Procarbazine – Uses, Dosage, Side Effects, Interactions

Contraindication?

The following conditions are contraindicated? with this drug. Check with your physician if you have any of the following:

• is allergic to procarbazine or to any of the ingredients of the medication
• has severe? depletion of neutrophils (white blood cells), platelets, or red blood cell
• a bacterial infection?
• opportunistic fungal infection?
• an infection? due to a protozoa organism
• decreased function of bone marrow?
• anemia?
• increased risk of bleeding due to clotting disorder
• decreased blood platelets
• low levels of white blood cells
• alcoholism
• a painful condition that affects the nerves in the legs and arms called peripheral neuropathy?
• liver problems
• pregnancy
• a patient who is producing milk and breastfeeding
• kidney? disease with likely reduction in kidney function
• an increased risk of developing an uncommon viral infection? called an opportunistic infection

Dosage?

Strengths: 50 mg

Hodgkin’s Disease

As a single agent:

• Initial dose: Single or divided doses of 2 to 4 mg/kg/day orally for one week (to minimize nausea? and vomiting? experienced by a high percentage of patients beginning therapy)
• Maintenance dose: 4 to 6 mg/kg/day orally until a maximum response is obtained or until the white blood count falls below 4000 or the platelets fall below 100,000; when the maximum response is obtained the dose may be maintained at 1 to 2 mg/kg/day orally
• Discontinue therapy for hematologic or other toxicity until satisfactory recovery, then resume therapy (at the discretion of the physician based on patient evaluation and laboratory studies) at 1 to 2 mg/kg/day

In combination with other anticancer drugs:

• The dose of this drug should be reduced (e.g., in the MOPP regimen, the dose is 100 mg/m2/day for 14 days)

Usual Pediatric Dose for Hodgkin’s Disease

Close clinical? monitoring? is necessary to minimize toxicity (e.g., tremors, coma, convulsions). Dosage should be individualized. The following dosage schedule is provided as a guideline only:

• Initial dose: 50 mg/m2/day orally for the first week
• Maintenance dose: 100 mg/m2/day orally until a maximum response is obtained or until leukopenia? or thrombocytopenia occurs; when the maximum response is obtained the dose may be maintained at 50 mg/m2/day orally
• Discontinue therapy for hematologic or other toxicity until satisfactory recovery, then resume therapy (at the discretion of the physician based on patient evaluation and laboratory studies).

Side Effects

The Most Common

• nausea, vomiting,
• leukopenia and thrombocytopenia
• somnolence, lethargy, hallucinations, confusion,
• agitation,
• cerebellar ataxia,
• paresthesias, myalgia, a
• decrease of deep tendon reflexes,
• hypotension and allergic skin reactions.
• arthralgia, fever, weakness,
• dermatitis, coma, alopecia, and convulsions.
• anorexia, stomatitis, diarrhea, drowsiness, and depression.
• bone marrow depression,
• hemolysis, bleeding tendencies, psychoses, dizziness,
• peripheral neuropathy, tremors, flu-like syndrome,
• pulmonary reactions, tachycardia,
• ocular defects such as blurred vision and
• papilledema, impaired liver function,

More Common

• shortness of breath, pneumonitis, and productive cough.
• peripheral leukocyte and platelet counts,
• optic neuroretinitis and pulmonary eosinophilia.
• anemia, dry mouth, dysphagia,
• constipation, fatigue pruritus,
• herpes, hyperpigmentation, flushing, intercurrent infections,
• pleura effusion, edema,
• jaundice, headache,
• apprehension, nervousness,
• inability to focus, insomnia,
• pyrexia, hypersensitivity reactions,
• hemorrhage, pancytopenia eosinophilia,
• petechiae, purpura, epistaxis,
• hemoptysis, hematemesis, melena,
• nystagmus, urticaria, hearing loss,
• \diaphoresis, chills, hoarseness,
• slurred speech, enteritis, nightmares, falling,
• unsteadiness, abdominal pain, syncope, retinal hemorrhage,
• photophobia, diplopia, hematuria,
• urinary frequency, nocturia, foot drop and fetal harm.
• palpitations, sweating,
• hypotension and dyspnea.

Rare

• cough
• diarrhea
• fainting
• fever
• fast, slow, or pounding heartbeat
• hallucinations (hearing or seeing things that aren’t there)
• missing menstrual periods
• shortness of breath
• signs of bleeding (e.g., unusual bruising or bleeding, pinpoint red spots on skin, black tarry stools, bloody nose, blood in urine, coughing blood, cuts that don’t stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• lung infection (e.g., difficulty breathing, shortness of breath, wheezing)
• skin rash, hives, or itching
• sores in mouth and on lips
• symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
• tingling or numbness of fingers or toes
• tiredness or weakness (continuing)
• unusual infections (symptoms may include fever or chills, sore throat, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, painful or difficult urination, or listlessness)
• vision changes (e.g., blurred vision, increased sensitivity to sunlight)

Drug interactions

FDA Pregnancy Category D