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What is it? Hydro is a drug known as an 'antineoplastic'. The chemicals in it help stop the growth of abnormal tissue, which may be benign (non-cancerous) or malignant (cancer). It is most commonly used to treat leukaemia, but can also be used for non-malignant disorders, incuding psoriasis and has been used as a secondline treatment alongside the other systemics since the 1970s. The exact way in which hydro works in psoriasis is unclear, but it appears to interfere with the synthesis of genetic material (DNA) inside cells. It therefore stops cells from growing and multiplying, which stops the growth of the abnormal skin cells. Who is it for? Hydro is prescribed for severe, disabling psoriasis that is not adequately responsive to other forms of treatment, including topicals and UV therapy. Although Hydro can affect the liver and the kidneys, it is not as toxic as either MTX or Cyclosporin and is therefore useful for those people who cannot take either of these systemics (although blood tests are still taken to monitor and protect these two organs). How is it taken? Hydro is taken in capsule form (anything from 500mg to 1gm) once to three times a day depending on derm advice. If you are suffering from any stomach related side effects, splitting the total dose up over the day can combat this and research shows it is still as effective as taking it in one daily dose. It is essential that the you carefully check your dosage before taking it to make sure you are not ingesting more than prescribed. If for some reason you cannot swallow the capsules, it is possible to open them and dissolve the powder in a glass of water and swallow. If you do this, make sure you do not get the powder on the skin or in the nose/eyes. What are the side effects and contra-indications?
As with all drugs, Hydro can cause unwanted side effects. As we are all different, some people will suffer very little and a few will not be able to tolerate it at all. The most common side effects include headaches, nausea and tiredness. However, there are many more side effects indicated during research and there is a small chance that a taker may suffer some of these too:
As Hydro can affect the unborn feotus, it is essential that good contraception is used throughout the duration of taking it and for two months afterwards. This includes fathering a child for male patients. As Hydro is an immuno-suppressant, there is a great risk of infection and catching coughs and colds. The effectiveness of live vaccines can also be affected, such as the flu vaccine, yellow fever, tyhoid etc. You are also at greater risk of liver damage, as Hydro can affect the liver. This is reversible as soon as the drug is stopped (as it is with the other systemics). As Hydro can make the body create more Uric acid, it can also make a user develop gout. To combat this, take a high intake of fluids daily. What monitoring do I need? It is vital that you receive comprehensive and careful monitoring whilst taking Hydro. These tests are there to protect you and should indicate a problem long before it actually becomes one. Baseline Tests:
Follow Up Monitoring: You should have bloods taken at weekly intervals for the first six weeks (FBC/LFT/U&E) and, if there is no cause for concern, the intervals between tests can be extended to bi-monthly. As Hydro can affect the liver, alcohol is best avoided for the duration of treatment. How Long Can I Take It? Hydro can be stopped at any time, although the psoriasis can flare-up on stopping or it can be used long term or for as long as it keeps working if all bloodwork is positive. |
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