Hydrea (redirected from Hydra, Saronic Islands)

Hydrea,

trademark for an antineoplastic (hydroxyurea).

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hydroxyurea Warning - Hazardous drug!

Droxia, Hydrea

Pharmacologic class: Antimetabolite

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Boxed Warning

• Drug may cause severe and even life-threatening adverse effects. Administer under supervision of physician experienced in using drug to treat sickle cell anemia.
• Drug damages genes, chromosomes, and DNA and may be carcinogenic. Secondary leukemias have occurred in patients receiving it as long-term therapy for myeloproliferative disorders. Prescriber and patient must carefully weigh potential benefits against undefined risk of secondary cancers.

Action

Unknown. May inhibit enzyme necessary for DNA synthesis without disrupting RNA or protein synthesis.

Availability

Capsules: 200 mg, 250 mg, 300 mg, 400 mg, 500 mg

⊘Indications and dosages

➣ Head and neck cancer; ovarian cancer; malignant melanoma

Adults: 60 to 80 mg/kg (2 to 3 g/m²) P.O. as a single daily dose q 3 days, or 20 to 30 mg/kg/day P.O. as a single dose. Begin therapy 7 days before radiation.

➣ Resistant chronic myelogenous leukemia

Adults: 20 to 30 mg/kg/day P.O. in one or two divided doses

➣ Sickle cell anemia

Adults and children: 15 mg/kg/day P.O. as a single dose. May increase by 5 mg/kg/day P.O. q 12 weeks, up to 35 mg/kg/day.

Off-label uses

• Thrombocythemia
• Human immunodeficiency virus

Contraindications

• Hypersensitivity to drug or tartrazine
• Bone marrow depression
• Severe anemia or thrombocytopenia

Precautions

Use cautiously in:
• renal or hepatic impairment
• obese patients
• females of childbearing age
• elderly patients.

Administration

• Provide frequent mouth care.

Route	Onset	Peak	Duration
P.O.	Unknown	2 hr	24 hr

Adverse reactions

CNS: drowsiness, malaise, confusion, dizziness, headache

GI: nausea, vomiting, diarrhea, constipation, stomatitis, anorexia

GU: dysuria, hyperuricemia, infertility, renal tubular dysfunction

Hematologic: anemia, megaloblastosis, leukopenia, thrombocytopenia, bone marrow depression

Hepatic: hepatitis

Metabolic: hyperuricemia

Skin: alopecia, erythema, pruritus, rash, urticaria, exacerbation of post-radiation erythema

Other: chills, fever

Interactions

Drug-drug. Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions

Myelosuppressants: additive bone marrow depression

Drug-diagnostic tests. Blood urea nitrogen, creatinine, uric acid: increased values

Hemoglobin, platelets, red blood cells, white blood cells: decreased values

Mean corpuscular volume: transient increase

Patient monitoring

• Assess CBC weekly.
• Closely monitor patient with renal or hepatic impairment. Check kidney and liver function tests often.
• Assess fluid status. Make sure patient drinks 10 to 12 glasses of water daily.

Patient teaching

• Advise patient to mark dates for drug doses, diagnostic tests, and treatments on calendar.
☞ Instruct patient to immediately report easy bruising, bleeding, unusual tiredness, or yellowing of skin or eyes.
• Tell patent to report such adverse effects as appetite loss, nausea, vomiting, oral lesions, constipation, diarrhea, confusion, dizziness, headache, and rash.
• Instruct female patient to use barrier contraception.
• Tell patient he'll undergo regular blood testing to monitor drug effects.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.