell anemia with recurrent moderate to severe painful crises.1
- For management of melanoma, resistant chronic myelocytic leukemia, recurrent, metastatic, or inoperable carcinoma of the ovary and Sickle-cell anemia.
- Siklos is indicated for the prevention of recurrent painful vaso-occlusive crises including acute chest syndrome in pediatric and adult patients suffering from symptomatic sickle-cell syndrome.
- Prevention of vaso-occlusive complications of sickle cell disease in patients over 2 years of age
- Hydroxyurea is an antimetabolite that is used in the treatment of cancer and to stimulate fetal hemoglobin production in sickle cell disease.
- Hydroxyurea Capsules USP is indicated for the treatment of Resistant chronic myeloid leukemia. Locally advanced squamous cell carcinomas of the head and neck (excluding the lip) in combination with chemoradiation. /Included in US product label/
- Hydroxyurea has been used in the treatment of psoriasis and is reportedly beneficial in the treatment of hypereosinophilic syndrome that does not respond to corticosteroid therapy.
- Hydroxyurea is used to treat cancer of the white blood cells called chronic myeloid leukemia (CML). It may also be given together with radiation treatment for head and neck cancer (advanced squamous cell cancer). Hydroxyurea interferes with the growth of cancer cells, which are eventually destroyed by the body.
- Essential Thrombocythemia (ET)
- Hypereosinophilic Syndrome (HES)
- Meningiomas
- Polycythemia Vera (PV)
- Sickle Cell Crisis
- Inoperable Ovarian cancer
ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. The Web site is maintained by the National Library of Medicine (NLM) and the National Institutes of Health (NIH). Each ClinicalTrials.gov record presents summary information about a study protocol and includes the following: Disease or condition; Intervention (for example, the medical product, behavior, or procedure being studied); Title, description, and design of the study; Requirements for participation (eligibility criteria); Locations where the study is being conducted; Contact information for the study locations; and Links to relevant information on other health Web sites, such as NLM’s MedlinePlus for patient health information and PubMed for citations and abstracts for scholarly articles in the field of medicine. Hydroxyurea is included in the database.
Use in Cancer
Hydroxyurea is approved to treat:
- Chronic myelogenous leukemia that is refractory (does not respond to treatment).
- Squamous cell carcinoma of the head and neck (excluding the lip) that is locally advanced. It is used with chemoradiation.
The use of hydroxyurea to treat cancer is approved for the Hydrea brand. Hydroxyurea is also approved to treat sickle cell anemia. This use is approved for the Droxia brand.
Hydroxyurea is also being studied in the treatment of other conditions and types of cancer.
Contraindications
- decreased blood platelets
- low levels of a type of white blood cell called neutrophils
- inflammation of blood vessels in the skin
- redness of skin following radiation therapy
- pregnancy
- a patient who is producing milk and breastfeeding
- anemia due to depressed bone marrow
- lung tissue problem
- chronic kidney disease stage 3A (moderate)
- chronic kidney disease stage 3B (moderate)
- chronic kidney disease stage 4 (severe)
- chronic kidney disease stage 5 (failure)
Dosage
Strengths: 500 mg; 200 mg; 300 mg; 400 mg; 1000 mg; 100 mg
Chronic Myelogenous Leukemia
- Oral Capsules (i.e., Hydrea): Individualize treatment based on tumor type, disease state, response to treatment, patient risk factors, and current clinical practice standards
- As monotherapy or in conjunction with other antitumor agents or radiation therapy to treat neoplastic diseases.
- Prophylactic administration of folic acid is recommended.
- Blood counts should be monitored at least once a week during therapy.
- Severe anemia should be corrected before initiating therapy.
- For the treatment of resistant chronic myeloid leukemia (CML).
- For the treatment of locally advanced squamous cell carcinomas of the head and neck (excluding lip), in combination with concurrent chemoradiation.
Head and Neck Cancer
- Oral Capsules (i.e., Hydrea): Individualize treatment based on tumor type, disease state, response to treatment, patient risk factors, and current clinical practice standards
- As monotherapy or in conjunction with other antitumor agents or radiation therapy to treat neoplastic diseases.
- Prophylactic administration of folic acid is recommended.
- Blood counts should be monitored at least once a week during therapy.
- Severe anemia should be corrected before initiating therapy
- For the treatment of resistant chronic myeloid leukemia (CML).
- For the treatment of locally advanced squamous cell carcinomas of the head and neck (excluding lip), in combination with concurrent chemoradiation.
Sickle Cell Anemia
Oral Tablets (i.e., Siklos):
- Initial dose: 15 mg/kg orally once a day
- Increase 5 mg/kg/day every 8 weeks or if a painful crisis occurs; increase only if blood counts are in an acceptable range
- Maximum dose: 35 mg/kg/day
BLOOD COUNTS IN THE ACCEPTABLE RANGE:
- Neutrophils greater than or equal to 2000 cells/mm3
- Platelets greater than or equal to 80,000/mm3
- Hemoglobin greater than 5.3 g/dL
- Reticulocytes greater than or equal to 80,000/mm3 if the hemoglobin concentration is less than 9 g/dL
Oral Capsules (i.e., Droxia):
- Initial dose: 15 mg/kg orally once a day
- Increase 5 mg/kg/day every 12 weeks; increase only if blood counts are in an acceptable range
- Maximum dose: 35 mg/kg/day
BLOOD COUNTS IN THE ACCEPTABLE RANGE:
- Neutrophils greater than or equal to 2500 cells/mm3
- Platelets greater than or equal to 95,000/mm3
- Hemoglobin greater than 5.3 g/dL
- Reticulocytes greater than or equal to 95,000/mm3 if the hemoglobin concentration is less than 9 g/dL
- Dosage is based on the actual or ideal patient weight, whichever is less.
- Blood counts should be monitored every 2 weeks.
- Tablets may be spilt or quartered along score lines, tablet doses can be rounded to the nearest 50 mg or 100 mg strength based on clinical judgment; capsules should be swallowed whole and should not be opened or chewed.
- Prophylactic administration of folic acid is recommended.
Pediatric Dose for Sickle Cell Anemia
Oral Tablets (i.e., Siklos):
- Initial dose: 20 mg/kg orally once a day
- Increase 5 mg/kg/day every 8 weeks or if a painful crisis occurs; increase only if blood counts are in an acceptable range
- Maximum dose: 35 mg/kg/day
BLOOD COUNTS IN THE ACCEPTABLE RANGE:
- Neutrophils greater than or equal to 2000 cells/mm3
- Platelets greater than or equal to 80,000/mm3
- Hemoglobin greater than 5.3 g/dL
- Reticulocytes greater than or equal to 80,000/mm3 if the hemoglobin concentration is less than 9 g/dL
- Dosage is based on the actual or ideal patient weight, whichever is less.
- Blood counts should be monitored every 2 weeks.
- Tablets may be spilled or quartered along score lines, tablet doses can be rounded to the nearest 50 mg or 100 mg strength based on clinical judgment.
- Prophylactic administration of folic acid is recommended.
Dose Adjustments
SICKLE CELL ANEMIA:
- Treatment for Sickle Cell Anemia should be interrupted if blood counts are in the toxic range:
TOXIC RANGE
- Neutrophils less than 2000 cells/mm3 (younger patients with lower baseline counts may safely tolerate absolute neutrophil counts down to 1250/mm3)
- Platelets less than 80,000/mm3
- Hemoglobin less than 4.5 g/dL
- Reticulocytes less than 80,000/mm3 if the hemoglobin concentration is less than 9 g/dL
Dosing After Hematologic Recovery:
- Upon recovery, reduce from dose associated with hematologic toxicity:
- Tablets: Reduce by 5 mg/kg/day; may titrate up or down every 8 weeks in 5 mg/kg/day increments
- Capsules: Reduce by 2.5 mg/kg/day; may titrate up or down every 12 weeks in 2.5 mg/kg/day increments
- Patients should be at a stable dose with no hematologic toxicity for 24 weeks.
- Permanently discontinue if the patient develops hematologic toxicity twice.
NEOPLASTIC DISEASES:
- Myelosuppression: Provide supportive care and modify dose or discontinue therapy as needed.
- If cutaneous vasculitic ulcers occur, institute treatment and discontinue this drug.
Side Effects
The Most Common
- nausea
- vomiting
- diarrhea
- loss of appetite
- weight gain
- sores in the mouth and throat
- constipation
- rash
- pale skin
- dizziness
- headache
- hair loss
- changes in skin and nails
- fast heartbeat
- ongoing pain that begins in the stomach area but may spread to the back
- leg wounds or ulcers
- pain, itching, redness, swelling, or blisters on the skin
- pain in the upper right part of the stomach
- blood in the urine
- yellowing of the skin or eyes
- numbness, burning, or tingling in the hands or feet
- fever, cough, shortness of breath, and other breathing problems
More common
- Black, tarry stools
- blood in the urine or stools
- chills
- cough
- fever
- hoarseness
- lower back or side pain
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- sore throat
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual tiredness or weakness
- Blackening of the fingernails and toenails
- trouble breathing
- numbness, tingling, or burning pain in your hands or feet;
- skin numbness or purple discoloration;
- skin ulcers or open sores;
- sudden chest pain, wheezing, dry cough, feeling short of breath;
- low blood cell counts–fever, chills, tiredness, mouth sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed; or
- signs of liver or pancreas problems–loss of appetite, upper stomach pain (that may spread to your back), nausea or vomiting, fast heart rate, dark urine, jaundice (yellowing of the skin or eyes).
Rare
- Confusion
- dizziness
- headache
- joint pain
- seeing, hearing, or feeling things that are not there
- seizures
- swelling of the feet or lower legs
- Back, leg, or stomach pains
- bleeding gums
- bleeding under the skin
- blisters on the skin
- bluish or pale color on the skin of the fingers or toes
- chest tightness
- coldness of the fingers or toes
- crater-like lesions on the skin
- dark urine
- drowsiness
- fast heartbeat
- general body swelling
- hives, itching, skin rash
- irritation
- itching, pain, redness, or swelling on the leg
- joint stiffness or swelling
- loss of appetite
- muscle spasms (tetany) or twitching seizures
- nausea
- nosebleeds
- numbness or tingling of the fingers or toes
- pain in the fingers or toes
- sore on the leg
- swelling of the eyelids, face, lips, hands, or feet
- trembling
- trouble swallowing
- vomiting
- weight loss
- yellowing of the eyes or skin
Drug Interactions
| DRUG | INTERACTION |
|---|---|
| Abatacept | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Abatacept. |
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Hydroxyurea. |
| Acenocoumarol | The risk or severity of bleeding can be increased when Acenocoumarol is combined with Hydroxyurea. |
| Acetaminophen | The risk or severity of methemoglobinemia can be increased when Acetaminophen is combined with Hydroxyurea. |
| Acetylsalicylic acid | The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Hydroxyurea. |
| Adalimumab | The risk or severity of adverse effects can be increased when Adalimumab is combined with Hydroxyurea. |
| Adenovirus | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Hydroxyurea. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Hydroxyurea. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Hydroxyurea. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Hydroxyurea. |
| Allogeneic | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Hydroxyurea. |
| Allopurinol | The risk or severity of adverse effects can be increased when Allopurinol is combined with Hydroxyurea. |
| Alteplase | The risk or severity of bleeding can be increased when Alteplase is combined with Hydroxyurea. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Hydroxyurea. |
| Aminosalicylic acid | The risk or severity of methemoglobinemia can be increased when Aminosalicylic acid is combined with Hydroxyurea. |
| Amitriptyline | The metabolism of Amitriptyline can be decreased when combined with Hydroxyurea. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Hydroxyurea. |
| Amyl Nitrite | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Amyl Nitrite. |
| Anagrelide | The risk or severity of bleeding can be increased when Anagrelide is combined with Hydroxyurea. |
| Anakinra | The risk or severity of adverse effects can be increased when Anakinra is combined with Hydroxyurea. |
| Ancrod | The risk or severity of bleeding can be increased when Ancrod is combined with Hydroxyurea. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding can be increased when Anistreplase is combined with Hydroxyurea. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Hydroxyurea. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Hydroxyurea. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Antipyrine. |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Hydroxyurea. |
| Antithrombin III | The risk or severity of bleeding can be increased when Antithrombin III human is combined with Hydroxyurea. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Hydroxyurea. |
| Apixaban | The risk or severity of bleeding can be increased when Apixaban is combined with Hydroxyurea. |
| Apremilast | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Apremilast. |
| Ardeparin | The risk or severity of bleeding can be increased when Ardeparin is combined with Hydroxyurea. |
| Argatroban | The risk or severity of bleeding can be increased when Argatroban is combined with Hydroxyurea. |
| Aripiprazole | The metabolism of Aripiprazole can be decreased when combined with Hydroxyurea. |
| Aripiprazole | The metabolism of Aripiprazole lauroxil can be decreased when combined with Hydroxyurea. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Arsenic trioxide. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Articaine. |
| ACOVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Hydroxyurea. |
| Atomoxetine | The metabolism of Atomoxetine can be decreased when combined with Hydroxyurea. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Hydroxyurea. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Hydroxyurea. |
| Bacillus | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Hydroxyurea. |
| Bacillusantigen | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Hydroxyurea. |
| Bacillus calmette | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Hydroxyurea. |
| Baricitinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Hydroxyurea. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Hydroxyurea. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Hydroxyurea. |
| Belatacept | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Belatacept. |
| Belimumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Belinostat. |
| Belumosudil | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding can be increased when Bemiparin is combined with Hydroxyurea. |
| Bendamustine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Bendamustine. |
| Bendroflumethia | The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Hydroxyurea. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Benzocaine. |
| Benzthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Hydroxyurea. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Benzyl alcohol. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Hydroxyurea. |
| Betibeglogene | The therapeutic efficacy of Betibeglogene autotemcel can be decreased when used in combination with Hydroxyurea. |
| Betrixaban | The risk or severity of bleeding can be increased when Betrixaban is combined with Hydroxyurea. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Hydroxyurea. |
| Bimekizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Bimekizumab. |
| Bivalirudin | The risk or severity of bleeding can be increased when Bivalirudin is combined with Hydroxyurea. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Hydroxyurea. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Blinatumomab. |
| Bordetella | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Hydroxyurea. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Hydroxyurea. |
| Bosutinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Bosutinib. |
| Brentuximab ve | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Brentuximab vedotin. |
| Brodalumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Brodalumab. |
| Budesonide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Budesonide. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Bupivacaine. |
| Busulfan | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Busulfan. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Butacaine. |
| Butalbital | The risk or severity of methemoglobinemia can be increased when Butalbital is combined with Hydroxyurea. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Cabazitaxel. |
| Canakinumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Canakinumab. |
| Cangrelor | The risk or severity of bleeding can be increased when Cangrelor is combined with Hydroxyurea. |
| Capecitabine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Capecitabine. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Hydroxyurea. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Carbamazepine is combined with Hydroxyurea. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Hydroxyurea. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Hydroxyurea. |
| Celecoxib | The risk or severity of methemoglobinemia can be increased when Celecoxib is combined with Hydroxyurea. |
| Certolizumab pegol | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Certolizumab pegol. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Chlorambucil is combined with Hydroxyurea. |
| Chloramphenicol | The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Hydroxyurea. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Chloroprocaine. |
| Chloroquine | The risk or severity of methemoglobinemia can be increased when Chloroquine is combined with Hydroxyurea. |
| Chlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Hydroxyurea. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ciclesonide. |
| Cilostazol | The risk or severity of bleeding can be increased when Cilostazol is combined with Hydroxyurea. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Cinchocaine. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Hydroxyurea. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Hydroxyurea. |
| Clobetasol propionate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Clobetasol propionate. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Hydroxyurea. |
| Clopidogrel | The risk or severity of bleeding can be increased when Clopidogrel is combined with Hydroxyurea. |
| Clostridium | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Hydroxyurea. |
| Clozapine | The risk or severity of neutropenia can be increased when Hydroxyurea is combined with Clozapine. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Cocaine. |
| Corticotropin | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Corticotropin. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Cortisone acetate. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Hydroxyurea. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Hydroxyurea. |
| Cyclopenthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Hydroxyurea. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Hydroxyurea. |
| Cyclosporine | Hydroxyurea may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Hydroxyurea. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Hydroxyurea. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran is combined with Hydroxyurea. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Hydroxyurea. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Hydroxyurea. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Hydroxyurea. |
| Dalteparin | The risk or severity of bleeding can be increased when Dalteparin is combined with Hydroxyurea. |
| Danaparoid | The risk or severity of bleeding can be increased when Danaparoid is combined with Hydroxyurea. |
| Dapsone | The risk or severity of methemoglobinemia can be increased when Dapsone is combined with Hydroxyurea. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Hydroxyurea. |
| Dasatinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Dasatinib. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Hydroxyurea. |
| Decitabine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Decitabine. |
| Defibrotide | The risk or severity of bleeding can be increased when Defibrotide is combined with Hydroxyurea. |
| Deflazacort | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Deflazacort. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Hydroxyurea. |
| Desirudin | The risk or severity of bleeding can be increased when Desirudin is combined with Hydroxyurea. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Hydroxyurea. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Deucravacitinib. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Dexamethasone. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Hydroxyurea. |
| Dextran | The risk or severity of bleeding can be increased when Dextran is combined with Hydroxyurea. |
| Dicoumarol | The risk or severity of bleeding can be increased when Dicoumarol is combined with Hydroxyurea. |
| Didanosine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Didanosine. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Difluocortolone. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Dimethyl fumarate. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Diphenhydramine. |
| Dipyridamole | The risk or severity of bleeding can be increased when Dipyridamole is combined with Hydroxyurea. |
| Diroximel | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Diroximel fumarate. |
| Docetaxel | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Docetaxel. |
| Doxorubicin | The risk or severity of adverse effects can be increased when Doxorubicin is combined with Hydroxyurea. |
| Drotrecogin alfa | The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Hydroxyurea. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Dyclonine. |
| Ebola Zaire | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Hydroxyurea. |
| Eculizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Eculizumab. |
| Edetic acid | The risk or severity of bleeding can be increased when Edetic acid is combined with Hydroxyurea. |
| Edoxaban | The risk or severity of bleeding can be increased when Edoxaban is combined with Hydroxyurea. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Hydroxyurea. |
| Emapalumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Emapalumab. |
| Enoxaparin | The risk or severity of bleeding can be increased when Enoxaparin is combined with Hydroxyurea. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Hydroxyurea. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Hydroxyurea. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Hydroxyurea. |
| Eribulin | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Eribulin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Hydroxyurea. |
| Estramustine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Estramustine. |
| Etanercept | The risk or severity of adverse effects can be increased when Etanercept is combined with Hydroxyurea. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Etidocaine. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Hydroxyurea. |
| Everolimus | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Everolimus. |
| Famtozinameran | The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Hydroxyurea. |
| Filgotinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Filgotinib. |
| Fingolimod | Hydroxyurea may increase the immunosuppressive activities of Fingolimod. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Hydroxyurea. |
| Flucytosine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Flucytosine. |
| Fludarabine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fludarabine. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Hydroxyurea. |
| Fluindione | The risk or severity of bleeding can be increased when Fluindione is combined with Hydroxyurea. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Hydroxyurea. |
| Fluocinolone | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Hydroxyurea. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fluocinonide. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fluocortolone. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Hydroxyurea. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Hydroxyurea. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Hydroxyurea. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fluprednisolone. |
| Flutamide | The risk or severity of methemoglobinemia can be increased when Flutamide is combined with Hydroxyurea. |
| Fluticasone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Fluticasone furoate. |
| Fluticasone | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Hydroxyurea. |
| Fondaparinux | The risk or severity of bleeding can be increased when Fondaparinux is combined with Hydroxyurea. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Gallium nitrate. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Hydroxyurea. |
| Gemtuzumab | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Hydroxyurea. |
| Glatiramer | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Glatiramer. |
| Golimumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Golimumab. |
| Guselkumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Guselkumab. |
| Haemophilus | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Hydroxyurea. |
| Haloperidol | The serum concentration of Haloperidol can be increased when it is combined with Hydroxyurea. |
| Heparin | The risk or severity of bleeding can be increased when Heparin is combined with Hydroxyurea. |
| Hepatitis A Vaccine | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Hydroxyurea. |
| Hepatitis B | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Hydroxyurea. |
| Human adenovirus | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Hydroxyurea. |
| Hydrochlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Hydroxyurea. |
| Hydrocortisone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Hydrocortisone acetate. |
| Irinotecan | The risk or severity of adverse effects can be increased when Irinotecan is combined with Hydroxyurea. |
| Isometheptene | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Isometheptene. |
| Isosorbide din | The risk or severity of methemoglobinemia can be increased when Isosorbide dinitrate is combined with Hydroxyurea. |
| Isosorbide mon | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Isosorbide mononitrate. |
| Ixabepilone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ixabepilone. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ixekizumab. |
| J COVID-19 Vaccine | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Hydroxyurea. |
| Jap encephalitis | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Hydroxyurea. |
| Leflunomide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Leflunomide. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Hydroxyurea. |
| Lepirudin | The risk or severity of bleeding can be increased when Lepirudin is combined with Hydroxyurea. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Levobupivacaine. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Lidocaine. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Hydroxyurea. |
| Lipegfilgrastim | Hydroxyurea may increase the myelosuppressive activities of Lipegfilgrastim. |
| Lomustine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Lomustine. |
| Lopinavir | The serum concentration of Hydroxyurea can be increased when it is combined with Lopinavir. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Hydroxyurea. |
| Measles virus | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Hydroxyurea. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Hydroxyurea. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Melphalan. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Hydroxyurea. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mepolizumab. |
| Meprednisone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mercaptopurine. |
| Metamizole | The risk or severity of myelosuppression can be increased when Metamizole is combined with Hydroxyurea. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Hydroxyurea. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Hydroxyurea. |
| Methoxy | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Hydroxyurea. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Hydroxyurea. |
| Metoclopramide | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Metoclopramide. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Hydroxyurea. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mitoxantrone. |
| M COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Hydroxyurea. |
| Modified vaccinia | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Hydroxyurea. |
| Mometasone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mometasone furoate. |
| Monomethyl f | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mosunetuzumab. |
| Mumps virus | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Hydroxyurea. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Hydroxyurea. |
| Mycophenolate | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Hydroxyurea. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Mycophenolic acid. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Hydroxyurea. |
| Natalizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Natalizumab. |
| Nelarabine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Nelarabine. |
| Nilotinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Nilotinib. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Hydroxyurea. |
| Nitric Oxide | The risk or severity of methemoglobinemia can be increased when Nitric Oxide is combined with Hydroxyurea. |
| Nitrofurantoin | The risk or severity of methemoglobinemia can be increased when Nitrofurantoin is combined with Hydroxyurea. |
| Nitroglycerin | The risk or severity of methemoglobinemia can be increased when Nitroglycerin is combined with Hydroxyurea. |
| Nitroprusside | The risk or severity of methemoglobinemia can be increased when Nitroprusside is combined with Hydroxyurea. |
| Nitrous oxide | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Nitrous oxide. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Hydroxyurea. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Obinutuzumab. |
| Ocrelizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ocrelizumab. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ofatumumab. |
| Olaparib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Olaparib. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Hydroxyurea. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Oxybuprocaine. |
| Ozanimod | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Paclitaxel. |
| Palbociclib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Hydroxyurea. |
| Panobinostat | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Panobinostat. |
| Parnaparin | The risk or severity of bleeding can be increased when Parnaparin is combined with Hydroxyurea. |
| Pazopanib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pazopanib. |
| Pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Hydroxyurea. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Hydroxyurea. |
| Peginterferon alf | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Hydroxyurea. |
| Peginterferon alfa | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Hydroxyurea. |
| Peginterferon beta | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Pemetrexed is combined with Hydroxyurea. |
| Penicillamine | The risk or severity of adverse effects can be increased when Penicillamine is combined with Hydroxyurea. |
| Pentosan pol | The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Hydroxyurea. |
| Pentostatin | The risk or severity of adverse effects can be increased when Pentostatin is combined with Hydroxyurea. |
| Pentoxifylline | The risk or severity of bleeding can be increased when Pentoxifylline is combined with Hydroxyurea. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Hydroxyurea. |
| Phenazopyridine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Phenazopyridine. |
| Phenindione | The risk or severity of bleeding can be increased when Phenindione is combined with Hydroxyurea. |
| Phenobarbital | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Phenobarbital. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Phenol. |
| Phenprocoumon | The risk or severity of bleeding can be increased when Phenprocoumon is combined with Hydroxyurea. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Hydroxyurea. |
| Phenytoin | The risk or severity of methemoglobinemia can be increased when Phenytoin is combined with Hydroxyurea. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Hydroxyurea. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pirfenidone. |
| Polythiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Hydroxyurea. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pomalidomide. |
| Ponatinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ponatinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ponesimod. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Pralatrexate. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Pramocaine. |
| Prasugrel | The risk or severity of bleeding can be increased when Prasugrel is combined with Hydroxyurea. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Hydroxyurea. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Hydroxyurea. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Prilocaine. |
| Primaquine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Primaquine. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Procaine. |
| Procarbazine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Procarbazine. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Proparacaine. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Propoxycaine. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Hydroxyurea. |
| Protein C | The risk or severity of bleeding can be increased when Protein C is combined with Hydroxyurea. |
| Protein S | The risk or severity of bleeding can be increased when Protein S human is combined with Hydroxyurea. |
| Quinine | The risk or severity of methemoglobinemia can be increased when Quinine is combined with Hydroxyurea. |
| Rabies immune | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Hydroxyurea. |
| Rabies antigen, A | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Hydroxyurea. |
| Rabie antigen, B | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Hydroxyurea. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Hydroxyurea. |
| Rasburicase | The risk or severity of methemoglobinemia can be increased when Rasburicase is combined with Hydroxyurea. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ravulizumab. |
| Reteplase | The risk or severity of bleeding can be increased when Reteplase is combined with Hydroxyurea. |
| Reviparin | The risk or severity of bleeding can be increased when Reviparin is combined with Hydroxyurea. |
| Rilonacept | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Rilonacept. |
| Risankizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Risankizumab. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Hydroxyurea. |
| Rivaroxaban | The risk or severity of bleeding can be increased when Rivaroxaban is combined with Hydroxyurea. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Hydroxyurea. |
| Ropegint | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Ropivacaine. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Hydroxyurea. |
| Rubella vaccine | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Hydroxyurea. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ruxolitinib. |
| Sarilumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Sarilumab. |
| Satralizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Satralizumab. |
| Secukinumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Secukinumab. |
| Siltuximab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Siltuximab. |
| Siponimod | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Hydroxyurea. |
| Sirolimus | The risk or severity of adverse effects can be increased when Sirolimus is combined with Hydroxyurea. |
| Smallpox | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Hydroxyurea. |
| Sodium citrate | The risk or severity of bleeding can be increased when Sodium citrate is combined with Hydroxyurea. |
| Sorafenib | The risk or severity of adverse effects can be increased when Sorafenib is combined with Hydroxyurea. |
| Spesolimab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Spesolimab. |
| Stavudine | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Stavudine. |
| Stiripentol | The metabolism of Hydroxyurea can be decreased when combined with Stiripentol. |
| Streptokinase | The risk or severity of bleeding can be increased when Streptokinase is combined with Hydroxyurea. |
| Streptozocin | The risk or severity of adverse effects can be increased when Streptozocin is combined with Hydroxyurea. |
| Sulfadiazine | The risk or severity of methemoglobinemia can be increased when Sulfadiazine is combined with Hydroxyurea. |
| Sulfamethoxazole | The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Hydroxyurea. |
| Sulfapyridine | The risk or severity of methemoglobinemia can be increased when Sulfapyridine is combined with Hydroxyurea. |
| Sulfasalazine | The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Hydroxyurea. |
| Sulfinpyrazone | The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Hydroxyurea. |
| Sulodexide | The risk or severity of bleeding can be increased when Sulodexide is combined with Hydroxyurea. |
| Sunitinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Sunitinib. |
| Tacrolimus | Tacrolimus may increase the immunosuppressive activities of Hydroxyurea. |
| Tedizolid | The risk or severity of myelosuppression can be increased when Hydroxyurea is combined with Tedizolid phosphate. |
| Temozolomide | The risk or severity of adverse effects can be increased when Temozolomide is combined with Hydroxyurea. |
| Temsirolimus | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Temsirolimus. |
| Tenecteplase | The risk or severity of bleeding can be increased when Tenecteplase is combined with Hydroxyurea. |
| Teniposide | The risk or severity of adverse effects can be increased when Teniposide is combined with Hydroxyurea. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Teprotumumab. |
| Teriflunomide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Teriflunomide. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Tetracaine. |
| Thalidomide | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Thalidomide. |
| Thiotepa | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Thiotepa. |
| Ticagrelor | The risk or severity of bleeding can be increased when Ticagrelor is combined with Hydroxyurea. |
| T encephalitis | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Hydroxyurea. |
| Ticlopidine | The risk or severity of bleeding can be increased when Ticlopidine is combined with Hydroxyurea. |
| Timolol | The metabolism of Timolol can be decreased when combined with Hydroxyurea. |
| Tinzaparin | The risk or severity of bleeding can be increased when Tinzaparin is combined with Hydroxyurea. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Hydroxyurea. |
| Tirofiban | The risk or severity of bleeding can be increased when Tirofiban is combined with Hydroxyurea. |
| Tixocortol | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Tixocortol. |
| Tocilizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Tocilizumab. |
| Tofacitinib | Hydroxyurea may increase the immunosuppressive activities of Tofacitinib. |
| Topotecan | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Topotecan. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Hydroxyurea. |
| Trabectedin | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Trabectedin. |
| Tramadol | The metabolism of Tramadol can be decreased when combined with Hydroxyurea. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Hydroxyurea. |
| Trastuzumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Trastuzumab emtansine. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Hydroxyurea. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Hydroxyurea. |
| Trichlormethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Hydroxyurea. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Hydroxyurea. |
| Triflusal | The risk or severity of bleeding can be increased when Triflusal is combined with Hydroxyurea. |
| Trilostane | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Trilostane. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Hydroxyurea. |
| Typhoid Vaccine | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Hydroxyurea. |
| Typhoid Vi | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Hydroxyurea. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Upadacitinib. |
| Urokinase | The risk or severity of bleeding can be increased when Urokinase is combined with Hydroxyurea. |
| Valproic acid | The risk or severity of methemoglobinemia can be increased when Valproic acid is combined with Hydroxyurea. |
| Varicella zoster | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Hydroxyurea. |
| Varicella zoster | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Hydroxyurea. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Vedolizumab. |
| Vibrio | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Hydroxyurea. |
| Vilanterol | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Vilanterol. |
| Vinblastine | The risk or severity of adverse effects can be increased when Vinblastine is combined with Hydroxyurea. |
| Vincristine | The risk or severity of adverse effects can be increased when Vincristine is combined with Hydroxyurea. |
| Vindesine | The risk or severity of adverse effects can be increased when Vindesine is combined with Hydroxyurea. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Vinorelbine is combined with Hydroxyurea. |
| Voclosporin | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Voclosporin. |
| Vorapaxar | The risk or severity of bleeding can be increased when Vorapaxar is combined with Hydroxyurea. |
| Vorinostat | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Vorinostat. |
| Warfarin | The risk or severity of bleeding can be increased when Warfarin is combined with Hydroxyurea. |
| Ximelagatran | The risk or severity of bleeding can be increased when Ximelagatran is combined with Hydroxyurea. |
| Yellow fever vaccine | The risk or severity of infection can be increased when Yellow fever vaccine is combined with Hydroxyurea. |
| Zidovudine | The risk or severity of adverse effects can be increased when Zidovudine is combined with Hydroxyurea. |
| Zopiclone | The risk or severity of methemoglobinemia can be increased when Hydroxyurea is combined with Zopiclone. |
Pregnancy and Lactation
AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned.
Pregnancy
Drugs that affect DNA synthesis, such as hydroxyurea, may be potential mutagenic agents. The physician should carefully consider this possibility before administering this drug to male or female patients who may contemplate conception. HYDREA can cause fetal harm when administered to a pregnant woman. Hydroxyurea has been demonstrated to be a potent teratogen in a wide variety of animal models,
including mice, hamsters, cats, miniature swine, dogs, and monkeys at doses within 1 fold of the human dose given on an mg/m2 basis. Hydroxyurea is embryotoxic and causes fetal malformations (partially ossified cranial bones, absence of eye sockets, hydrocephaly, bipartite sternebrae, missing lumbar vertebrae) at 180 mg/kg/day (about 0.8 times the maximum recommended human daily dose on an mg/m2 basis) in rats and at 30 mg/kg/day (about 0.3 times the maximum recommended human daily dose on a 6 mg/m2 basis) in rabbits. Embryotoxicity was characterized by decreased fetal viability, reduced live litter sizes, and developmental delays. Hydroxyurea crosses the placenta. Single doses of ≥375 mg/kg (about 1.7 times the maximum recommended human daily dose on an mg/m2 basis) to rats caused growth retardation and impaired learning ability. There are no adequate and well-controlled studies on pregnant women. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant.
Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, although the evidence for this recommendation for hydroxyurea is very weak.[1,2] In doses used for sickle cell disease, hydroxyurea appears to be acceptable to use in nursing mothers. Avoiding breastfeeding for 3 hours after the mother’s dose can decrease the infant dose by about half. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk.
How should this medicine be used?
Hydroxyurea comes as a capsule and tablet to take by mouth. It is usually taken once a day with a glass of water. When hydroxyurea is used to treat certain types of cancer, it may be taken once every third day. Take hydroxyurea at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydroxyurea exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may need to delay your treatment or adjust your dose of hydroxyurea depending on your response to treatment and any side effects that you may experience. Talk to your doctor about how you are feeling during your treatment. Do not stop taking hydroxyurea without talking to your doctor.
Your doctor will probably tell you to take another medication, folic acid (a vitamin), to decrease some of the side effects of this medication. Take this medication exactly as directed.
Swallow the capsules whole; do not split, chew, or crush them.
The hydroxyurea 1,000-mg tablets (Siklos) are scored so that they can easily be split into halves or quarters to provide smaller doses. Do not break the hydroxyurea 100-mg tablets into smaller parts. Your doctor will tell you how to break the tablets and how many tablets or parts of a tablet you should take.
If you are unable to swallow hydroxyurea tablets or portion(s) of tablets, you may dissolve your dose in water. Place your dose in a teaspoon and add a small amount of water. Wait about 1 minute to allow the tablet(s) to dissolve, then swallow the mixture right away.
You should wear rubber or latex gloves when you handle the capsules or tablets so that your skin does not come into contact with the medication. Wash your hands with soap and water before and after you touch the bottle or medication. If hydroxyurea gets into your eyes, immediately flush your eyes with water for at least 15 minutes. If the powder from a capsule or tablet spills, wipe it up immediately with a damp disposable towel. Then place the towel in a closed container, such as a plastic bag, and throw it away in a trash can that is out of the reach of children and pets. Clean the spill area using a detergent solution followed by clean water.
What special precautions should I follow?
Before taking hydroxyurea,
- tell your doctor and pharmacist if you are allergic to hydroxyurea, any other medications, or any of the inactive ingredients in hydroxyurea capsules or tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain medications for HIV (human immunodeficiency virus) such as didanosine (Videx) and stavudine (Zerit) and interferon (Actimmune, Avonex, Betaseron, Infergen, Intron A, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), high levels of uric acid in your blood, or leg ulcers; if you are being treated with or have ever been treated with radiation therapy, cancer chemotherapy, or hemodialysis; or if you have or have ever had kidney or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant or breastfeed while you are taking hydroxyurea. You will need to have a pregnancy test before you begin treatment with hydroxyurea. If you are a female, you should use effective birth control while taking hydroxyurea and for at least 6 months after stopping your treatment. If you are a male, you and your female partner should use effective birth control while taking hydroxyurea and for at least 6 months (Siklos) or at least 1 year (Droxia, Hydrea) after stopping your treatment. Talk to your doctor about birth control methods that you can use during and after your treatment and how long you should continue their use. If you become pregnant while taking hydroxyurea, call your doctor immediately. Hydroxyurea may harm the fetus.
- you should know that this medication may decrease fertility in men. Talk to your doctor about the risks of taking hydroxyurea.
- do not have any vaccinations without talking to your doctor.
