Characteristic | Hydroxyurea |
Drug class | Antimetabolite |
Mechanism of action | Not genotoxic, impairs DNA repair by inhibiting ribonucleotide reductase, increases HbF production |
Specificity | Affects all cell lines |
Pharmacology | Half-life 4 hours; 40% renally excreted, 60% metabolized |
Starting dose | 15 to 20 mg/kg per day orally for routine treatment of MPNs or sickle cell disease; 50 to 100 mg/kg per day orally for treatment of hyperleukocytosis |
Onset of action | 3 to 5 days for routine treatment of MPNs; weeks, up to 6 months, for treatment of sickle cell disease; 1 to 2 days for hyperleukocytosis |
Side effects observed in >10% of patients | Neutropenia, anemia, oral ulcers, mild gastrointestinal upset, hyperpigmentation, rash, nail changes |
Side effects observed in ≤10% of patients | Ankle ulcers, lichen planus-like lesions of the mouth and skin, nausea, diarrhea |
Rare side effects | Fever, liver function test abnormalities |
Contraindications | Severe bone marrow suppression (eg, neutropenia, thrombocytopenia); pregnancy, attempted conception, breast feeding |
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