hydroxyurea


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hydroxyurea

 [hi-drok″se-u-re´ah]
an antineoplastic agent that blocks the conversion of ribonucleotides to deoxyribonucleotides, thus stopping DNA synthesis; used in the treatment of melanoma, resistant chronic myelocytic leukemia, and recurrent, metastatic, or inoperable ovarian carcinoma. It is also used in sickle cell disease to reduce the frequency of painful crises and to reduce the need for blood transfusions.

hydroxyurea

Droxia, Hydrea

Pharmacologic class: Antimetabolite

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box 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, 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.

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 patient 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 will 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.

hy·drox·y·u·re·a

(hī-drok'sē-yū-rē'ă),
An oral antineoplastic agent that inhibits DNA synthesis; used to treat various malignancies including melanoma, chronic myelocytic leukemia, and carcinoma of the ovary.
Synonym(s): hydroxycarbamide

hydroxyurea

(hī-drŏk′sē-yo͝o-rē′ə)
n.
An antineoplastic drug, CH4N2O2, that suppresses the production of blood cell precursors in the bone marrow and is used in the treatment of certain leukemias, carcinomas, and sickle cell anemia.

hydroxyurea

Droxia®, Hydrea® A non-alkylating, myelosuppressive chemotherapeutic of low toxicity, used to treat myeloproliferative disorders and hemoglobinopathies AIDS HU ↓ HIV viral loads if given as part of a protease-sparing triple combination with nucleoside analogues ddI–
didanosine–Videx® and d4T–stavudine–Zerit®. See AIDS Hematology Hydroxyurea induces ↑ HbF synthesis in sickle cell–SC anemia, which may comprise 25% of the total Hb–the remainder is HbS–seemingly enough to prevent formation of HbS polymers, the bête noire of SC disease; hydroxyurea may be used to ↑ fetal Hb production–by ↑ γ-globulin production and ↑ RBC survival and ↓ bilirubin and LD in Pts with SC anemia; used in Pts with SC disease ≥ age 18, to prevent/↓ painful crises and ↓ need for blood transfusions, for Pts who have had at ≥3 painful crises in previous yr. See Sickle cell anemia Oncology Hydroxyurea is used as a single agent to control blast transformation in CML, manage P vera, essential thrombocythemia and, with prednisone, treat idiopathic hypereosinophilic syndrome; long-term therapy may prevent thrombosis; hydroxyurea therapy–HT has also been used to manage melanoma and inoperable ovarian CA Long-term effects Unknown; in Pts with P vera, leukemia is 3-fold higher in HT than in those treated with phlebotomy.

hy·drox·y·u·re·a

(hī-drok'sē-yū-rē'ă)
An oral antineoplastic agent that inhibits DNA synthesis; used to treat malignancies including melanoma, chronic myelocytic leukemia, and ovarian carcinoma.

hydroxyurea

Hydroxycarbamide, a CYTOTOXIC drug used in the chemotherapy of cancer. The drug is also capable of effecting a substantial reduction in the frequency and severity of crises in SICKLE CELL ANAEMIA. A brand name is Hydrea.

Hydroxyurea

A drug that has been shown to induce production of fetal hemoglobin. Fetal hemoglobin has a pair of gamma-globin molecules in place of the typical beta-globins of adult hemoglobin. Higher-than-normal levels of fetal hemoglobin can ameliorate some of the symptoms of thalassemia.

hy·drox·y·u·re·a

(hī-drok'sē-yū-rē'ă)
Oral antineoplastic agent that inhibits DNA synthesis; used to treat various malignancies including melanoma, chronic myelocytic leukemia, and carcinoma of the ovary.
References in periodicals archive ?
In this study, four configurations for non-covalent functionalization of drug hydroxyurea (HU) onto the Y-[Fe.sub.2][O.sub.3] nanoparticles (MNP) were examined in both gas and solution phases.
We next addressed whether leukemic cells and colon cancer cells grown in FCS or hPL respond equally to hydroxyurea. This drug is commonly used to cause replicative stress and to clinically reduce high leukemic blast counts (Eklund et al., 2001; Pons et al., 2018; Schafer et al., 2017; Schneider et al., 2010; Goder et al., 2018).
The statistically significant high level of HbF seen in the HbSS participants (19.09 [+ or -] 6.4) could be due either to the presence of a factor that is causing up-regulation of HbF, or due to hydroxyurea uptake that normally increases erythroid differentiation in the bone marrow.
He was successfully extubated and discharged a week later (hydroxyurea 1000 mg and ruxolitinib 5 mg both twice daily).
Iversen, "Hydroxyurea enhances methylnitrosourea skin tumorigenesis when given shortly before, but not after, the carcinogen," Carcinogenesis, vol.
Caption: Figure 3: Hydroxyurea addition to HDL, Hb, and [H.sub.2][O.sub.2] inhibits Hb cross-link formation.
Data about patients' weight, body mass index (BMI), blood pressure (BP), hospitalization, blood transfusion history, and use of hydroxyurea were collected by reviewing the electronic medical records and reflected the most recent measurements.
(12.) Charache S, Terrin ML, Moore RD, et al.; Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia.
Hydroxyurea, interferon alfa, and peginterferon alfa, and possibly anagrelide, have been shown to be effective for the prevention of venous thrombotic complications in patients with high-risk ET.
22 patients were on hydroxyurea (HU) before pregnancy, but stopped after confirmation of pregnancy.
There are many conventional therapeutic options for the management of CML including hydroxyurea, busulfan, interferon based regimens, leukapheresis, and stem cell transplantation (or bone marrow transplant) [3], with bone marrow transplantation being curative.
The patient's PV had previously been managed with hydroxyurea which was discontinued 2 months prior due to pancytopenia.