Hydroxycarbamid Devatis (Hydroxycarbamide)

Hydroxycarbamide is employed in hematologic disorders that involve abnormal cell proliferation or sickling of red blood cells.

• Sickle cell disease: reduces frequency of painful vaso‑occlusive crises and lowers need for blood transfusions.
• Chronic myelogenous leukemia: helps achieve cytogenetic remission when used in combination with other agents.
• Polycythemia vera: controls elevated red blood cell mass and decreases risk of thrombosis.
• Essential thrombocythemia: lowers platelet counts and reduces thrombotic complications.

• Hydroxycarbamide inhibits ribonucleotide reductase, the enzyme responsible for converting ribonucleotides to deoxyribonucleotides. This restriction limits the intracellular pool of deoxyribonucleotides, suppressing DNA synthesis and repair. The resulting decrease in cell proliferation particularly affects rapidly dividing hematopoietic cells, providing therapeutic benefit in myeloproliferative disorders and sickle cell disease.

Hydroxycarbamide may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea and vomiting: gastrointestinal upset occurring early in therapy.
• Alopecia: temporary hair thinning or loss.
• Skin hyperpigmentation: darkening of the skin, especially on the face and hands.
• Mild neutropenia or anemia: modest reductions in white or red blood cells.

Serious or Rare Side Effects

• Severe bone marrow suppression: profound pancytopenia requiring transfusion or treatment interruption.
• Hepatic toxicity: elevated liver enzymes or hepatitis.
• Renal impairment: acute kidney injury or worsening of pre‑existing renal disease.
• Cutaneous ulceration or necrosis: painful skin ulcers, particularly on the lower legs.

When prescribing hydroxycarbamide, clinicians should observe several safety measures.

• Blood count monitoring: perform complete blood counts regularly to detect myelosuppression.
• Renal function assessment: evaluate serum creatinine before initiation and periodically during therapy.
• Hepatic function assessment: monitor liver enzymes for signs of toxicity.
• Pregnancy risk: avoid use during pregnancy unless benefits outweigh risks; discuss contraception.
• Drug interactions: review concomitant medications for potential additive myelosuppressive effects.
• Store at below 25°C: keep in the original container, protect from moisture and direct sunlight.

Hydroxycarbamide can interact with other medicines, altering its safety profile.

Major Interactions (Avoid)

• Concurrent myelosuppressive chemotherapy: may cause excessive bone marrow suppression.
• Zidovudine (AZT): combined use can intensify hematologic toxicity.

Moderate Interactions (Monitor Closely)

• Allopurinol: may increase hydroxycarbamide plasma levels.
• Penicillins and sulfonamides: can enhance myelosuppression.
• Live vaccines: reduced efficacy and increased risk of infection.