INTRODUCTION
Several studies have documented the use of hydroxyurea (HU) as an effective, safe and affordable oral drug for SCD 1,2but utilization remains poor in Nigeria 3,4 and most parts of sub-Saharan Africa 5 partly because of safety concerns. As a drug that selectively suppresses hematopoiesis in a situation where enhanced erythropoiesis is desired6, questions about its benefits and risks will always arise. Children who have been followed up for over 15 years have shown no significant toxicity in terms of growth and sexual development7. Studies from Nigeria 8,9 and Africa including the NOHARM and REACH studies 10–12, are increasingly strengthening the general acceptance of HU as a safe intervention in children with SCD in Africa thus dispelling fears about altered response in African children because of host and environmental factors. As efforts are made to improve its uptake in Nigeria, cases of accidental ingestion may arise, which could further fuel the fear most families have about HU toxicity. We, hereby, report this case of accidental ingestion of a large dose of HU to further strengthen the safety profile of HU and to advocate for increased use of this cheap disease-modifying agent in Nigerian children with SCD.