Hydroxyurea | Side Effects, Dosage, Uses & More
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Generic Name:

hydroxyurea, Oral capsule

All Brands

  • Droxia
  • Hydrea
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Highlights for hydroxyurea

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Hydroxyurea is used to treat myeloid leukemia and head and neck cancer. It prevents cancer cells from growing. In people with sickle cell disease, this drug changes the shape of red blood cells. This can help prevent sickle cell crises.

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This drug comes in the form of a capsule you take by mouth.  

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Hydroxyurea can reduce your body’s ability to produce certain blood cells. This could decrease your body’s ability to fight off infection, make normal blood clots, or use oxygen. This is called bone marrow suppression. 

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Hydroxyurea may harm the fetuses of women who are pregnant and take the drug. Women of childbearing age who take this drug should use effective birth control during treatment and for at least 30 days after stopping this drug. Men who use this drug should use effective birth control during treatment and for at least 1 year after stopping this drug. 

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The more common side effects of this drug include stomach pain, constipation, diarrhea, nausea, vomiting, and loss of appetite. 

IMPORTANT INFORMATION

FDA Warning

Droxia has a black box warning. (These are only general warnings for Hydrea and the generic form.) This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suppressed immune system warning. Droxia can reduce your body’s ability to make certain blood cells. This can decrease your ability to fight off infection. This drug can also reduce your body’s ability to make normal blood clots or use oxygen. This is called bone marrow suppression. Your doctor will monitor you closely for side effects from bone marrow suppression. These side effects include fever, infection, bruising, or bleeding.

Cancer risk warning. Droxia can cause leukemia and skin cancer. However, this is rare. If you take this drug, use sunscreen and other protection from the sun and follow up with your doctor for regular skin checks. 

Harm to fetus

Hydroxyurea may harm the fetuses of women who are pregnant and take the drug. Women of childbearing age who take this drug should use effective birth control during treatment and for at least 30 days after stopping this drug. Men who use this drug should use effective birth control during treatment and for at least 1 year after stopping this drug.  

Blood vessel damage

Hydroxyurea may cause damage to your blood vessels. This has mostly occurred in people with cancer who were also taking interferon. 

Radiation rash

If you have received radiation therapy in the past and experienced a rash from it, taking Hydrea or the generic form of Hydrea may make the rash come back. 

What is hydroxyurea?

Hydroxyurea is a prescription drug. It comes as a capsule you take by mouth. It is available as the brand-name drugs Hydrea and Droxia. Hydrea is also available as a generic drug. Droxia is not. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Hydroxyurea may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Hydroxyurea is used to treat myeloid leukemia and head and neck cancers. It prevents cancer cells from growing. In people with sickle cell disease, hydroxyurea changes the shape of red blood cells to help prevent sickle cell crises.

How it works

Hydroxyurea belongs to a class of drugs called antimetabolites. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

How it works

Hydroxyurea belongs to a class of drugs called antimetabolites. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

In people with cancer, hydroxyurea acts as a substitute for some parts that the cancer cells need to grow. Cancer cells take in hydroxyurea, which stops the cancer cell from growing. Cancer cells grow more rapidly than normal cells, so they are more affected by the drug. In patients with sickle cell disease, this drug changes the shape of red blood cells. This makes it less likely for sickle cell crises to occur.

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hydroxyurea Side Effects

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More Common Side Effects

The more common side effects of hydroxyurea can include:

  • stomach pain

  • constipation

  • diarrhea

  • nausea

  • vomiting 

  • loss of appetite

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following: 

  • Leukemia. Symptoms can include:

    • More frequent infections than you normally have
  • Skin cancer. Symptoms can include:

    • Changes to skin color and texture
    • New moles or bumps on your skin
  • Blood vessel damage. Symptoms can include:

    • Developing open sores on your arms or legs
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Hydroxyurea can cause dizziness and drowsiness during the first few hours after you take it. These side effects are more likely to happen when you start treatment or when your doctor increases your dose. 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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hydroxyurea May Interact with Other Medications

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Hydroxyurea can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Interactions that increase the risk of side effects
  • Didanosine and stavudine (HIV Drugs). Taking these drugs with hydroxyurea increases your risk of damage to your pancreas and liver. You also have increased risk of nerve pain.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Hydroxyurea warnings
Pregnant women
Pregnant women

Hydroxyurea is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Women of childbearing age who take this drug should use effective birth control during treatment and for at least 6 months after stopping this drug. Men who use this drug should use effective birth control during treatment and for at least 1 year after stopping the drug. If you are a woman and you become pregnant while taking this drug, contact your doctor immediately.

Women who are breast-feeding
Women who are breast-feeding

Hydroxyurea may pass into breast milk and may cause side effects in a child who is breastfed. You should stop breastfeeding when you are taking hydroxyurea.

Talk to your doctor if you breastfeed your child. 

For seniors
For seniors

If you are older than 65 years, your body may be more sensitive to this drug and your doctor may have you take a lowered dose.

For children
For children

This medication has not been studied in children. It should not be used in people younger than 18 years.

When to call the doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

Allergies
Allergies

Hydroxyurea can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take hydroxyurea (Dosage)

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All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on: 

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Myeloid leukemia

Generic: hydroxyurea

Form: Oral capsule
Strengths: 500 mg

Brand: Hydrea

Form: Oral capsule
Strengths: 500 mg

Brand: Droxia

Form: Oral capsule
Strengths: 200 mg, 300 mg, 400 mg
Adult dosage (ages 18 years and older)
  • Hydrea and generic hydroxyurea: The initial dose is 15 mg per kilogram of body weight, taken once per day.
  • Droxia is not used for this condition.
Child dosage (ages 0–17 years)

It has not been confirmed that hydroxyurea is safe and effective for use in people younger than 18 years.

Special considerations

People with kidney disease:

  • Hydrea and generic: The initial dose is 7.5 mg per kilogram of body weight, taken once per day.

Head and neck cancer

Generic: hydroxyurea

Form: Oral capsule
Strengths: 500 mg

Brand: Hydrea

Form: Oral capsule
Strengths: 500 mg

Brand: Droxia

Form: Oral capsule
Strengths: 200 mg, 300 mg, 400 mg
Adult dosage (ages 18 years and older)
  • Hydrea and generic hydroxyurea: The initial dose is 15 mg per kilogram of body weight, taken once per day.
  • Droxia is not used for this condition.
Child dosage (ages 0–17 years)

It has not been confirmed that hydroxyurea is safe and effective for use in people younger than 18 years.

Special considerations

People with kidney disease:

  • Hydrea and generic: The initial dose is 7.5 mg per kilogram of body weight, taken once per day.

Sickle cell crisis prevention

Generic: hydroxyurea

Form: Oral capsule
Strengths: 500 mg

Brand: Hydrea

Form: Oral capsule
Strengths: 500 mg

Brand: Droxia

Form: Oral capsule
Strengths: 200 mg, 300 mg, 400 mg
Adult dosage (ages 18 years and older)
  • Droxia: The initial dose is 15 mg per kilogram of body weight, taken once per day.
  • Hydrea and generic hydroxyurea is not used for this condition.
Child dosage (ages 0–17 years)

It has not been confirmed that hydroxyurea is safe and effective for use in people younger than 18 years.

Special considerations

People with kidney disease:

  • Droxia: The initial dose is 7.5 mg per kilogram of body weight, taken once per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

If you stop taking the drug suddenly or don’t take it at all

Your cancer cells may divide more rapidly or your sickle cells may change back to their sickle shape. These effects can lead to more serious tumors in people with cancer or more sickle cell crises in people with sickle cell disease.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • mouth sores
  • rash
  • swelling or scaling of your hands and feet
  • darkening of your skin

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.   

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You may not feel any different. If you are taking this drug for cancer, your doctor may check your number of cancer cells. If you are taking this drug for sickle cell disease, your doctor may check the shape of your red blood cells. This information will help your doctor tell if this drug is working.

Hydroxyurea is used for long-term treatment.

Important considerations for taking hydroxyurea
take hydroxyurea with or without food
You can take hydroxyurea with or without food
Do not cut or crush
Do not cut or crush the capsule
storage
Store this drug carefully
See Details
medication is refillable
A prescription for this medication is refillable
See Details
Self-management
Self-management
See Details
Clinical monitoring
Clinical monitoring
See Details
Sun sensitivity
Sun sensitivity
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
Hidden costs
Hidden costs
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prior authorization
Insurance
See Details

Store this drug carefully

  • Keep the hydroxyurea generic at room temperature between 68°F and 77°F (20°C and 25°C). Keep it away from light.
  • Keep Hydrea and Droxia at 77°F (20°C). They can be kept between 59ºF and 86ºF (15ºC and 30ºC) for short periods. Keep them away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Self-management

Hydroxyurea can irritate or damage your skin if they come in contact. Wash your hands before and after handling the capsules or the bottle.

Clinical monitoring

Your doctor will monitor your blood cells. They will check either the number of cancer cells in your body or the shape of your red blood cells. Your doctor may do a complete blood cell count to measure the number of the different types of cells in your blood.

Sun sensitivity

Hydroxyurea can make your skin more sensitive to the sun. This increases your risk of skin cancer. Avoid the sun if you can. If you can’t, be sure to wear protective clothing and apply sunscreen.

Hidden costs

You may need to purchase:

  • Protective gloves to reduce contact between your skin and hydroxyurea
  • Another medication called folic acid, which corrects a potential side effect of hydroxyurea 

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

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How Much Does hydroxyurea Cost?

Oral capsule

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Lowest price for hydroxyurea

Walmart $22.33
Sams Club $22.33
Kroger Pharmacy $27.37
These prices represent the lowest priced national pharmacies for hydroxyurea on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for hydroxyurea on GoodRx. They may be lower than your insurance.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on April 16, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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