From the Guidelines
Yes, Hydrea (hydroxyurea) can cause bleeding as a side effect, particularly due to its effect on platelet count, as noted in the NCCN guidelines insights: myeloproliferative neoplasms, version 2.2018 1. This medication, commonly used to treat certain cancers, sickle cell disease, and polycythemia vera, works by suppressing bone marrow function, which can lead to decreased production of blood cells including platelets. When platelet counts drop (thrombocytopenia), bleeding risk increases because platelets are essential for normal blood clotting. Some key points to consider include:
- Patients taking Hydrea may experience symptoms such as easy bruising, nosebleeds, bleeding gums, blood in urine or stool, or unusual vaginal bleeding.
- The risk of bleeding typically increases with higher doses and longer treatment duration.
- Regular blood tests are necessary while taking Hydrea to monitor blood cell counts, and patients should promptly report any unusual bleeding to their healthcare provider.
- Dose adjustments or temporary discontinuation may be needed if significant bleeding occurs, as outlined in guidelines such as those from the NCCN 1 and other studies 1.
- Patients should also avoid activities with high injury risk and use caution with medications that might increase bleeding risk, such as aspirin or NSAIDs, unless specifically directed by their doctor. It's also worth noting that while hydroxyurea can increase the risk of bleeding, it is also effective in reducing the risk of thrombotic complications in patients with polycythemia vera, as shown in studies like the ECLAP study 1.
From the FDA Drug Label
Advise patients to report signs and symptoms of infection or bleeding immediately [see Warnings and Precautions (5. 1)]. Yes, hydrea can cause bleeding. Patients taking hydroxyurea capsules should be advised to report signs and symptoms of bleeding immediately 2.
- Key points:
- Hydrea (hydroxyurea) may cause myelosuppression, which can lead to bleeding.
- Patients should be monitored for signs and symptoms of bleeding.
- Patients should report any signs or symptoms of bleeding immediately to their healthcare provider.
From the Research
Hydrea and Bleeding
- There is no direct evidence in the provided studies that Hydrea (hydroxyurea) causes bleeding.
- However, some studies report cases of hemolytic anemia, which can lead to anemia and potentially increase the risk of bleeding 3, 4.
- One study reports a case of disseminated intravascular coagulation, which can increase the risk of bleeding, but this was in a patient being treated with nilotinib after hydroxyurea 5.
- The main side effects of hydroxyurea reported in the studies are macrocytic anemia, leucopenia, and thrombocytopenia, which can increase the risk of bleeding 3, 6.
- It is essential to monitor patients taking hydroxyurea for signs of hemolysis and anemia, as these can increase the risk of bleeding 4.