Hydroxyurea is a chemotherapy drug used to treat certain types of cancer like advanced cancer of the head and neck, and refractory chronic myeloid leukemia.
Hydroxyurea is also used in the treatment of sickle cell disease, a genetic blood disorder.
The drug is also being studied in the treatment of other conditions and types of cancer.
Some doctors may prescribe hydroxyurea as an off-label drug to treat polycythemia vera (PCV), essential thrombocythemia, psoriasis, acute myeloid leukemia (AML), meningioma, melanoma, and ovarian cancer.
If you’re taking hydroxyurea, you may need to adjust your diet. Keep reading to learn what foods to eat and avoid when taking hydroxyurea and why.
What foods to avoid when taking hydroxyurea
As your body is going through treatment, it will require optimal nutrition. It is best to avoid certain foods that can harm your health, especially your liver, where hydroxyurea is being processed.
Here are some foods to avoid when taking hydroxyurea:
1) Citrus fruits such as grapefruit and grapefruit juice
In the liver, there are certain enzymes called CYP enzymes that help to break down hydroxyurea.
Citrus fruits, such as grapefruit, contain compounds that can affect these enzymes, which can lead to a higher concentration of hydroxyurea in your system.
Hence, it is important to exercise caution when consuming citrus fruits such as:
- Grapefruits
- Oranges
- Lemons
- Limes
2) Alcohol
Alcohol is infamously known to harm the liver. It can lead to alcoholic fatty liver disease. Since hydroxyurea is metabolized in the liver, you should avoid excessive alcohol intake.
3) Processed foods and sugary foods
Not only are processed and sugary foods low in nutrients, but they are also linked to a myriad of health issues, such as liver disease, diabetes, obesity, stroke, heart disease, and cancers.
You should avoid processed foods such as:
- Chips
- Fries
- Burgers
- Hot dogs
- Canned products
4) Herbal supplements that affect the liver
Some of the more popular herbal supplements that may affect liver health are:
- St. John’s Wort
- Black cohosh
- Ginseng
- Ginkgo biloba
Since hydroxyurea is being processed in the liver, it is best to avoid these supplements when taking hydroxyurea.
You should inform your doctor of all the herbal supplements and medications you are taking when you are on hydroxyurea.
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16 foods to eat while taking hydroxyurea
Whether you are taking hydroxyurea for cancer, sickle cell disease, or any other disease it is used to treat, you may experience a change in appetite and the way your body absorbs and processes certain nutrients.
This may result in unintentional weight loss and loss of lean body mass, as well as malnutrition.
Hence, it is important to eat a balanced and nutritious diet to support your body physically and mentally through the process.
Your diet should contain enough protein, carbohydrates, and fats to maintain your weight. Hydroxyurea may also affect your body’s ability to absorb some vitamins and minerals, causing a depletion of those minerals.
It is so important to discuss your nutrient requirements with your doctor as everyone’s nutrient needs can vary.
Your doctor and dietitian can give you personalized dietary advice based on your health status and needs.
They may also start you on certain vitamin and mineral supplements to help reduce the side effects of hydroxyurea.
Besides eating more foods and supplements that contain the necessary vitamins and minerals, you should also drink plenty of water to keep yourself hydrated at all times.
Some of the most important vitamins that you need more of while taking hydroxyurea are:
| Nutrients | Function | Examples of foods |
| Vitamin B9 (folate) | Production of DNA and cell formation | Spinach Asparagus Broccoli Lentils Peas Fortified grains and cereals |
| Vitamin B12 (cobalamin) | Production of red blood cells and maintaining normal nerve functions | Eggs Salmon Beef Tuna Fortified grains and cereals |
| Vitamin D | Promotes calcium absorption in the gut and maintains bone health | Salmon Sardines Eggs Fortified grains and cereals |
| Zinc | Promotes immune function | Pumpkin seeds Peanuts Oysters Crabs Sardines Fortified grains and cereals |
| Iron | Production of hemoglobin | Lean meat Spinach Lentils Fortified grains and cereals |
Other things to avoid when taking hydroxyurea
The way hydroxyurea works may interfere with several normal bodily functions, such as:
Increases your chance and getting an infection
Precautions:
- Avoid large crowds or people with infection. If you have to, wear a face mask to protect yourself.
- Wash your hands regularly to prevent infection
- Keep all cuts or scratches clean.
- Ask your doctor before scheduling dental appointments or procedures.
- Consult your doctor immediately if you develop any signs or symptoms of an infection, such as a fever, cough, or painful urination.
Increases your risk of bleeding
Precautions:
- Use a soft-bristled toothbrush and avoid picking or flossing your teeth.
- Be careful around sharp objects such as knives, razors, and fingernail or toenail cutters.
- Avoid contact sports or other situations where you are at risk of falls or injuries
- Do not take medications that interfere with blood clotting. You should consult your doctor before using any new medications or supplements.
- Consult your doctor immediately if you develop any signs or symptoms of abnormal bleeding, such as unusual gum bleeding, bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
Increases the risk of skin cancer
Precautions:
- Wear adequate sunscreen and re-apply regularly when outdoors
- Avoid the sun between 10 am to 2 pm when it is the strongest
- Wear sun protection such as hats, sunglasses and long-sleeved clothes and long pants as much as possible
Alters your body’s response to vaccinations
Precautions:
- Do not have any live virus vaccinations.
- Consult your doctor before receiving any form of vaccination
Causes harm to the fetus
Precautions:
- Your doctor should ensure you are not pregnant before starting you on hydroxyurea.
- Talk to your doctor about birth control methods that you can use during and after your treatment and how long you should continue their use.
- If you become pregnant while taking hydroxyurea, call your doctor immediately.
- You should not breastfeed while you are taking hydroxyurea because this drug is excreted in human breast milk
May cause damage to the sperm or infertility in males
Precautions:
- Consult your doctor before using this medicine if you plan to have children
How to take hydroxyurea
Route, dosage, and timing
Hydroxyurea is taken by mouth. It may come in the form of a capsule or tablet.
You should take hydroxyurea in the dosage and frequency as prescribed. You should also take hydroxyurea at around the same time every day.
Do not stop taking hydroxyurea without talking to your doctor.
When you are taking hydroxyurea, your doctor will monitor your response to treatment and any side effects that you may experience.
They may need to delay your treatment or adjust your dose of hydroxyurea depending on your responses.
If you have any questions about how you are feeling or how your body is responding to the medication, you should talk to your doctor about it.
Here are some important instructions to remember when taking hydroxyurea:
- Swallow the capsules whole
- Do not split, chew, or crush them
If you need to split the tablet, your doctor and pharmacist will advise you on the correct technique to do it. Some tablets come with score lines for you to split them safely.
What to do if I miss a dose of hydroxyurea?
If you miss a dose of hydroxyurea, you should take it as soon as possible unless it is almost time for your next dose.
If the time for your next dose is closer, you should skip the missed dose and go back to your regular dosing schedule.
You should never take double the prescribed dose to compensate for missed doses.
What happens if I overdose on hydroxyurea?
There are several symptoms of overdose that you can look out for, including:
- Drowsiness
- Mouth sores
- Pain, swelling, and purplish discoloration of your hands and feet
If you suspect that you may have overdosed on hydroxyurea, call the poison control helpline immediately.
In the United States, the toll-free poison control helpline is 1-800-222-1222. Alternatively, you can go to the nearest emergency department to get medical help.
In more severe cases of an overdose, the person may:
- Collapse or go unconscious
- Develop a seizure
- Have breathing difficulties
If any of the above happens, you need to seek emergency medical help immediately.
Should I take hydroxyurea with food?
Hydroxyurea can be taken before or after food. However, taking it after meals or at bedtime may reduce the effects of appetite loss from this drug. You should also take hydroxyurea at around the same time every day.
What are the side effects of hydroxyurea?
The side effects of hydroxyurea range from mild to severe. Mild side effects that are commonly reported include:
- Loss of appetite
- Headache
- Dizziness
- Difficult or painful urination
- Fever and chills
- Digestion issues
- Skin or nail changes
- Feeling weak
- Macrocytosis (blood investigation reports showing red blood cells that are larger than normal) – your doctor may prescribe you vitamin B9 supplements to reduce the chance of macrocytosis
More serious side effects include:
- Increased risk of developing other cancers
- Increased risk of developing lung problems: you may notice shortness of breath, dry cough, chest discomfort, unexplained weight loss, and appetite loss
- Severe skin ulcers and gangrenes
- Increased risk of developing hemolytic anemia: you may notice yellowing of your skin, dark-colored urine, weakness, dizziness, fatigue, and confusion
- Increased risk of developing injuries to the pancreas, nerves, and liver when used together with antiretroviral drugs (drugs used to treat human immunodeficiency virus (HIV) or AIDS)
- Allergic reactions such as itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, dizziness, or palpitations
You should consult your doctor if any of the side effects start to bother you. If you develop any problems in breathing, pain in your chest, abnormal bleeding, or any of the more serious side effects, you should seek medical attention immediately.
What happens if you touch hydroxyurea?
Since hydroxyurea is a chemotherapy drug, it has cytotoxic properties, which are dangerous to people who are not supposed to be taking this drug.
Hydroxyurea can irritate or damage your skin if the medication comes in contact with your skin; hence it should be handled with care.
When storing hydroxyurea, you should:
- Keep it out of the reach of children
- Store it in a closed container at room temperature
- Keep it away from heat, moisture, direct light, and freezing temperature
- Store any broken tablets in a bottle and use them within 3 months
- Throw away any unused broken tablets after 3 months
- Dispose of expired or excess medications properly.
When handling hydroxyurea, you should:
- Wear rubber or latex gloves so that your skin does not come into contact with the medication when handling the bottle or medicine.
- Wash your hands with soap and water before and after you touch the bottle or medication.
- Do not open the capsules or break the tablets. Avoid exposure to crushed, broken, or opened capsules or tablets.
- If the hydroxyurea gets into your eyes, you should flush your eyes with water for at least 15 mins
- If the powder from a capsule or tablet spills, wipe it up immediately with a damp disposable towel. Then, dispose of the empty capsule/tablet and towel in a closed container, such as a plastic bag, and throw it away in a trash can that is out of the reach of children and pets. Clean the spill area using a detergent solution at least 3 times, followed by clean water.
- If the hydroxyurea gets in contact with your skin, you should wash your skin immediately with soap and water
For more information on how to dispose of the medications that you do not need, you should ask your healthcare provider.
Conclusion
Hydroxyurea is an antimetabolite medication that is used to treat certain cancers and sickle cell disease.
You should take hydroxyurea exactly as prescribed to ensure that it works best for you. You can take hydroxyurea before or after food.
Aim to eat a balanced and nutritious diet while taking hydroxyurea. Your diet should contain more food with high levels of vitamin B9, vitamin B12, vitamin D, zinc, and iron, such as eggs, fish, lean meat, vegetables, and fortified grains and cereals.
While taking hydroxyurea, you should also avoid foods that are harmful to your body, specifically your liver, such as alcohol, processed food, sugary food, and certain herbal supplements.
It is important to inform your healthcare team about the medications and supplements you are taking before they start you on hydroxyurea.
You should also ask your doctor about the side effects and what to expect when you take hydroxyurea.
You should take note of the precautions while handling hydroxyurea because it has cytotoxic properties.
If any of the side effects or signs of overdose occur, you should consult your doctor immediately.
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