hydroxycarbamide at a glance
Medicine class
Cytotoxic antineoplastic treatment and ribonucleotide reductase inhibitor.
Licensed uses
Sickle cell disease, selected myeloproliferative disorders, chronic myeloid leukaemia and, for Hydrea, cervical cancer with radiotherapy.
What is hydroxycarbamide used for?
UK-licensed indications differ between products.
Xromi: prevention of vaso-occlusive complications of sickle cell disease in patients older than 9 months.
Siklos: prevention of recurrent painful vaso-occlusive crises, including acute chest syndrome, in symptomatic sickle cell syndrome in adults and children older than 2 years.
Hydroxycarbamide medac: chronic or accelerated-phase chronic myeloid leukaemia, and high-risk essential thrombocythaemia or polycythaemia vera.
Hydrea: specified treatment contexts in chronic myeloid leukaemia and cervical cancer alongside radiotherapy.
How does hydroxycarbamide work?
Hydroxycarbamide inhibits ribonucleotide reductase, reducing the building blocks needed for DNA synthesis and slowing cell proliferation. In sickle cell disease, it also increases fetal haemoglobin, helping red cells remain flexible and reducing sickling and vessel blockage.
hydroxycarbamide preparations and strengths
Capsule
Route: Oral
Strengths: 500 mg
Oral solution
Route: Oral
Strengths: 100 mg/mL
Tablet
Route: Oral
Strengths: 100 mg, 1000 mg
How to take hydroxycarbamide
Take hydroxycarbamide exactly as directed by the specialist team. Follow the instructions for your formulation and avoid contact with damaged tablets, opened capsules or spilled solution.
Swallow hard capsules whole; do not allow them to dissolve in the mouth.
Siklos tablets may be divided as marked or dispersed in a small amount of water immediately before use.
Measure Xromi with the supplied oral syringe selected by the healthcare professional. It may be taken with or after food; use a consistent method and drink water afterwards.
Wash hands before and after handling. Clean spills promptly and keep the treatment away from children.
hydroxycarbamide side effects
Common or expected effects
- Reduced blood-cell production, including low neutrophils, platelets or red cells
- Enlarged red blood cells
- Nausea or constipation
- Headache or dizziness
- Dry skin, pigmentation changes, hair loss or skin ulcers
- Reduced sperm production
Get urgent medical advice
- Severe bone-marrow suppression causing infection, bleeding or symptomatic anaemia
- Serious lung inflammation with fever, cough or breathlessness
- Painful or worsening leg ulcers and vasculitic skin injury
- Liver injury or pancreatitis, particularly with certain older HIV treatments
- Rare corneal stem-cell injury causing eye pain, redness, light sensitivity or impaired vision
hydroxycarbamide in pregnancy
Hydroxycarbamide may harm a developing baby and is contraindicated or not recommended during pregnancy depending on the product. People who could conceive or father a child need specialist contraception and pre-conception advice. Contact the specialist team promptly if pregnancy is suspected; do not change treatment without supervision.
hydroxycarbamide interactions
Check prescription, non-prescription and complementary treatments with the specialist or pharmacist.
Live vaccines
Immune suppression may permit severe vaccine-related infection and reduce the antibody response; specialist advice is required.
Cytotoxic treatments or radiotherapy
Combined treatment can increase bone-marrow suppression, gastrointestinal toxicity and mucositis, and may aggravate radiation-related skin redness.
Common questions about hydroxycarbamide
Answers are fully visible for fast scanning and source review.
Is hydroxycarbamide the same as hydroxyurea?
Yes. Hydroxyurea is another name for hydroxycarbamide.
Why are blood tests needed?
Hydroxycarbamide can suppress production of white cells, platelets and red cells. Testing detects harmful changes before serious infection, bleeding or anaemia develops.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.