Also found in: Dictionary, Encyclopedia, Wikipedia.
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.
Unknown. May inhibit enzyme necessary for DNA synthesis without disrupting RNA or protein synthesis.
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.
• Human immunodeficiency virus
• Hypersensitivity to drug or tartrazine
• Bone marrow depression
• Severe anemia or thrombocytopenia
Use cautiously in:
• renal or hepatic impairment
• obese patients
• females of childbearing age
• elderly patients.
• Provide frequent mouth care.
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
Skin: alopecia, erythema, pruritus, rash, urticaria, exacerbation of post-radiation erythema
Other: chills, fever
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
• 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.
• 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.
hydroxyureaDroxia®, 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.