Medications to target sickle cells, infections and pain

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Learn about hydroxyurea, a medicine that helps red blood cells stay round and flexible; antibiotics to treat infections; and medications to manage mild-to-moderate pain.

Key points

  • Hydroxyurea is a prescription medication taken by mouth each day. It helps red blood cells travel easily through tiny blood vessels and helps reduce complications of sickle cell disease.
  • Antibiotic medications are used to treat infections. Infections can be a medical emergency for people with sickle cell disease, so it is important to treat an infection early.
  • Most sickle cell disease pain can be treated with over-the-counter medications.
  • People with more severe pain may be given opioids as needed or may be admitted to the hospital to receive pain medications through an intravenous line (IV).

Your health-care team may recommend a few types of medication to help you 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 or pneumonia
  • 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 can be 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 tube). Medications given through an IV are usually stronger than medicines taken by mouth.

Your health-care provider might suggest using balanced analgesia (pain relief) for your sickle cell pain. This means prescribing a range of pain medications to maximize your pain relief and minimize negative side effects.

Acetaminophen

Acetaminophen has 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 health-care provider will still recommend an appropriate dose based on your age and weight. If you need 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 that you stick to the recommended dose of acetaminophen. Taking too much can damage your 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 health-care provider about all the medications you are taking so they can make sure you are staying within the recommended daily dose.

Side effects of acetaminophen

Acetaminophen is a safe and effective pain reliever when you take it 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 specific enzymes in your 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 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 or in the hospital.

Because each NSAID is slightly different, one might work more quickly for you or have different side effects than others. For short flares of pain, a medication that acts quickly and gets out of your system right away might be best. For episodes of pain that last a long time, you may do better with longer-lasting medication.

Side effects of NSAIDs

  • One of the most common side effects of NSAIDs is stomach upset. You can usually avoid this by taking 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 you see blood in your bowel movements, or they are black in colour, if you are vomiting brown or bright red or have severe stomach pain while taking NSAIDs, stop taking the medication and see your health-care provider right away.
  • NSAIDs can make your headaches worse. If you tend to get migraines, don't take NSAIDs on more than 15 days of the month.
  • In very rare cases, NSAIDs can cause bleeding problems. If you are taking NSAIDs, you may need to stop taking them for a short time if you need to have surgery.
Last updated: September 25th 2023