Sunday, October 2, 2016

Procarbazine


Generic Name: procarbazine (pro CAR ba zeen)

Brand Names: Matulane


What is procarbazine?

Procarbazine is a cancer medication that interferes with the growth and spread of cancer cells in the body.


Procarbazine is given with other cancer medications to treat Hodgkin's Disease (a type of blood cancer).


Procarbazine may also be used for purposes not listed in this medication guide.


What is the most important information I should know about procarbazine?


Do not use procarbazine if you are pregnant. It could harm the unborn baby. You should not take procarbazine if you are allergic to it, or if you have bone marrow suppression.

Before you take procarbazine, tell your doctor if you have liver or kidney disease, low white or red blood cell counts, low platelet counts, fluid retention, or if you have received other cancer medications or radiation within the past 30 days.


Do not drink alcohol while taking procarbazine. Avoid smoking during your treatment.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.


Do not receive a "live" vaccine while taking procarbazine. The vaccine may not work as well during this time. While you are taking procarbazine, you must not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while taking procarbazine?" section of this leaflet. Eating tyramine while you are taking procarbazine can raise your blood pressure to dangerous levels, causing life-threatening symptoms.

What should I discuss with my healthcare provider before taking procarbazine?


You should not take procarbazine if you are allergic to it, or if you have bone marrow suppression.

To make sure you can safely use procarbazine, tell your doctor if you have any of these other conditions:


  • kidney disease;

  • liver disease;


  • anemia (low red blood cells);




  • low levels of platelets in the blood;




  • low white blood cell counts;




  • fluid retention; or




  • if you have received other cancer medications or radiation within the past 30 days.




FDA pregnancy category D. Do not use procarbazine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. Procarbazine can lower sperm count in men, which may affect fertility (your ability to have children). It is not known whether procarbazine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking procarbazine.

How should I take procarbazine?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.


Procarbazine can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Avoid activities that may increase your risk of bleeding or injury.

To make sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Do not miss any follow-up visits to your doctor.


Store at room temperature away from moisture and heat.

See also: Procarbazine dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe nausea and vomiting, tremors, or seizure (convulsions).


What should I avoid while taking procarbazine?


Do not drink alcohol. Procarbazine can cause unpleasant side effects when you drink alcohol. Avoid smoking during your treatment. Smoking may increase your risk of lung cancer while taking procarbazine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.


Do not receive a "live" vaccine while using procarbazine. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), oral polio, typhoid, chickenpox (varicella), BCG (Bacillus Calmette and Guérin), and nasal flu vaccine. While you are taking procarbazine, you should avoid foods that are high in tyramine, including:

  • avocados, bananas, figs, raisins, and sauerkraut;




  • beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, and shrimp paste;




  • beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits;




  • caffeine (including coffee, tea, cola); and




  • cheeses, including American, blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton, and Swiss;




  • chocolate;




  • ginseng;




  • sour cream and yogurt;




  • soy sauce, miso soup, bean curd, fava beans; or




  • yeast extracts.



Eating tyramine while you are taking procarbazine can raise your blood pressure to dangerous levels, causing life-threatening side effects.


Procarbazine side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • diarrhea that is watery;




  • feeling like you might pass out;




  • numbness, burning pain, or tingly feeling;




  • confusion, hallucinations, problems with vision or speech, trouble with walking or daily activities;




  • feeling unsteady, loss of balance or coordination;




  • tremors, seizure (convulsions);




  • cough, chest pain, trouble breathing;




  • fever, chills, body aches, flu symptoms;




  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;




  • white patches or sores inside your mouth or on your lips;




  • jaundice (yellowing of the skin or eyes);




  • black, bloody, or tarry stools; or




  • coughing up blood or vomit that looks like coffee grounds.



Less serious side effects may include:



  • mild nausea, vomiting, loss of appetite, stomach pain;




  • dry mouth, constipation, mild diarrhea;




  • temporary hair loss;




  • mild itching or rash;




  • muscle of joint pain;




  • headache, dizziness, feeling tired;




  • urinating more than usual; or




  • changes in your menstrual periods.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Procarbazine Dosing Information


Usual Adult Dose for Hodgkin's Disease:

For administration as a single agent: To minimize the nausea and vomiting experienced by a high percentage of patients beginning procarbazine therapy, single or divided doses of 2 to 4 mg/kg/day for the first week are recommended. Daily dosage should then be maintained at 4 to 6 mg/kg/day until maximum response is obtained or until the white blood count falls below 4000 or the platelets fall below 100,000. When maximum response is obtained, the dose may be maintained at 1 to 2 mg/kg/day. Upon evidence of hematologic or other toxicity, the drug should be discontinued until there has been satisfactory recovery. After toxic side effects have subsided, therapy may then be resumed at the discretion of the physician, based on clinical evaluation and appropriate laboratory studies, at a dosage of 1 to 2 mg/kg/day.

When used in combination with other anticancer drugs, the procarbazine dose should be appropriately reduced, e.g., in the MOPP regimen, the procarbazine dose is 100 mg/m2/day for 14 days.

Usual Adult Dose for Anaplastic Astrocytoma:

60 mg/m2 orally once a day on days 8 through 21, when administered as a part of the regimen which also includes lomustine (CeeNU) and vincristine. The PCV regimen may be continued for 29 days.

Usual Adult Dose for Glioblastoma Multiforme:

60 mg/m2 orally once a day on days 8 through 21, when administered as a part of the regimen which also includes lomustine (CeeNU) and vincristine. The PCV regimen may be continued for 29 days.


What other drugs will affect procarbazine?


Before taking procarbazine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They may increase certain side effects of procarbazine.

Tell your doctor about all other medicines you use, especially:



  • blood pressure medication;




  • an antidepressant such as amitriptyline (Elavil, Vanatrip), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), and others;




  • a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);




  • diet pills, stimulants, or ADHD medication such as Adderall or Ritalin; or




  • phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine).



This list is not complete and other drugs may interact with procarbazine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More procarbazine resources


  • Procarbazine Side Effects (in more detail)
  • Procarbazine Dosage
  • Procarbazine Use in Pregnancy & Breastfeeding
  • Procarbazine Drug Interactions
  • Procarbazine Support Group
  • 0 Reviews for Procarbazine - Add your own review/rating


  • procarbazine Advanced Consumer (Micromedex) - Includes Dosage Information

  • Procarbazine Professional Patient Advice (Wolters Kluwer)

  • Procarbazine MedFacts Consumer Leaflet (Wolters Kluwer)

  • Matulane Prescribing Information (FDA)

  • Matulane Monograph (AHFS DI)



Compare procarbazine with other medications


  • Anaplastic Astrocytoma
  • Anaplastic Oligodendroglioma
  • Glioblastoma Multiforme
  • Hodgkin's Lymphoma


Where can I get more information?


  • Your doctor or pharmacist can provide more information about procarbazine.

See also: procarbazine side effects (in more detail)



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