Hydroxyurea (Hydrea)
General information
Class/mechanism: Exact mechanism unclear, but data suggests that hydroxyurea inhibits DNA synthesis by inhibiting ribonucleotide reductase, which inhibits cancer cell growth. May sensitize tumors to radiation by keeping cells in the G1 phase of the cell cycle, where they are most vulnerable to radiation, and/or by interfering with DNA repair processes. Does not appear to affect RNA and protein synthesis.[1][2]
Route: PO
Extravasation: n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is used
- Acute myeloid leukemia
- Acute promyelocytic leukemia
- Cervical cancer
- Chronic myeloid leukemia
- Essential thrombocythemia
- Glioblastoma
- Head and neck cancer
- Hypereosinophilic syndrome
- Myelofibrosis
- Polycythemia vera
- Sickle cell anemia
Diseases for which it was used
Patient drug information
- Brief patient counseling information can be found in the Hydroxyurea (Hydrea) package insert[1]
- Hydroxyurea (Hydrea) patient drug information (Chemocare)[3]
- Hydroxyurea (Hydrea) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 1967-12-07: Initial FDA approval
- Uncertain date: Approved for the treatment of resistant chronic myeloid leukemia. (Based on Koller & Miller 1986)
- Uncertain date: Approved for the treatment of locally advanced squamous cell carcinomas of the head and neck (excluding the lip) in combination with chemoradiation. (No supporting studies are cited)
- 2017-12-21: Granted regular FDA approval (as Siklos) to reduce the frequency of painful crises and the need for blood transfusions in pediatric patients from 2 years of age and older with sickle cell anemia with recurrent moderate to severe painful crises.
History of changes in EMA indication
- 1967-12-07: EURD
History of changes in PMDA indication
- 2013-03-25: New additional indications for the treatment of essential thrombocythemia and polycythemia vera.
Also known as
- Generic names: dhnp, hidroxiurea, hydroxycarbam, hydroxycarbamid, hydroxycarbamide
- Brand names: Biosupressin, Cytodrox, Droxia, Droxiurea, Durea, Hidrea, Hondrea, Hydab, Hydrea, Hydrine, Hydrourea, Hytas, Litalir, Myelostat, Mylocel, Neodrea, Onco Carbide, Siklos, Syrea, Ureax, Xromi
References
- Drugs
- Oral medications
- Human DNA synthesis inhibitors
- Acute myeloid leukemia medications
- Acute promyelocytic leukemia medications
- Cervical cancer medications
- Chronic myeloid leukemia medications
- Essential thrombocythemia medications
- Glioblastoma medications
- Head and neck cancer medications
- Hypereosinophilic syndrome medications
- Myelofibrosis medications
- Polycythemia vera medications
- Sickle cell anemia medications
- Melanoma medications (historic)
- FDA approved in 1967
- EMA approved in 1967
- WHO Essential Cancer Medicine