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Hydroxycarbamide
See also Cytotoxic and immunosuppressant drugs
General information
Hydroxycarbamide (hydroxyurea) is used to treat a variety of cancers, myeloproliferative disorders, and sickle cell disease, and has been studied in patients with HIV infection [ ]. It inhibits ribonucleotide reductase and increases concentrations of iron nitrosyl hemoglobin, nitrite, and nitrate, suggesting in vivo metabolism of hydroxycarbamide to nitric oxide [ ].
Organs and systems
Hematologic
Concern about the toxicity of hydroxycarbamide, expressed in a report from the AIDS Clinical Trials Group, led to a retrospective study of hydroxycarbamide in combination with didanosine [ ]. Hematological adverse events were the most frequent and involved 37 of the 65 patients. Neutropenia was the commonest adverse event (26 patients) and it was occasionally accompanied by anemia or thrombocytopenia. However, these effects normalized spontaneously, despite continued therapy.
Of 16 children receiving hydroxycarbamide in combination with nucleoside analogues, four developed neutropenia (below 1.5 × 10 9 /l) by weeks 2 or 4 [ ]. Hydroxycarbamide was temporarily withdrawn and then reintroduced without further ill effects after the neutrophil count had returned to normal.
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