Nail Changes on HU

[Smoothie2020]

Is anyone else experiencing nail color changes? I take hydroxyurea and a couple of my nails are darker than the others. I showed to hematologist and he acted like it was no big deal. I’ve been looking for home remedies to reverse but haven’t found anything.

[YDDUK2007]

This is Not big issue It's Side Offects Hu Please Patient it will heal in a few days no need to worry Tace Care Yourself.

[hunter5582]

This is a known HU side effect. It typically happens with long-term use. The impact is likely just cosmetic. How big of a deal it is depends on how big of a deal it is to you. I am not aware that there are any remedies other than discontinuing the HU. Here is a bit of info on HU.

online.epocrates.com/drugs/...

drugs.com/monograph/hydroxy...

If you find that the impact of HU is not acceptable based on your risk tolerance, there are other options to treat MPNs.

All the best.

[azaelea]

Yes, I have discolourment of nails too. Been on Hydroxy four and half years and for some time now my toenails have been pure white and crumbly. Fortunately up to now it’s just my toenails ,fingernails are ok. I think it’s just one of these side effects we have to put up with, though annoying. All best wishes.

[Bluetop]

Yes, I have been on hydroxy for 7 years and my toe nails are a crumbling mess, my finger nails seem to go in cycles, but one has been split vertially for a couple of years now. Otherwise hydroxy seems to have worked OK for me.

[sbs_patient]

I've had PV since 2015 and was on HU from 2016 through 2022. I experienced nail darkening soon thereafter; when my dose was raised from 500 mg to 1000 mg, the nail darkening got worse and I then experienced serious ulceration on the backs of my hands. Dose was then reduced to 500mg, but this wasn't doing much for me, and I started taking Jakafi about 6 months ago; all seems to be going well now. As Hunter says, there are now other (and better) treatment options for MPNs. Good luck!

[Meatloaf9]

I have had darkening on some of my toenails. I have been on HU for about 19 months. It lasts quite a while but seems to come and go. My mpn specialist did not seem concerned about it. My mpn specialist recommended that I continue with HU since he said all my blood counts and CMP were perfect, his words. So, I will continue with the HU for now. Best to you.

[Solyesh]

Yes, I had severe darkening and streaking of my fingernails on HU. It is a potential known effect - mine started bout 3 months in and was the first indication that I would become fairly intolerant to HU (even though it was effective in bringing my platelets down) as the hyperpigmentation then became accompanied by severe rashes and other symptoms. Luckily most don't go down that path. My nails eventually returned to normal about 6 months after stopping the HU when I moved to Peg.

[Smoothie2020 in reply to Solyesh]

Thanks for responding. How long have you been on Peg and is it as effective as HU in keeping platelets down?

[Solyesh in reply to Smoothie2020]

I have now been on some dose of Peg almost a year. It has taken a while to get to what we hope is the right dose (90 mcg every 15-16 days). Initially my platelets came into range (412) almost immediately on Peg which is not necessarily always the case as it can take time for Peg to be effective but the Peg dose was likely too high initially (180 mcg/2 weeks) and started to affect my liver readings. Right now my platelets are at 560. My MPN specialist is OK with having them under 600 (as opposed to under 450) given no history of thrombosis but ideally we'd have them under 500 so I adjusted the Peg dose by a two days (from 17/18 days to 15/16 days). The Peg has brought all other numbers into range (used to have persistently high WBCs as well) and has been easy to take (no real symptoms to speak of).