Hydroxyurea

Hydroxyurea in sickle cell disease: Recommendations of use.

We’ve enjoyed three articles about hydroxyurea so far. Let’s summarize the recommendations for the administration of hydroxyurea alias Hydroxycarbamide. 

These are;

  1. Educate all patients with SCA and their family members about hydroxyurea therapy. 
  2. In adults with SCA who have three or more sickle cell-associated moderate to severe pain crises in 12 months, treat with Hydroxycarbamide.
  3. In adults with SCA who have sickle cell-associated pain that interferes with daily activities and quality of life, administer Hydroxycarbamide.
  4. In adults with SCA who have a history of severe or recurrent ACS, treat with hydroxyurea.
  5. In adults with SCA who have severe symptomatic chronic anaemia that interferes with daily activities or quality of life, administer Hydroxycarbamide.
  6. In patients with SCA, from 9 months of age and older, offer treatment with hydroxyurea regardless of clinical severity to reduce SCD-related complications.

Note: The panel intentionally used the term “offer” realizing that patients’ values and preferences may differ particularly considering the treatment burden (e.g., laboratory monitoring, office visits), availability of the drug in a liquid form, and cost. Therefore, the panel strongly encourages shared decision making and discussion of hydroxyurea therapy with all patients.

Related article: Hydroxyurea in sickle cell disease: What You Need To Know: Part 1

  1. You can add hydroxyurea in adults and children with SCD who have CKD and are taking erythropoietin. It will improve anaemia.
  2. In females who are pregnant or breastfeeding, discontinue hydroxyurea therapy.
  3. To ensure proper use of Hydroxycarbamide and maximize benefits and safety, use an established prescribing and monitoring protocol.
  4. In people with HbS β+-thalassemia or HbSC who have recurrent sickle cell-associated pain that interferes with daily activities or quality of life, consult a sickle cell expert for consideration of Hydroxycarbamide therapy.
  5. In people not demonstrating a clinical response to appropriate doses and duration of Hydroxycarbamide therapy, consult a sickle cell expert.

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