Contolling Hydroxyurea fatigue by time of day you take the medication

I take 500 mg twice a day, 4 days each week and have not experienced any fatigue as a result. I know many who take HU do have this side effect and hope that they will respond to you question. If I recall from other HU threads, I'm not sure time of day for dosing makes much difference. You could experiment with it and see if it helps - but check with your doctor first. Good luck!

I take it at night because of the fatigue. I still have fatigue during the day.

I have PV and take either 1000 mg or 1500 mg depending on the day of the week.. I take the pills all at one time at 7PM CST which is usually just after eating dinner… I’ve not experienced any fatigue in the 2 1/2 years I’ve been taking this dose… I don’t know if having ET makes it more likely to experience fatigue than it does for those of us who have PV..

I take 1 500mg HU daily.
I’m just as tired when I take it morning / afternoon / evening.

According to the National Institutes of Health, HU has a half life of about 2 to 4 hours (this can vary by person). That means that your body washes half the drug out of your system every 2-4 hours.

Let's say you take 1,000 mg at 10 pm. By 2 am, your excretory system will have washed out half the dose, leaving 500 mg. By 6 am, that amount reduces to 125 mg. At 10 am, there's about 62 mg, and so on.

If you take HU in the morning, you can see you're going to be dealing with a higher dose during waking hours. So if HU causes fatigue, try taking it at night.

Drinking 64 ounces of water throughout your waking hours will help HU circulate better and help your kidneys wash it out more effectively. I have no scientific info on this, but some patients who are alert to water intake say this makes them feel less sluggish.

I start front-loading water as soon as I get up, about 16 ounces with breakfast and another 16 by lunch time.

Hope this is useful info for someone!

Thank you! Does anyone know what Hydrea is comprised of? What is the make up and are there natural remedies to drive platelets count down?

I take 500mg at night and am usually fatigued until about 8-9 am. I am supposed to be taking 1000mg per day but it lowers my red cells and hematocrit too much and get severe anemia.

Hi @taisaint, All of this information can be found in National Institute of Health, Pub Med articles and pharmaceutical websites by typing in Hydroxurea. This is a medication that’s been used reliably to treat certain blood cancers and conditions for a couple of decades. There can be risks and side effects to all meds, even supplements. So I’d like to caution you about reading into some of these articles if you feel the outcome might prevent you from taking a medication such as Hydrea.

I agree, knowledge is power. I like to research and know what I’m taking as well. But I also had a very aggressive form of leukemia and would not be alive today had I not taken all the meds with the black box warning label. They worked and I’m alive and healthy because of these drugs.
Here are links to the mechanism of action for Hydroxyurea:
https://pubmed.ncbi.nlm.nih.gov/1641648/
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https://go.drugbank.com/drugs/DB01005
From our prior conversations, I know you have both PV and ET with a mutation in the JAK2 gene, causing an overproduction of both red blood cells and platelets. There may be foods and supplements which can impact platelet and red blood levels. However, if your levels are elevated because of a genetic mutation that won’t be impacted or helped by foods or supplements. The rate of production of cells would be driven by the mutation.

I think I already gave you information about the JAK2 mutation and the myeloproliferative diseases it can cause. But if I didn’t here’s a link to a great tutorial about MPNs and the JAK2 gene.
https://www.healthline.com/health/cancer/myeloproliferative-disorders#symptoms
I know you’d really like to try a natural route. Honestly, we all would! Sometimes we don’t have choices. In your case, I think it’s really important to try the medication that your doctor has suggested to get the proliferation of the blood cells under control.
Have you consulted with an MPN (myeloproliferative neoplasm) specialist?

Thank you Lori. Your suggestions and referrals help.

Good morning, @marnie12. It can be confusing or frustrating trying to find credible information on the internet sometimes. While being a powerful tool, it can also lead us down a rabbit hole filled with information we don’t need to follow! I know! I’ve been dragged along those paths myself. 😅 So I’m happy to help members whenever I can, to find appropriate information.
Were you diagnosed with a blood condition?