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Hydroxyurea Dosage

Applies to the following strength(s): 500 mg ; 200 mg ; 300 mg ; 400 mg ; 1000 mg

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

Usual Adult Dose for Chronic Myelogenous Leukemia

NOTE: Different products have different approved indications. Consult the manufacturer product information for approved indications.

15 mg/kg/day orally

Comments:
-Therapy should be individualized based on tumor type, disease state, response to treatment, patient risk factors, and current clinical practice standards.
-All dosages should be based on patient actual or ideal weight, whichever is less.
-Prophylactic administration of folic acid is recommended.
-Blood counts should be monitored at least once a week during therapy.
-Severe anemia should be corrected before initiating therapy.

Uses:
-Resistant chronic myeloid leukemia (CML)
-Locally advanced squamous cell carcinomas of the head and neck, (excluding lip) in combination with concurrent chemoradiation

Usual Adult Dose for Head and Neck Cancer

NOTE: Different products have different approved indications. Consult the manufacturer product information for approved indications.

15 mg/kg/day orally

Comments:
-Therapy should be individualized based on tumor type, disease state, response to treatment, patient risk factors, and current clinical practice standards.
-All dosages should be based on patient actual or ideal weight, whichever is less.
-Prophylactic administration of folic acid is recommended.
-Blood counts should be monitored at least once a week during therapy.
-Severe anemia should be corrected before initiating therapy.

Uses:
-Resistant chronic myeloid leukemia (CML)
-Locally advanced squamous cell carcinomas of the head and neck, (excluding lip) in combination with concurrent chemoradiation

Usual Adult Dose for Sickle Cell Anemia

NOTE: Different products have different approved indications. Consult the manufacturer product information for approved indications.

Initial dose: 15 mg/kg orally per day; increase 5 mg/kg/day every 12 weeks
Maximum dose: 35 mg/kg/day

Dosing based on blood counts:
-Counts in acceptable range: Increase dose 5 mg/kg/day every 12 weeks to a maximum dose of 35 mg/kg/day (maximal dose is the highest dose that does not produce toxic blood counts over 24 consecutive weeks); increase dosing only if blood counts are in acceptable range; do not increase if myelosuppression occurs
-Counts between acceptable and toxic range: Do not increase dose; if in toxic range, discontinue therapy until hematologic recovery
-Dosing after hematologic recovery: Reduce dose by 2.5 mg/kg/day. Reduce the dose from the dose associated with hematologic toxicity. May titrate up or down every 12 weeks in 2.5 mg/kg/day increments. The patient should be at a stable dose with no hematologic toxicity for 24 weeks. Discontinue treatment permanently if patient develops hematologic toxicity twice.

-BLOOD COUNTS IN THE ACCEPTABLE RANGE:
Neutrophils greater than or equal to 2500 cells/mm3
Platelets greater than or equal to 95,000/mm3
Hemoglobin greater than 5.3 g/dL
Reticulocytes greater than or equal to 95,000/mm3 if the hemoglobin concentration is less than 9 g/dL
-BLOOD COUNTS IN THE TOXIC RANGE:
Neutrophils less than 2000 cells/mm3
Platelets less than 80,000/mm3
Hemoglobin less than 4.5 g/dL
Reticulocytes less than 80,000/mm3 if the hemoglobin concentration is less than 9 g/dL

Comments:
-Dosage is based on the actual or ideal patient weight, whichever is less.
-The patient blood count should be monitored every 2 weeks.
-Fetal hemoglobin (HbF) levels may be used to evaluate the efficacy of therapy in clinical use. Obtain HbF levels every 3 to 4 months. Monitor for an increase in HbF of at least 2-fold over the baseline value.
-Prophylactic administration of folic acid is recommended.

Use: To reduce the frequency of painful crises and to reduce the need for blood transfusions in patients with sickle cell anemia with recurrent moderate to severe painful crises.

Renal Dose Adjustments

-CrCl 60 mL/minute or greater: Initial dose: 15 mg/kg/day
-CrCl less than 60 mL/minute or end stage renal disease (ESRD): Initial dose: 7.5 mg/kg/day

Liver Dose Adjustments

Data not available; however, caution is recommended.

Dose Adjustments

-Concurrent use of this drug with other myelosuppressive agents may require adjustment of dosages.
-Although no specific dose adjustment guidelines have been suggested, elderly patients may require a lower dose of this drug.

Precautions

US BOXED WARNINGS:
-MYELOSUPPRESSION: This drug may cause severe myelosuppression. Blood counts should be monitored at baseline and throughout treatment. Treatment should be interrupted and the dose should be reduced as necessary.
MALIGNANCIES: This drug is carcinogenic. Patients should use sun protection and be monitored for malignancies.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis: Administer the dose following hemodialysis.

Other Comments

Administration advice:
-All dosage should be based on the patient's actual or ideal weight, whichever is less.
-The contents of capsules may be emptied into a glass of water and administered immediately. The contents of the capsule should not be inhaled or allowed to come into contact with the skin or mucous membranes.

General:
-Different individual products are used for specific indications. The manufacturer product information should be consulted prior to using a product.

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