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Hydroxyurea is a cheap, decades-old pill that lowers high blood counts in polycythaemia vera and essential thrombocythaemia and is also the main drug for sickle cell disease.
First-line cytoreduction in high-risk PV and ET (reduces thrombosis; PT-1 trial superior to anagrelide in ET). Historic role in CML before imatinib. Also used in sickle cell disease and, less often, for leukocytosis in acute leukaemia. Concerns: leg ulcers, skin cancers, questionable leukaemogenicity.
Inhibits ribonucleotide reductase, depleting deoxyribonucleotides and arresting S-phase; lowers blood counts in myeloproliferative disease.
1.Hydroxyurea (hydroxycarbamide) slips into a pocket on its target.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic; typically a low-tier drug costing a few dollars a month.
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE search: hydroxycarbamide. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Region | Year | Indication |
|---|---|---|
| US | 1967 | CML, head and neck cancer with radiotherapy, melanoma, ovarian cancer (historic labelling) |
| US | 1998 | Sickle cell anaemia (Droxia) |
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Query for this drug: (TITLE:"Hydroxyurea" OR ABSTRACT:"Hydroxyurea" OR TITLE:"hydroxycarbamide" OR ABSTRACT:"hydroxycarbamide" OR TITLE:"Hydrea" OR ABSTRACT:"Hydrea" OR TITLE:"Droxia" OR ABSTRACT:"Droxia" OR TITLE:"Siklos" OR ABSTRACT:"Siklos") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Hydroxyurea (hydroxycarbamide), not a curated reading list.
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