Hydroxycarbamide is a chemotherapy treatment. It is also known as Hydrea. It was once also called Hydroxyurea.
It is a treatment for a number of different cancer types.
You pronounce hydroxycarbamide as hi-drox-ee-car-bo-mide.
How does hydroxycarbamide work?
Hydroxycarbamide is one of a group of chemotherapy drugs known as anti metabolites. These drugs stop cells making and repairing
. Cancer cells need to make and repair DNA in order to grow and multiply.
How do you have hydroxycarbamide?
You have hydroxycarbamide as tablets or capsules.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
How often do you have hydroxycarbamide?
How often you have hydroxycarbamide depends on your cancer type.
You might have hydroxycarbamide as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover.
Or you might have hydroxycarbamide as continuous treatment.
You can have hydroxycarbamide in combination with radiotherapy. When this happens, you usually start taking hydroxycarbamide 7 days before the radiotherapy treatment.
Your doctor can tell you more about how often you will have your treatment.
Tests
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
What are the side effects of hydroxycarbamide?
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Risk of bruising and bleeding
This is due to a
drop in the number of platelets in your blood
. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).Risk of infection
Increased risk of getting an infection
is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathless and looking pale
You might be
breathless and look pale
due to a drop in red blood cells. This is called anaemia.Loss of appetite
You might
lose your appetite
for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.Inflammation of the lining of the gut and bowel
This can cause bleeding from your back passage when pooing and blood in your poo. It can also be very painful. Contact your advice line or tell your doctor or nurse if you have any of these symptoms.
Tummy (abdominal) discomfort or pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Hair loss
You could
lose all your hair
. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.Skin and nail changes
Skin and nail problems
include a skin rash, dry skin, itching and darker skin. Your nails may also become brittle, dry, change colour or develop ridges. This usually goes back to normal when you finish treatment.Sore weak muscles
Your muscles might feel sore, weak and tired especially when climbing stairs, walking or getting out of a chair.
Problems passing urine
You might find it painful and difficult to pass urine. Contact your advice line or tell your doctor or nurse if this happens.
An increased level of certain substances in the blood
You might have an increased level of creatinine, urea and uric acid in the blood. You have regular blood tests to check these.
High temperature
If you get a high temperature, let your healthcare team know straight away. Ask them if you can take paracetamol to help lower your temperature.
Chills
You might feel cold for no apparent reason. Chills can also happen when you have a high temperature
Having no energy or strength
This is usually mild. You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard and eat a well balanced diet.
Talk to your doctor or nurse if this effect is stopping you from doing your usual daily activities.
Feeling or being sick
Feeling or being sick
is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, try eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Diarrhoea or constipation
Tell your healthcare team if you have
diarrhoea or constipation
. They can give you medicine to help.Sore mouth
Mouth sores and ulcers
can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep the mouth moist. Tell your doctor or nurse if you have ulcers.Indigestion
You might have heartburn, which is a burning sensation in the lower chest. The backflow of food and stomach acid from the stomach into the food pipe (oesophagus) causes heartburn.
Your doctor or nurse can prescribe medicine to help.
Inflammation of the pancreas
This drug can cause inflammation of the pancreas (pancreatitis). Tell your doctor straight away if you have sudden and severe pain in your tummy (abdomen).
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- skin cancer - cover up or use sunblock when you go out in the sun. Check your skin regularly, and tell your doctor if you notice any changes to your skin.
- feeling disorientated and having hallucinations
- fits (convulsions), dizziness, headaches and feeling drowsy
- damage to the nerves in your hands and feet causing pain, tingling or numbness
- changes to your lungs included fluid on the lung and inflammation causing shortness of breath
- changes or damage to your liver, including hepatitis
Rare side effects
This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- loss of blood supply to parts of the body (gangrene)
- changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) – you have regular blood tests to check for this
Other side effects
There isn't enough information to work out how often this side effect might happen. People who take hydroxycarbamide as a long term treatment can develop a second cancer (leukaemia). If this is a concern for you, talk to your doctor.
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do you need to know?
Other medicines, food and drink
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
Loss of fertility
You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Hydroxycarbamide can affect the production of sperm. Men might be able to store sperm before starting treatment.
Contraception and pregnancy
This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment.
Women must not become pregnant for at least 6 months after the end of treatment. Men should not father a child for at least a year after treatment.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant while having treatment.
Breastfeeding
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Do not handle the tablets or capsules if you are breastfeeding.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment. For example, if you need treatment for anything else, including teeth problems.
Immunisation
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
recovers from treatment.
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
