What are the associations between Hydroxyurea (Hydroxycarbamide) and vertigo or dizziness?

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From the Guidelines

Hydroxyurea can cause vertigo and dizziness as side effects, though these are not among the most common adverse reactions. Patients taking hydroxyurea for conditions like sickle cell disease, polycythemia vera, or certain cancers may experience these symptoms as part of a broader spectrum of neurological side effects. If you're experiencing dizziness or vertigo while taking hydroxyurea, you should report these symptoms to your healthcare provider rather than discontinuing the medication on your own. Your doctor might consider adjusting your dosage, which typically ranges from 500 mg to 3 g per day as tolerated 1, or implementing supportive measures to manage these symptoms. The dizziness may be related to hydroxyurea's effects on blood cell production or its impact on blood pressure regulation. Staying well-hydrated and changing positions slowly (from lying to sitting to standing) may help minimize these symptoms. Other more common side effects of hydroxyurea include bone marrow suppression, gastrointestinal disturbances, and skin changes, so regular blood monitoring is essential while on this medication.

Some key points to consider when taking hydroxyurea include:

  • Monitoring for signs of bone marrow suppression, such as leukopenia, thrombocytopenia, or anemia 1
  • Reporting any symptoms of dizziness or vertigo to your healthcare provider
  • Staying well-hydrated to minimize the risk of dizziness and other side effects
  • Regular blood monitoring to check for signs of bone marrow suppression and other side effects
  • Potential interactions with other medications, such as myelosuppressive agents or radiation therapy, which may increase the risk of bone marrow depression 1

It's also important to note that hydroxyurea has been shown to be beneficial in reducing the frequency of painful crises and other complications in patients with sickle cell disease 1. However, the decision to start or continue hydroxyurea therapy should be made on an individual basis, taking into account the potential benefits and risks of the medication.

In terms of management, the American Society of Hematology recommends offering hydroxyurea to every child with HbSS or Sb0-thalassemia at 9 months of age, even without clinical symptoms 1. The dosage and administration of hydroxyurea may vary depending on the individual patient and their condition, and regular monitoring is necessary to minimize the risk of side effects.

Overall, while hydroxyurea can cause vertigo and dizziness as side effects, these symptoms can often be managed with supportive measures and dosage adjustments. The benefits of hydroxyurea therapy in reducing the frequency of painful crises and other complications in patients with sickle cell disease make it an important treatment option for many patients.

From the Research

Hydroxyurea Side Effects: Vertigo or Dizziness

  • There is no direct mention of vertigo or dizziness as side effects of hydroxyurea in the provided studies 2, 3, 4, 5, 6.
  • The studies primarily focus on the efficacy and safety of hydroxyurea in treating sickle cell disease, with reported side effects including impaired spermatogenesis 6 and potential effects on fertility and reproduction 3.
  • However, the studies do not provide comprehensive information on all possible side effects of hydroxyurea, including vertigo or dizziness.
  • It is essential to consult the prescribing information or a healthcare professional for a complete list of potential side effects associated with hydroxyurea treatment.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hydroxyurea therapy for sickle cell anemia.

Expert opinion on drug safety, 2015

Research

Hydroxyurea (hydroxycarbamide) for sickle cell disease.

The Cochrane database of systematic reviews, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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