Hydroxycarbamide is also known as Hydrea®. It is used to treat chronic myeloid leukaemia (CML), myeloproliferative disorders, and other cancers, such as cervical cancer.
Hydroxycarbamide is used to treat blood cancers such as chronic myeloid leukaemia (CML) and the following myeloproliferative disorders:
It may sometimes be used to treat other cancers, such as cervical cancer.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
During treatment, you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse, or pharmacist in this information.
While you are having this treatment, you will have regular blood tests. These are done to check that your blood cells are at a safe level for you to have chemotherapy.
You will see a doctor or nurse before and during chemotherapy. They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy.
Your course of chemotherapy
Hydroxycarbamide comes in capsules, so you can take it at home.
How often you take the capsules, and how long you take them for, will depend on the type of cancer you have. If you have a blood cancer, you might take hydroxycarbamide capsules every day. Your nurse or doctor will discuss your treatment plan with you. They may give you a copy of the treatment plan to take home with you.
The nurse or pharmacist will give you the capsules to take home. Always take them exactly as explained. This is important to make sure they work as well as possible for you.
Your nurse or pharmacist may also give you anti-sickness drugs and other medicines to take home. Take all your capsules and tablets exactly as the nurse or pharmacist explains to you.
Taking hydroxycarbamide capsules
Take the capsules at the same time every day. Tell your doctor, nurse or pharmacist if you have difficulties swallowing the capsules. They can give you advice.
If you forget to take the capsules, you should take the missed dose as soon as possible within the same day. If a full day has gone by, tell your doctor or nurse. Do not take a double dose unless your doctor tells you to.
Other things to remember about your capsules:
- Wash your hands after taking them.
- Other people should avoid direct contact with your chemotherapy drugs.
- Keep them in the original package at room temperature, away from heat and direct sunlight.
- Keep them safe and out of sight and reach of children.
- If you are sick just after taking the capsules, contact the hospital. Do not take another dose.
- If your treatment is stopped, return any unused capsules to the pharmacist.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Risk of infection
This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is sometimes called neutropenia.
An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. Contact the hospital straight away on the 24-hour contact number you have been given if:
- your temperature goes over 37.5°C (99.5°F)
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection
- your temperature goes below 36°C (96.8°F).
Symptoms of an infection include:
- feeling shivery and shaking
- a sore throat
- a cough
- needing to pass urine (pee) a lot, or discomfort when you pass urine.
It is important to follow any specific advice your cancer treatment team gives you.
The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time, until your cell count increases.
Bruising and bleeding
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.
If the number of platelets is low, you may bruise or bleed easily. You may have:
- bleeding gums
- heavy periods
- blood in your urine (pee) or stools (poo)
- tiny red or purple spots on the skin that may look like a rash.
Tell your doctor if you have any unexplained bruising or bleeding. You may need a drip to give you extra platelets. This is called a platelet transfusion.
Anaemia (low number of red blood cells)
This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:
- pale skin
- lack of energy
- feeling breathless
- feeling dizzy and light-headed.
Tell your doctor or nurse if you have these symptoms.
If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.
You may feel sick during this treatment. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.
If you feel sick, take small sips of fluids and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital straight away. They will give you advice and may change the anti-sickness drug to one that works better for you.
Loss of appetite
This treatment can affect your appetite. Do not worry if you do not eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.
This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.
If you have diarrhoea:
- try to drink at least 2 litres (3½ pints) of fluids each day
- avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
- contact the hospital for advice.
This treatment can cause constipation. Constipation means that you are not able to pass stools (poo) as often as you normally do. It can become difficult or painful. Here are some tips that may help:
- Drink at least 2 litres (3½ pints) of fluids each day.
- Eat high-fibre foods, such as fruit, vegetables and wholemeal bread.
- Do regular gentle exercise, like going for short walks.
If you have constipation, contact the hospital for advice. Your doctor can give you drugs called laxatives to help.
This treatment can cause tummy pain and indigestion. It can also cause inflammation of the pancreas, but this is rare. Tell your nurse or doctor if you have pain in your tummy (abdomen).
Sore mouth and throat
This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.
If your mouth or throat is sore:
- tell your nurse or doctor – they can give you a mouthwash or medicines to help
- try to drink plenty of fluids
- avoid alcohol, tobacco, and foods that irritate your mouth and throat.
Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.
Feeling tired is a common side effect of this treatment. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy.
If you feel sleepy, do not drive or use machinery.
Your hair may get thinner. But you are unlikely to lose all the hair from your head. Hair loss usually starts after your first or second treatment. It is almost always temporary, and your hair will usually grow back after treatment finishes. Your nurse can talk to you about ways to cope with hair loss.
This treatment may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Your skin may also darken. It will return to its normal colour after you finish treatment. If you have had radiotherapy, either recently or in the past, the area that was treated may become red or sore.
Taking hydroxycarbamide for a long time can increase your risk of developing skin cancer. It is important to protect your skin by:
- avoiding being out in the sun
- using sunscreen
- wearing protective clothing and a hat.
Your doctor or nurse can give you more advice. They can also tell you about skin changes to look out for.
Always tell your doctor or nurse about any changes to the skin. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
If you take hydroxycarbamide for a long time, you may get ulcers on your legs and feet. Tell your doctor if you notice a break in the skin of your leg or foot. Your treatment may need to be adjusted. Leg and foot ulcers usually get better after treatment finishes.
This treatment can affect your nails. They may grow more slowly or break more easily. You might notice ridges or white or dark lines across your nails. Sometimes nails can become loose or fall out. When treatment finishes, any changes usually disappear as the nails grow out.There are things you can do to look after your nails:
- Moisturise your nails and cuticles regularly.
- Keep your nails clipped short.
- Wear gloves to protect your nails when you are doing things in the house or garden.
- Keep your hands and nails clean to help avoid infection, but avoid bathing in very hot water.
- Do not use false nails, gels or other acrylics during this treatment, as they may increase the risk of infection.
- It is fine to wear nail varnish, but try to use a water-based polish. Avoid using harsh chemicals, such as acetone, when taking off the polish.
- If your toenails are affected, wear well-fitted shoes to cushion them.
Tell your doctor or nurse if you notice changes to your nails. They can give you advice or arrange for you to see a podiatrist for foot care advice if needed.
Numb or tingling hands or feet (peripheral neuropathy)
This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks.
Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.
This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.
Changes in the way the liver and kidneys work
Hydroxycarbamide can affect how your liver and kidneys work. This is usually mild and goes back to normal after treatment.
You will have blood tests before, during, and after chemotherapy to check how well your kidneys and liver are working.
Problems passing urine (peeing)
Hydroxycarbamide may cause problems with passing urine. Tell your doctor or nurse straight away if you have pain or difficulty peeing.
Raised levels of uric acid (tumour lysis syndrome)
This treatment may cause the cancer cells to break down quickly. This releases uric acid (a waste product) into the blood. The kidneys usually get rid of uric acid, but may not be able to cope with large amounts. Too much uric acid can cause swelling and pain in the joints, which is called gout.
Your doctor may give you allopurinol (Zyloric®) tablets to help prevent this. Drinking at least 2 litres (3½ pints) of fluid a day will also help. You will have regular blood tests to check the uric acid levels.
Effects on the nervous system
Hydroxycarbamide can affect the nervous system. You may feel:
Very rarely, hydroxycarbamide can cause seizures (fits).
Tell your doctor or nurse straight away if you notice any of these symptoms. It is important not to drive or operate machinery if you have these symptoms.
Effects on the lungs
This treatment can cause changes to the lungs. Tell your doctor if you develop:
- a cough
You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.
Rarely, hydroxycarbamide can cause an allergic reaction. Signs of a reaction can include:
- a rash
- feeling itchy
- feeling short of breath
- swelling of your face or lips
- feeling unwell.
Tell your nurse straight away if you have any of these symptoms. If you develop any of these symptoms after you get home, contact the hospital straight away, or go to the nearest accident and emergency (A&E) department.
Rarely, hydroxycarbamide can increase the risk of developing a second cancer years later. But the benefits of treatment usually far outweigh this risk. Your doctor can talk to you about this.
It is important to tell your doctor straight away if you feel unwell or have any severe side effects, even if they are not mentioned here.
You may have hydroxycarbamide to treat conditions other than cancer. The dose is usually much lower than when it is used to treat cancer. This means you may not have the side effects we mention.
Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
- throbbing pain, redness or swelling in a leg or arm
- suddenly feeling breathless or coughing
- sharp chest pain, which may be worse when you cough or take a deep breath.
If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.
A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.You can help reduce the risk of developing a blood clot by:
- staying active during treatment
- drinking plenty of fluids, especially water.
You may be given anticoagulants to help prevent a clot.
Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:
- medicines you have been prescribed
- medicines you buy in a shop or chemist
- vitamins, herbal drugs and complementary therapies.
Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.
You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.
Problems with lactose
These tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest some sugars or are lactose intolerant, talk to your doctor before taking this drug.
Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.
Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations.
If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines, such as shingles, contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.
Your doctor will advise you not to become pregnant or father a child while having this treatment. The drugs may harm a developing baby. It is important to use effective contraception during, and for a few months after, treatment. You can talk to your doctor or nurse about this.
If you have sex during a course of chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.
Changes to your periods
This treatment can sometimes stop the ovaries working. You may not get a period every month and they may stop. For some women, this is temporary and the ovaries start working again. For some women, this is permanent and they start menopause early.
Women are advised not to breastfeed while having this treatment. This is because the drugs could be passed to the baby through breast milk.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.