← Search & browse all drugs
ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › ANTINEOPLASTIC AGENTS › OTHER ANTINEOPLASTIC AGENTS › Other antineoplastic agents
hydroxycarbamide
L01XX05
Forms & Strengths
- Capsules: 200 mg, 300 mg, 400 mg, 500 mg
- Tablets (hydroxyurea): 1000 mg
Adult Dosing
- Solid tumors: Intermittent therapy 80 mg/kg as a single dose every 3 days; Continuous therapy 20-30 mg/kg once daily
- CML: 20-30 mg/kg once daily
- Sickle cell anemia: Initial 15 mg/kg/day, increased by 2.5-5 mg/kg/day every 12 weeks to maximum tolerated dose (usually 35 mg/kg/day)
Pediatric Dosing
- Sickle cell anemia (pediatric patients > 2 years): Initial 15-20 mg/kg once daily, titrated up to a maximum of 30-35 mg/kg/day based on efficacy and toxicity
Indications
- Reduction of frequency of painful crises and need for blood transfusions in sickle cell anemia
- Treatment of resistant chronic myeloid leukemia (CML)
- Treatment of polycythemia vera and essential thrombocythemia at high risk for thromboembolism
Mechanism of Action
- Ribonucleotide reductase inhibitor that blocks conversion of ribonucleotides to deoxyribonucleotides
- Causes immediate inhibition of DNA synthesis without significantly inhibiting RNA or protein synthesis
- Increases fetal hemoglobin (HbF) levels in sickle cell anemia by inducing gamma-globin gene expression and decreasing neutrophil adhesion
Contraindications
- Hypersensitivity to hydroxycarbamide or any component of the formulation
- Severe bone marrow suppression (neutrophils < 1.5 x 10^9/L or platelets < 100 x 10^9/L)
- Pregnancy and lactation due to teratogenic risks
Adverse Reactions
- Myelosuppression (leukopenia, neutropenia, thrombocytopenia, anemia)
- Gastrointestinal disturbances (stomatitis, nausea, vomiting, diarrhea, anorexia)
- Dermatological effects (cutaneous vasculitis, ulcerations, alopecia, hyperpigmentation)
- Elevated liver enzymes and serum creatinine/BUN
- Pulmonary toxicity (diffuse pulmonary infiltrates, dyspnea)
Drug Interactions
- Concomitant live vaccines: May potentiate replication and adverse effects of vaccine viruses; avoid use
- Antiretroviral drugs (didanosine, stavudine): Increased risk of severe hepatotoxicity, pancreatitis, and peripheral neuropathy
- Myelosuppressive agents and radiation therapy: Additive bone marrow suppression; dosage adjustments may be necessary
Curated Content: Needs Vetting Before Put to Clinical Use