Hydroxyurea

Hydroxyurea

Drug monograph · NCLEX study reference
Trade names	Hydrea, Droxia
Therapeutic class	Antisickling agent, antineoplastic
Pharmacologic class	Ribonucleotide reductase inhibitor
Onset / peak / duration	Hematologic effect over weeks to months.
Half-life / level	Variable; monitor CBC.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Supportive care; hold for low counts.
Pregnancy / lactation	Contraindicated in pregnancy.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Hydroxyurea (brand names Hydrea, Droxia) — Antisickling agent, antineoplastic; Ribonucleotide reductase inhibitor.

Identification

• Therapeutic class: Antisickling agent, antineoplastic.
• Pharmacologic class: Ribonucleotide reductase inhibitor.

Pharmacology

• Mechanism of action: Increases fetal hemoglobin to reduce sickling; also cytotoxic.
• Onset / peak / duration: Hematologic effect over weeks to months.
• Half-life / therapeutic level: Variable; monitor CBC.

Clinical use

• Indications: Sickle cell disease (reduces crises), certain myeloproliferative disorders.
• Usual dose, route, frequency: PO once daily, titrated.
• Maximum dose / adjustments: Dose by blood counts; reduce in renal impairment.

Safety

• Contraindications: Severe bone marrow suppression, pregnancy.
• Black box warning: Myelosuppression and carcinogenicity (handle as a hazardous drug).
• Interactions: Other myelosuppressive drugs, certain antiretrovirals.
• Pregnancy / lactation: Contraindicated in pregnancy.
• High-alert: No.

Adverse effects

• Common side effects: Myelosuppression, GI upset, skin and nail changes.
• Serious effects to report: Severe neutropenia or thrombocytopenia, leg ulcers, infection.
• Antidote / reversal: Supportive care; hold for low counts.

Nursing process

• Assessment before administration: CBC, renal function, pregnancy status.
• Interventions during therapy: Handle with gloves (hazardous drug); monitor counts; encourage hydration.
• Monitor: CBC regularly, renal function, signs of infection.
• Evaluation / expected outcome: Fewer sickle cell crises.

Patient teaching

• Patient teaching: Wear gloves to handle (or wash hands well); use contraception; report fever or infection.
• Notify provider if: Fever, sore throat, unusual bruising, leg sores.
• Administration tips: Hazardous-drug handling precautions; consistent daily dosing.