Is hydroxyurea a natural substance?

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Last updated: July 19, 2025View editorial policy

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Hydroxyurea is Not a Natural Substance

Hydroxyurea is a synthetic antimetabolite drug, not a natural substance. 1 It is a chemotherapeutic agent that has been used for over 30 years in the treatment of certain cancers, hematologic conditions, and sickle cell disease. 1

Chemical Nature and Development

Hydroxyurea (also known as hydroxycarbamide) is a synthetic compound that:

  • Functions as an antimetabolite that inhibits DNA replication 1
  • Is manufactured pharmaceutically rather than extracted from natural sources
  • Is available in various formulations including capsules, fast-dissolving tablets, or compounded liquid 1

Medical Applications

Hydroxyurea has several important clinical applications:

  • Treatment of psoriasis (though not FDA-approved for this indication) 1
  • First-line disease-modifying therapy for sickle cell disease, particularly for HbSS and Sβ0-thalassemia genotypes 1, 2
  • Management of certain myeloproliferative neoplasms 1

Mechanism of Action

The drug works through several mechanisms:

  • In sickle cell disease, it increases fetal hemoglobin (HbF) production, which helps prevent sickling of red blood cells 1, 2
  • In psoriasis, it inhibits DNA replication, affecting rapidly dividing cells 1
  • Causes mild myelosuppression, which is monitored during therapy 1

Dosing and Administration

Hydroxyurea is administered as a synthetic pharmaceutical product:

  • For psoriasis: Initial dose of 500 mg PO twice daily, potentially increasing to up to 3 g/day as tolerated 1
  • For sickle cell disease: Typically taken once daily orally, with dosing based on patient response and monitoring of blood counts 1

Safety Considerations

As a synthetic medication, hydroxyurea requires careful monitoring:

  • Regular blood count monitoring is essential (CBC with differential) 1
  • Potential side effects include bone marrow suppression, gastrointestinal symptoms, and dermatologic reactions 1
  • Pregnancy category D - should be avoided during pregnancy and breastfeeding 1

Common Misconception

A common misconception might be confusing hydroxyurea with natural compounds due to its name containing "urea" (which can be found naturally). However, hydroxyurea is entirely synthetic and manufactured as a pharmaceutical product, not extracted or derived from natural sources.

The evidence clearly establishes that hydroxyurea is a synthetic pharmaceutical agent developed for medical use, not a natural substance found in nature.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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