Your child's health-care team may recommend a few types of medications to help manage sickle cell disease, such as medications that target sickle cells, antibiotics to treat infections and pain medications.
Medication to target sickle cells
Hydroxyurea
Hydroxyurea (often sold as Droxia® or Hydrea®) is a prescription medicine that can help many people with sickle cell disease. It comes in liquid or capsule form and is taken by mouth each day.
Hydroxyurea works by helping red blood cells stay round and flexible. This lets them travel more easily through tiny blood vessels.
Hydroxyurea does not cure sickle cell disease, but research shows that, for many people, it:
- leads to fewer incidents of acute chest syndrome
- reduces the number of pain crises
- lowers the need for blood transfusions
- lowers the need for hospital visits and treatment
Medications for infection
Antibiotics
Infections are treated with antibiotic medicines.
Infections may represent a medical emergency for people with sickle cell disease. So, at the first sign of an infection, such as a fever, it is important to see a health-care provider right away. Treating infection early can help prevent more serious problems.
Medications for mild-to-moderate pain
Most pain related to sickle cell disease can be treated with over-the-counter pain medications such as acetaminophen and ibuprofen. Some people who have more severe pain are given opioids (such as hydrocodone or morphine) as needed. Others may be admitted to the hospital to receive pain medications through an IV (intravenous line). Medications delivered through an IV are usually stronger than medicines taken by mouth.
Your child's health-care provider might suggest using balanced analgesia (pain relief) for their sickle cell pain. This means prescribing a range of pain medications to maximize your child's pain relief and minimize negative side effects.
Acetaminophen
Acetaminophen is an over-the-counter medication in pill form. It is thought to reduce pain by affecting the parts of the brain that receive pain messages.
While you do not need a prescription for acetaminophen, your child's health-care provider will still recommend an appropriate dose based on your child's age and weight. If your child needs acetaminophen, a generic (non-brand name) version works just as well as a brand-name version, such as Tylenol®. It usually costs less.
It is very important to stick to the recommended dose of acetaminophen. Taking too much can damage your child's liver.
Many medications include acetaminophen with other medicines. For example, oxycodone or tramadol may include acetaminophen. Even cold medication or sleep aids might include acetaminophen.
Tell your child's health-care provider about all the medications your child is taking so they can make sure your child is staying within the recommended daily dose.
Side effects of acetaminophen
Acetaminophen is a safe and effective pain reliever when it is taken in prescribed doses and for a short time. In rare cases, acetaminophen can cause diarrhea, loss of appetite, stomach pain or cramps, skin rash, hives or itching, increased sweating, yellow eyes or skin, liver injury and swelling of face, lips, tongue or throat.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are pills that are commonly used to treat pain flares caused by inflammation. Inflammation is usually shown by redness, swelling or heat. NSAIDs work by interfering with special enzymes in the body, which reduces inflammation and pain.
NSAIDs work best in short courses to manage pain from headaches, toothaches, muscle aches and menstrual cramps. Sometimes, they may be used with acetaminophen or opioids to more effectively manage chronic pain conditions such as musculoskeletal pain.
There are many types of NSAIDs, but you can only take one type at a time.
Some NSAIDs, such as ibuprofen and naproxen, are available over the counter. You may recognize ibuprofen by the brand names Advil® and Motrin®. Other NSAIDs are available only with a prescription. These include diclofenac, meloxicam and celecoxib. One type of NSAID, toradol, is given through an IV for severe pain in the hospital.
Because each NSAID is slightly different, one might work more quickly for your child or have different side effects than others. For short flares of pain, a medication that acts quickly and gets out of your child's system right away might be best. For episodes of pain that last a long time, you may do better with a longer-lasting medication.
Side effects of NSAIDs
- One of the most common side effects of NSAIDs is stomach upset. This can usually be avoided by taking the medication with food (even just some crackers or a glass of milk) and taking the correct dose.
- When used regularly for a long time, or in high doses, NSAIDs can cause kidney problems. They can also cause stomach ulcers, which can lead to dangerous bleeding and perforations (tiny holes in the stomach lining). If your child sees blood in their bowel movements, or their bowel movements are black in colour, if your child is vomiting brown or bright red or has severe stomach pain while taking NSAIDs, they should stop taking the medication and see their health-care provider right away.
- NSAIDs can make headaches worse. If your child tends to get migraines, they should not take NSAIDs more than 15 days per month.
- In very rare cases, NSAIDs can cause bleeding problems. If your child is taking NSAIDs, they may need to stop taking them for a short time if they need to have surgery.