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Procarbazine

Class
DNA crosslinking agents
Subclass
Alkylating agents
Generic name
Procarbazine hydrochloride
Brand names
Matulane®
Common formulations
Capsule
Indications for use
Labeled indications
Adults
•
Treatment of Hodgkin's disease (stage lll, stage IV)
Off-label indications
Adults
•
Treatment of non-Hodgkin's lymphoma
Safety risks
Contraindications
Concomitant MAOI therapy
Severe bone marrow suppression
Warnings and precautions
Extrapyramidal signs
•
Use caution with Parkinson's disease.
Hemolysis
•
Use caution with G6PD deficiency.
Hepatic coma
•
Use caution with cirrhosis.
Hypotension
•
Use caution with cardiac disease, coronary artery disease (e.g., angina), or cardiac arrhythmias.
Lung cancer
•
Use caution with Hodgkin's disease receiving MOPP combination chemotherapy and with exposure to tobacco smoke.
Manic episode
•
Use caution with a history of bipolar disorder.
Seizures
•
Use caution with a seizure disorder.
Specific populations
Renal impairment
eGFR 20-50 mL/min/1.73 m²
•
Use with caution. Reduce dose by 0-50%. Titrate slowly.
eGFR 10-20 mL/min/1.73 m²
•
Use with caution. Reduce dose by 0-50%. Titrate slowly.
eGFR < 10 mL/min/1.73 m²
•
Avoid use as much as possible. Reduce dose by 0-50%. Titrate slowly.
Renal replacement therapy
Continuous renal replacement
•
Dose as in eGFR 10-20 mL/min/1.73 m². Reduce dose by 0-50%. Monitor serum concentrations.
Intermittent hemodialysis
•
Avoid use as much as possible. Dose as in eGFR < 10 mL/min/1.73 m². Reduce dose by 0-50%. Monitor serum concentrations.
Peritoneal dialysis
•
Avoid use as much as possible. Dose as in eGFR < 10 mL/min/1.73 m². Reduce dose by 0-50%. Monitor serum concentrations.
Hepatic impairment
Any severity
•
Use with caution.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: D
•
Avoid use. Evidence of fetal harm in humans. This drug can harm a developing fetus.
•
There have been reports of malformations in the offspring of women who were exposed to this drug in combination with other antineoplastic agents during pregnancy.
•
Adequate methods of contraception should be encouraged.
•
If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus.
•
Verify negative pregnancy status in females of reproductive potential prior to initiating therapy.
•
This drug inhibits DNA, RNA, and protein synthesis which can impair fertility in both males and females.
Breastfeeding
Do not use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Unknown frequency
•
Allergic reactions, alopecia, anemia, ataxia, central nervous system depression, carcinomatosis, coma, ↓ WBC count, ↓ platelet count, dermatitis, disorientation, drug-induced liver injury, fixed drug eruption, foot drop, gynecomastia, hyperpigmentation, hyperpyrexia, hypertension, hypotension, leukemia, male infertility, myelosuppression, neuropathy, nystagmus, orthostatic hypotension, papilledema, pleural effusion, pneumonitis, abdominal pain, amenorrhea, bleeding, constipation, convulsion, cough, diarrhea, diplopia, dizziness, dry mouth, dysphagia, generalized pruritus, hallucinations, hematemesis, hematuria, hematuria, melena, menstrual irregularity, nausea, nervousness, nightmares, nocturia, paresthesia, photophobia, seizure, skin rash, syncope, urinary frequency, vomiting, retinal hemorrhage, stomatitis, tachycardia, toxic epidermal necrolysis
Interactions
Drug(s)
Check Interactions
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