From the Research
Hydroxyurea is not commonly associated with hearing loss or ototoxicity as a side effect. While hydroxyurea can cause numerous side effects including bone marrow suppression, gastrointestinal symptoms, skin changes, and neurological effects, hearing problems are not typically listed among its known adverse reactions 1. If a patient taking hydroxyurea experiences hearing changes, it would be considered unusual and should prompt investigation for other causes. The medication works by inhibiting DNA synthesis, primarily affecting rapidly dividing cells, and the mechanisms by which it acts do not typically impact the auditory system.
Key Points to Consider
- Patients taking hydroxyurea should be monitored regularly for its common side effects through blood tests and clinical evaluations, but routine hearing assessments are not standard practice unless the patient reports hearing changes 2.
- If hearing loss occurs while taking hydroxyurea, patients should consult their healthcare provider to determine if the medication is the cause or if another condition is responsible, as hearing loss can have many different etiologies including age-related changes, noise exposure, or other medications known to affect hearing.
- A recent study found that hydroxyurea may be effective in decreasing the frequency of pain episodes and other acute complications in adults and children with sickle cell anaemia of HbSS or HbSβºthal genotypes 3.
- However, there is still insufficient evidence on the long-term benefits of hydroxyurea, particularly with regard to preventing chronic complications of SCD, or recommending a standard dose or dose escalation to maximum tolerated dose.
Important Considerations for Sickle Cell Disease Patients
- Patients with sickle cell disease are at a higher risk of hearing loss, with one study finding that 62% of children with SCD had hearing loss, compared to 50% of children with sickle cell trait 4.
- Routine auditory testing should be done for children with SCD to detect hearing loss before it impacts development.
- The relationship between sickle cell anemia and hearing loss is documented, but little is known about the relationship, and numerous investigations have assessed peripheral auditory sensitivity with a wide disparity of results 5.
Recommendation
Hydroxyurea should not be discontinued or avoided due to concerns about hearing loss, as the evidence suggests that it is not a common side effect of the medication. However, patients taking hydroxyurea should be monitored regularly for its common side effects, and routine hearing assessments should be performed if the patient reports hearing changes.