procarbazine

n.
A potent antineoplastic drug, C₁₂H₁₉N₃O, used primarily to treat advanced Hodgkin's disease.

[PRO(PYL) + CARB(O)- + AZINE.]

Key Terms: Cytotoxic drug, DNA, Platelets.

Definition

Procarbazine is an anticancer agent that kills cancer cells, also known by the brand name Matulane. It has received approval by the Food and Drug Administration (FDA) for the treatment of advanced Hodgkin's disease in combination with other anticancer drugs.

Purpose

Procarbazine is used in the treatment of various cancers, although the best established usage is with Hodgkin's disease. Other cancers in which procarbazine is sometimes used include other lymphomas, brain tumors, skin cancer, lung cancer, and multiple myeloma.

Description

Procarbazine is a cytotoxic drug, which means that it kills cancer cells. Procarbazine works by interfering with way the DNA and RNA in cells produce proteins by binding to it in the cells.

Recommended Dosage

Procarbazine is often given at a dose of 60 to 100 mg per square meter of body surface area for ten to fourteen days of each course of therapy. In addition, patients who have had pre-existing problems with liver, kidney, or bone marrow function may receive reduced doses.

Precautions

While on therapy with procarbazine, patients should not drink alcohol because it may interact with the drug to cause a flushed and hot sensation. Certain foods such as chocolate, fava beans, imported beer, Chianti wines, and ripe cheeses (camembert, cheddar, emmenthaler, stilton), caviar, pickled herring, fermented sausages (bologna, pepperoni, salami, summer sausage), should be avoided as they may cause a dangerous increase in blood pressure if eaten while receiving procarbazine.

Side Effects

A carefully monitored side effect of procarbazine is a decrease in the white blood cells that fight infection and the platelet cells that prevent bleeding. The most severe side effect is nausea and vomiting. Patients should adhere to the antiemetic regimen prescribed for them to prevent this side effect. There may be neurologic side effects such as confusion, sleepiness, depression, nightmares, agitation, and nervousness. Patients may have reproductive dysfunction.

Interactions

Procarbazine has numerous drug interactions. Therefore, it is important that patients alert their physicians to all medications they are taking (prescription, over-the counter, or herbal) prior to starting treatment with procarbazine or any other drug.

—Bob Kirsch

Brand names: Matulane®

Chemical formula:

Español:
• Clorhidrato de procarbazina, Cápsula oral

Procarbazine Hydrochloride Oral capsule

What is this medicine?

PROCARBAZINE is a chemotherapy drug. This medicine reduces the growth of cancer cells. It is used to treat Hodgkin's disease. It is often given with other cancer drugs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•infection (especially virus infection such as chickenpox or herpes)
•kidney disease
•liver disease
•low blood counts like low platelets, red blood cells, white blood cells
•smoke tobacco
•an unusual or allergic reaction to procarbazine, other chemotherapy, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
•alcohol
•green tea
•furazolidone
•isoniazid
•linezolid
•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
•medicines for allergies, colds, or congestion
•medicines for migraine
•medicines for depression, anxiety, or psychotic disturbances
•some medications for Parkinsons disease like entacapone, levodopa, tolcapone
•stimulant medicines for attention disorders, weight loss, or to stay awake

This medicine may also interact with the following medications:
•dextromethorphan
•medicines for sleep during surgery
•medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim
•medicines to numb skin or other tissue during procedures
•meperidine
•pentazocine
•phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
•phenytoin
•tramadol
•trazodone
•tyramine in some foods and drinks; ask your dietician for a complete list of foods to avoid
•vaccines

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor for checks on your progress. This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

This medicine can interact with certain foods that contain tyramine. The combination may cause severe headaches, a rise in blood pressure, irregular heart beat, or you may otherwise feel unwell. Foods that contain significant amounts of tyramine include aged cheeses, meats and fish (especially aged, smoked, pickled, or processed such as bologna, pepperoni, salami, summer sausage), beer and ale, alcohol-free beer, wine (especially red), sherry, hard liquor, liqueurs, avocados, bananas, figs, raisins, soy sauce, miso soup, yeast/protein extracts, bean curd, fava or broad bean pods, or any over-ripe fruit. Ask your doctor or health care professional, pharmacist, or nutritionist for a complete listing of tyramine-containing foods. Also, avoid drinks containing caffeine, such as tea, coffee, chocolate, or cola.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.

Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

It is recommended that you stop smoking tobacco products (like cigarettes or cigars) while taking this medicine. Smoking tobacco products may increase your risk of developing lung cancer in the future.

Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

Men should inform their doctors if they wish to father a child. This medicine may lower sperm counts.

Tell your health care professional that you are taking this medicine if you are scheduled to have any surgery, procedure or medical testing.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
•signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
•signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine
•signs of decreased red blood cells - unusually weak or tired, fainting spells, lightheadedness
•breathing problems
•changes in vision
•confusion
•cough
•fast, irregular heartbeat
•hallucination
•mouth sores
•muscle weakness
•pain, tingling, numbness in the hands or feet
•problems with balance, talking, walking
•seizures
•yellowing of the eyes or skin
•tremor

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•constipation or diarrhea
•darker skin color
•dizziness
•dry mouth
•hair loss
•headache
•loss of appetite
•nausea, vomiting
•trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

An antineoplastic agent that acts by inhibiting the synthesis of DNA, RNA and protein.

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