Krabinex Special Precautions

Hydroxyurea should be used with caution in the following: Patients with marked bone marrow depression (leukopenia is generally its first and most common manifestation. Thrombocytopenia and anemia occur less often and are seldom seen without a preceding leukopenia); Patients who have previously received radiotherapy or cytotoxic cancer chemotherapeutic agents because bone marrow depression is more likely to occur in these kinds of patients; Patients who have received irradiation therapy in the past may have an exacerbation of post irradiation erythema; Patients with severe anemia. Anemia must be corrected with whole blood replacement before initiating therapy with Hydroxyurea;
Patients with marked renal dysfunction; Other side effects reported have included gastro-intestinal disturbances, pulmonary oedema, mild dermatological reactions, alopecia, and neurological reactions such as headache, dizziness, drowsiness, disorientation, hallucinations and convulsions.
Therapy with Hydroxyurea requires close supervision. The complete status of the blood, including bone marrow examination, if indicated, as well as kidney function and liver function should be determined prior to, and repeatedly during treatment. The determination of the hemoglobin level, total leukocyte counts and platelet counts should be performed at least once a week throughout the course of Hydroxyurea therapy. If the white blood cell count falls down to less than 2500/mm³, or the platelet count to less than 100,000/mm³, therapy should be interrupted until the values rise significantly toward normal levels. If anemia occurs, it should be managed with whole blood replacement, without interrupting Hydroxyurea therapy. Pre-existing anemia should be corrected before beginning therapy with Hydroxyurea. Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures, e.g. topical anesthetics and orally administered analgesics. If the reaction is severe, Hydroxyurea therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed. However, it has rarely been necessary to terminate these therapies.
Use in Pregnancy: Hydroxyurea is a known teratogenic agent in animals. Therefore, Hydroxyurea should not be used in women who are or may become pregnant unless in the judgment of the physician, the potential benefits outweigh the possible hazards.
Use in Elderly: Elderly patients may be more sensitive to the effects of Hydroxyurea; therefore, may require a lower dose regimen.