Procarbazine Brand Name– Matulane
What is Procarbazine
Procarbazine is an oral, cell cycle-phase specific antineoplastic agent used in the treatment of Hodgkin lymphoma, non-Hodgkin’s lymphomas, brain tumors, and lung cancers.
It has been described as a nonclassic alkylating agent and is not cross-resistant with the other alkylating agents.
Today, it is used almost exclusively for Hodgkin lymphoma.
Procarbazine originally was synthesized as a monoamine oxidase inhibitor, and this activity, as well as a disulfiram-like reaction, are part of its unusual adverse effect profile.
Procarbazine was approved by the FDA in 1969.
Indications
- Hodgkin lymphoma
- malignant glioma
- medulloblastoma
- non-Hodgkin’s lymphoma (NHL)
- non-small cell lung cancer (NSCLC)
- stem cell transplant preparation
For the treatment of Hodgkin lymphoma
Side Effects
- abdominal pain
- alopecia
- anemia
- anorexia
- anxiety
- arthralgia
- ataxia
- azoospermia
- chills
- coma
- confusion
- constipation
- cough
- depression
- diaphoresis
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysphagia
- edema
- eosinophilia
- epistaxis
- fatigue
- fever
- flushing
- gynecomastia
- hallucinations
- headache
- hearing loss
- hematemesis
- hematuria
- hemolytic anemia
- hemoptysis
- hoarseness
- hyporeflexia
- hypotension
- increased urinary frequency
- infection
- infertility
- insomnia
- jaundice
- lethargy
- leukopenia
- melena
- musculoskeletal pain
- myalgia
- nausea
- new primary malignancy
- nightmares
- nocturia
- nystagmus
- pancytopenia
- papilledema
- paresthesias
- peripheral neuropathy
- petechiae
- photophobia
- pleural effusion
- pneumonitis
- pruritus
- purpura
- rash
- retinal hemorrhage
- seizures
- sinus tachycardia
- skin hyperpigmentation
- stomatitis
- syncope
- teratogenesis
- thrombocytopenia
- tremor
- urticaria
- vitamin B6 deficiency
- vomiting
- weakness
- xerostomia
Generalized allergic reactions have been reported with procarbazine use. Discontinue procarbazine in patients who develop hypersensitivity reactions.
Monitoring Parameters
- CBC with differential
- LDH
- LFTs
- reticulocyte count
- serum creatinine/BUN
- urinalysis
Contraindications
- alcoholism
- anemia
- angina
- bipolar disorder
- bleeding
- bone marrow suppression
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cerebrovascular disease
- children
- coronary artery disease
- dental disease
- dental work
- diarrhea
- G6PD deficiency
- hepatic disease
- herpes infection
- hyperthyroidism
- infection
- infertility
- intramuscular injections
- leukopenia
- mania
- MAOI therapy
- neutropenia
- Parkinson’s disease
- peripheral neuropathy
- pheochromocytoma
- pregnancy
- radiation therapy
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- schizophrenia
- seizure disorder
- stomatitis
- thrombocytopenia
- thyroid disease
- tobacco smoking
- vaccination
- varicella
- viral infection
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acrivastine; Pseudoephedrine
- Aldesleukin, IL-2
- Alfentanil
- Alprazolam
- Amide local anesthetics
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Armodafinil
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atomoxetine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Barbiturates
- Belladonna; Opium
- Benzodiazepines
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzonatate
- Benzphetamine
- Beta-agonists
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Caffeine
- Caffeine; Ergotamine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carmustine, BCNU
- Celecoxib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Clonazepam
- Clorazepate
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Desloratadine; Pseudoephedrine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Diclofenac
- Diclofenac; Misoprostol
- Diethylpropion
- Diflunisal
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dobutamine
- Dopamine
- Echinacea
- Entacapone
- Ephedrine
- Epinephrine
- Esomeprazole; Naproxen
- Estazolam
- Ester local anesthetics
- Ethanol
- Etodolac
- Famotidine; Ibuprofen
- Febuxostat
- Fenoprofen
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Flucytosine
- Flurazepam
- Flurbiprofen
- food
- General anesthetics
- Green Tea
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Levodopa
- Levomethadyl
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Live Vaccines
- Lomustine, CCNU
- Loratadine; Pseudoephedrine
- Lorazepam
- Maprotiline
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Meperidine
- Meperidine; Promethazine
- Mepivacaine; Levonordefrin
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Methylphenidate
- Midazolam
- Midodrine
- Mirtazapine
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Oxaprozin
- Oxazepam
- Oxycodone
- Oxymorphone
- Palifermin
- Pegfilgrastim
- Pemoline
- Penicillamine
- Pentazocine
- Pentazocine; Naloxone
- Phendimetrazine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Piroxicam
- Prilocaine; Epinephrine
- Propoxyphene
- Pseudoephedrine
- Quazepam
- Racepinephrine
- Rasagiline
- Remifentanil
- Reserpine
- Ritodrine
- Rofecoxib
- Sedating H1-blockers
- Selective serotonin reuptake inhibitors
- Selegiline
- Serotonin norepinephrine reuptake inhibitors
- Sibutramine
- Sodium Oxybate
- Sufentanil
- Sulindac
- Sympathomimetics
- Tapentadol
- Tedizolid
- Temazepam
- tobacco
- Tolcapone
- Tolmetin
- Tramadol
- Trandolapril; Verapamil
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
- Verapamil
- Vilazodone
- Vortioxetine
