Hydroxycarbamid Teva (Hydroxycarbamide)

Hydroxycarbamide acts on rapidly dividing cells by inhibiting DNA synthesis, making it useful in several hematologic and oncologic conditions.

• Sickle cell disease: reduces frequency of vaso‑occlusive crises and related pain episodes.
• Chronic myelogenous leukemia: helps achieve cytogenetic remission when combined with targeted therapy.
• Polycythemia vera: lowers elevated red blood cell mass and decreases thrombotic risk.
• Essential thrombocythemia: controls platelet overproduction and reduces clotting complications.
• Melanoma: used as part of combination regimens to limit tumor growth.

• Hydroxycarbamide inhibits ribonucleotide reductase, the key enzyme responsible for converting ribonucleotides to deoxyribonucleotides. This blockade reduces the intracellular pool of deoxyribonucleotides, impairing DNA synthesis and replication in rapidly proliferating cells, leading to cell cycle arrest and apoptosis in malignant or abnormal hematopoietic cells.

Hydroxycarbamide may cause a range of adverse reactions, from mild to severe, that require monitoring during therapy.

Common Side Effects

• Nausea and vomiting: mild to moderate gastrointestinal upset.
• Fatigue: persistent tiredness affecting daily activities.
• Hair thinning or loss: reversible with discontinuation.
• Skin discoloration: darkening of the skin or nails.
• Mild cytopenias: slight reductions in white blood cells or platelets.

Serious or Rare Side Effects

• Severe bone marrow suppression: profound pancytopenia requiring transfusion.
• Acute tumor lysis syndrome: rapid cell breakdown leading to metabolic disturbances.
• Pulmonary hypertension: rare but potentially life‑threatening lung vascular disease.
• Renal impairment: worsening kidney function in susceptible individuals.
• Secondary malignancies: increased risk of developing other cancers with long‑term use.

Before initiating Hydroxycarbamide, clinicians should assess baseline health status and monitor patients regularly.

• Monitor blood counts: perform complete blood count (CBC) weekly during dose escalation.
• Assess renal function: check serum creatinine and adjust dose in renal impairment.
• Evaluate hepatic status: monitor liver enzymes for potential toxicity.
• Counsel on contraception: advise effective birth control for patients of reproductive potential.
• Store at ambient temperature: keep in original container, protect from moisture and direct sunlight.

Hydroxycarbamide can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Azathioprine: additive myelosuppression may lead to severe pancytopenia.
• Live vaccines: increased risk of infection due to immunosuppression.
• Allopurinol: may potentiate hydroxycarbamide toxicity and require dose reduction.

Moderate Interactions (Monitor Closely)

• NSAIDs: can affect renal function, especially in patients with pre‑existing kidney disease.
• Phenytoin: may increase hydroxycarbamide metabolism, reducing therapeutic effect.
• Antacids containing aluminum or magnesium: may decrease absorption if taken simultaneously.