Does hydroxyurea cause diarrhea?

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Last updated: June 30, 2025View editorial policy

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From the Guidelines

Hydroxyurea can cause diarrhea as a side effect, as evidenced by the most recent and highest quality study available 1.

Key Points to Consider

  • The incidence of diarrhea with hydroxyurea is generally reported to be less than 10% of patients.
  • If diarrhea occurs, it's often mild to moderate in severity and may improve with continued use as the body adjusts to the medication.
  • However, if diarrhea becomes severe, persistent, or is accompanied by signs of dehydration, patients should contact their healthcare provider promptly.
  • The mechanism behind hydroxyurea-induced diarrhea likely relates to its effects on rapidly dividing cells, including those lining the gastrointestinal tract, as hydroxyurea works by inhibiting DNA synthesis in actively dividing cells.

Management and Monitoring

  • Patients taking hydroxyurea should be monitored for signs of gastrointestinal toxicity, including diarrhea, nausea, vomiting, and loss of appetite.
  • The dosage of hydroxyurea may need to be adjusted if gastrointestinal side effects become severe or intolerable.
  • Patients should be advised to contact their healthcare provider if they experience any severe or persistent side effects while taking hydroxyurea.

Conclusion Not Applicable - Direct Answer Only

As per the guidelines and evidence provided, the focus is on the direct answer to the question, prioritizing morbidity, mortality, and quality of life as outcomes. Therefore, the management and monitoring of hydroxyurea-induced diarrhea should be tailored to the individual patient's needs and medical history, with a focus on minimizing adverse effects while maintaining therapeutic efficacy, as supported by the highest quality evidence available 1.

From the Research

Hydroxyurea and Diarrhea

There is limited information available on the specific topic of hydroxyurea causing diarrhea. However, some studies provide insight into the gastrointestinal side effects associated with hydroxyurea:

  • Hydroxyurea is known to cause ulcers in the gastrointestinal tract, including the ileocecal valve 2.
  • The pathophysiology of non-oral gastrointestinal ulceration related to hydroxyurea is unclear, but withdrawal of the drug typically leads to complete resolution 2.
  • While diarrhea is not explicitly mentioned in the available studies, the occurrence of ulcers and other gastrointestinal issues suggests that hydroxyurea may have adverse effects on the gastrointestinal system.
  • Other side effects of hydroxyurea include oral ulcers, skin hyperpigmentation, atrophic lesions, longitudinal melanonychia, cutaneous xerosis, ichthyosis, and auricular spinocellular carcinoma 3, 4, 5.
  • It is essential to note that the available studies do not directly address the question of whether hydroxyurea causes diarrhea, but they do indicate that the drug can cause other gastrointestinal and mucocutaneous adverse effects 2, 6, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hydroxyurea-induced oral ulceration.

Oral surgery, oral medicine, oral pathology and oral radiology, 2015

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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