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Procarbazine

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Procarbazine, Matulane

  • See Also
  1. Chemotherapy
  2. Alkylating Agent
  • Indications
  1. FDA Approved
    1. Hodgkin Lymphoma (stage 3-4, MOPP Protocol)
  2. Off-Label
    1. Non-Hodgkin Lymphoma
    2. Cutaneous T-Cell Lymphoma
    3. CNS Neoplasms (advanced disease, e.g. glioblastoma multiforme)
  • Mechanism
  1. See Alkylating Agent
  2. Triazene alkylating antineoplastic (Methylhydrazine derivative) active in the S phase of the cell cycle (DNA duplication)
  3. Inhibits trans-methylation of Methionine into Transfer RNA, blocking Protein synthesis
  4. As an Alkylating Agent, also forms cytotoxic free radicals which damage DNA
  • Medications
  1. Capsule: 50 mg
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  1. Bone Marrow Suppression
  2. Secondary Malignancy
  3. Hemolysis (with RBC Heinz bodies)
  4. Impaired future fertility
  5. Alopecia
  6. Hypersensitivity
  7. Neurologic effects (children)
    1. Seizures
    2. Tremors
    3. Altered Mental Status
  • Safety
  1. Avoid in Lactation
  2. Avoid in Pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function tests
    4. Urinalysis
  • Drug Interactions
  1. High Tyramine Intake
    1. Risk of Hypertensive Emergency
  2. Alcohol
    1. Disulfiram reaction
  3. Procarbazine decreases other drug levels
    1. Digoxin
  4. Procarbazine increases other drug levels
    1. Opioids
    2. Sympathomimetics
    3. Tricyclic Antidepressants
  • Resources
  1. Procarbazine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1aa75a3a-18c9-49e1-91a6-293d0b7da756
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia