Hydroxyurea Dosage

This dosage information may not include all the information needed to use Hydroxyurea safely and effectively. See additional information for Hydroxyurea.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Solid Tumors

Solid Tumors:
Intermittent Therapy: 80 mg/kg administered orally as a single dose every third day.

Continuous Therapy: 20 to 30 mg/kg administered orally as a single dose daily.

Concomitant Therapy with Irradiation: Carcinoma of the head and neck: 80 mg/kg administered orally as a single dose every third day.

Administration of hydroxyurea should be begun at least seven days before initiation of irradiation and continued during radiotherapy as well as indefinitely afterwards provided that the patient may be kept under adequate observation and there is no evidence of unusual or severe reactions.

Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures such as topical anesthetics and orally administered analgesics. If the reaction is severe, hydroxyurea therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed. However, it has rarely been necessary to terminate these therapies.

Severe gastric distress, such as nausea, vomiting, and anorexia, resulting from combined therapy may usually be controlled by temporary interruption of hydroxyurea administration.

Usual Adult Dose for Sickle Cell Anemia

Initial Dose: 15 mg/kg (10-20 mg/kg) once a day. The dose may be increased in 5 mg/kg/day increments every 12 weeks to a maximum dose of 35 mg/kg/day.

Usual Adult Dose for Chronic Myelogenous Leukemia

Resistant Chronic Myelocytic Leukemia: Until the intermittent therapy regimen has been evaluated, continuous therapy at 20 to 30 mg/kg administered orally as a single dose daily is recommended.

An adequate trial period for determining the antineoplastic effectiveness of hydroxyurea is six weeks of therapy. When there is regression in tumor size or arrest in tumor growth, therapy should be continued indefinitely.

Therapy should be interrupted if the white blood cell count drops below 2500/mm3, or the platelet count below 100,000/mm3. In these cases, the counts should be rechecked after three days, and therapy resumed when the counts rise significantly toward normal values. Since the hematopoietic rebound is prompt, it is usually necessary to omit only a few doses. If prompt rebound has not occurred during combined hydroxyurea tablets and irradiation therapy, irradiation may also be interrupted. However, the need for postponement of irradiation has been rare. Radiotherapy has usually been continued using the recommended dosage and technique. If severe anemia occurs, it should be corrected without interrupting hydroxyurea therapy. Because hematopoiesis may be compromised by extensive irradiation or by other antineoplastic agents, it is recommended that hydroxyurea be administered cautiously to patients who have recently received extensive radiation therapy or chemotherapy with other cytotoxic drugs.

Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures such as topical anesthetics and orally administered analgesics. If the reaction is severe, hydroxyurea therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed. However, it has rarely been necessary to terminate these therapies.

Severe gastric distress, such as nausea, vomiting, and anorexia, resulting from combined therapy may usually be controlled by temporary interruption of hydroxyurea administration.

Renal Dose Adjustments

Renal Dose Adjustments for Adults:

Sickle cell anemia:
CrCl 60 mL/minute or Greater: Initial dose: 15 mg/kg/day
CrCl Less than 60 mL/minute: Reduce initial dose to 7.5 mg/kg/day

Other indications:
CrCl 10 to 50 mL/minute: 50% of normal dose
CrCl Less than 10 mL/minute: 20% of normal dose

Liver Dose Adjustments

There are no data that support specific guidance for dosage adjustment in patients with hepatic impairment. Close monitoring of hematologic parameters is advised.

Dose Adjustments

Concurrent use of hydroxyurea with other myelosuppressive agents may require adjustment of dosages.

Precautions

Elderly patients may be more sensitive to the effects of hydroxyurea, and may require a lower dose regimen.

Dialysis

Dialysis Dose Adjustments for Adults:

Sickle cell anemia:
Hemodialysis: Reduce initial dose to 7.5 mg/kg/dose and administer following hemodialysis (titrate dose to response and toxicity avoidance)

Other indications:
Hemodialysis: Administer the dose following hemodialysis.

Other Comments

All dosage should be based on the patient's actual or ideal weight, whichever is less.

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