# Hydroxyurea in Nigeria - Source: https://ogbogwu.com/drugs/hydroxyurea/ - Drug class: Antineoplastic / disease-modifying agent (Sickle Cell) - Also known as: Hydroxycarbamide, Hydrea, Siklos - Prescription required: yes - On the WHO Model List of Essential Medicines - Last updated: July 2026 ## Price in Nigeria Hydroxyurea prices in Nigeria vary by brand, strength, and where you buy it. Confirm the current price with a licensed pharmacy, and always check the product is NAFDAC-registered before you pay. ## What is Hydroxyurea? Hydroxyurea (also called hydroxycarbamide) is the single most important medicine for sickle cell disease — and that matters enormously in Nigeria, which has the largest sickle cell population in the world, with tens of thousands of affected babies born every year. It is a daily capsule or tablet that changes the course of the disease, reducing the frequency of painful crises, cutting the need for blood transfusions, and lowering the risk of serious complications. It is sold as Hydrea, Siklos, and generic hydroxyurea. In sickle cell disease, an abnormal form of haemoglobin makes red blood cells stiffen into a sickle shape, block small blood vessels, and cause the sudden severe pain known as a crisis. Hydroxyurea works mainly by boosting the body's production of fetal haemoglobin (HbF) — a type of haemoglobin that resists sickling — so red cells stay flexible and rounded for longer. Over months, this leads to fewer crises, fewer chest and other complications, and often a better quality of life. Hydroxyurea is a prescription medicine that must be supervised by a doctor, usually a haematologist, because the dose is adjusted to each person and regular blood tests are needed to watch the blood count. It is taken long-term, and its full benefit builds up over several months rather than days. It is safe and life-changing for most people with sickle cell when properly monitored, but it must not be used in pregnancy, and men and women should use contraception while on it. Buy it from a licensed pharmacy and verify the NAFDAC number. ## What is Hydroxyurea used for? - Reducing the number and severity of painful sickle cell crises - Reducing the frequency of acute chest syndrome and the need for blood transfusions - Long-term protection against sickle cell complications, improving quality of life - Certain blood cancers such as chronic myeloid leukaemia and essential thrombocythaemia (a separate, specialist use) ## Dosage Always follow a doctor's or pharmacist's instructions; this is general reference information. - Adults: For sickle cell disease, hydroxyurea is started at a low dose based on body weight (often around 15mg/kg once daily) and gradually increased by a doctor to the best tolerated dose, guided by blood counts. It is taken once a day at the same time. The full benefit builds over 3-6 months, so it must be taken consistently even before improvement is felt. Regular blood tests are essential to guide the dose. - Children: Hydroxyurea is used in children with sickle cell disease and is highly effective, but the dose is carefully weight-based and set by a specialist, with close blood-count monitoring. Siklos comes in a form that makes paediatric dosing easier. - Elderly: Used with the same monitoring; dose adjusted for kidney function. Take it every day — skipping doses reduces its protective effect. Do not stop it because you feel well; the benefit depends on continuous use. Keep every appointment for blood tests, since the dose is set by your blood count. Handle the capsules with clean, dry hands and wash your hands afterwards. Continue folic acid and stay well hydrated, and keep using pain relief and other sickle cell care as advised. ## Side effects Common: A drop in blood counts (white cells, platelets, or haemoglobin) — the main reason for regular monitoring; usually managed by adjusting the dose; Nausea or mild stomach upset; Darkening of the skin or nails; Mild hair thinning; Headache or dizziness. Serious (seek medical help immediately): A very low white-cell count, raising infection risk: fever, sore throat, or feeling very unwell — seek care urgently; A very low platelet count: unusual bruising or bleeding; Leg ulcers that are slow to heal; Signs of a serious allergic or skin reaction; Severe or persistent symptoms during any infection. When to see a doctor: Seek care urgently for a fever or signs of infection while on hydroxyurea, as a low white-cell count can make infections dangerous, and for unusual bruising or bleeding. Do not miss your scheduled blood tests. Contact your doctor about slow-healing leg ulcers, and always seek prompt help for a sickle cell crisis, chest pain, or breathlessness as you normally would. ## Warnings Do not take if: Do not use in pregnancy — hydroxyurea can harm the developing baby; effective contraception is essential for both women and men while taking it and for a period afterwards; Do not use while breastfeeding; Do not use if blood counts are already very low, until corrected and under specialist care; Use with caution and dose adjustment in kidney or liver impairment; Do not use without regular blood-count monitoring. Interactions: Other medicines that lower blood counts (including some antiretrovirals and chemotherapy) increase the risk of low counts; Certain HIV medicines (e.g. didanosine, stavudine) combined with hydroxyurea raise the risk of serious side effects; Live vaccines should be discussed with your doctor; Tell your doctor about all medicines, as hydroxyurea affects the bone marrow. Pregnancy & breastfeeding: Hydroxyurea must not be used in pregnancy, as it can cause harm to the baby, and it should not be used while breastfeeding. Both women and men of reproductive age should use reliable contraception during treatment and for a time after stopping, as advised by the doctor. If pregnancy is planned or occurs, the treatment plan must be reviewed with a haematologist promptly rather than simply stopped, given the risks of uncontrolled sickle cell disease in pregnancy. ## Brands in Nigeria Well-known NAFDAC-registered brands: Hydrea (Bristol Myers Squibb, made in United Kingdom); Siklos (Addmedica, made in France). Full searchable brand list: https://ogbogwu.com/drugs/hydroxyurea/brands/ ## How to verify it is genuine 1. Get hydroxyurea on prescription from a licensed pharmacy, ideally through a sickle cell clinic or haematologist 2. Check the NAFDAC registration number on the pack and verify it on the NAFDAC Green Book or app 3. Check the expiry date and that the packaging is sealed and untampered 4. Genuine capsules/tablets should be uniform; discard any that look irregular or discoloured 5. For Hydrea (Bristol Myers Squibb) or Siklos (Addmedica), check the manufacturer branding and batch number; for generics, confirm the manufacturer 6. Because it needs blood-test monitoring, use a consistent, trusted source and stay linked to a clinic rather than buying ad hoc from unverified sellers Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/ ## FAQs ### How does hydroxyurea help sickle cell disease? Hydroxyurea reduces how often and how severely sickle cell crises happen. It works mainly by increasing the amount of fetal haemoglobin (HbF) your body makes — a type of haemoglobin that does not sickle — so your red blood cells stay flexible and are less likely to block small blood vessels. Over months of daily use, this leads to fewer painful crises, fewer episodes of acute chest syndrome, less need for blood transfusions, and often a much better quality of life. It is the main disease-modifying treatment for sickle cell disease, which is why it matters so much in Nigeria. ### Is hydroxyurea safe for my child with sickle cell? Yes — hydroxyurea is used in children with sickle cell disease and is very effective, and international and Nigerian guidance supports its use even from a young age when a specialist prescribes and monitors it. The keys to safety are a correctly set, weight-based dose and regular blood tests to watch the blood count, both managed by a doctor. Many parents worry because hydroxyurea is also used in some cancers, but at sickle cell doses and with proper monitoring, its benefits in preventing crises and complications are well established. Discuss it with your child's haematologist. ### Do I still need folic acid and pain medicine if I take hydroxyurea? Yes. Hydroxyurea reduces how often crises happen, but it is not a cure and does not replace the rest of sickle cell care. You should continue folic acid (to support red-cell production), stay well hydrated, keep up with vaccinations and any prescribed penicillin prophylaxis in children, and still have pain relief ready for crises. Hydroxyurea works alongside these measures. Keep attending your sickle cell clinic so your treatment and monitoring stay on track. ## Sources - NAFDAC Greenbook (official register of approved products in Nigeria) - WHO Model List of Essential Medicines - British National Formulary (BNF) - Nigerian Standard Treatment Guidelines (Federal Ministry of Health)