Matulane-Procarbazine

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

WARNING It is recommended that procarbazine be given only by or under the supervision of a physician experienced in the use of potent antineoplastic drugs. Adequate clinical and laboratory facilities should be available to patients for proper monitoring of treatment.

Uses For This Medication

 
  • Procarbazine is used in combination with other chemotherapy medications to treat Hodgkin’s lymphoma.
  • This medication may also be given for brain tumors as well as other conditions as determined by your doctor.
  How This Medication Works   Procarbazine is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death. Benefits of This Medication   Procarbazine, alone or together with other chemotherapy medications, may slow down the growth of the tumor, or cancer. In addition, for some cancers, procarbazine, in combination with other chemotherapy medications, may lengthen how long a person lives. Who Should Not Take This Medication   You should not take this medication if you:
  • Are allergic to procarbazine or any of its components. 
  • Have very low white blood cell, red blood cell, or platelet levels. Your doctor or healthcare provider will check your blood before starting procarbazine to make sure that it is safe to start this medication.
  Precautions to be Aware of Before Taking This Medication  

Blood related precautions

  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example, ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises. Do not floss if you have been told your platelets are low.
  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often with soap and water, brush and floss your teeth daily, except when your platelets are low.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
 

Organ related precautions

  This medication is broken down by enzymes (chemicals) in the liver and cleared from the body by the kidneys. In patients with severe liver or kidney disease, procarbazine may not break down and be cleared from the body as well which can lead to high levels of this medication in the body and a greater chance of side effects. If you have any liver or kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.

Miscellaneous precautions

 
  • Do not drink alcohol while taking procarbazine. Drinking alcohol will cause a reaction known as “Antabuse (disulfiram) like reaction” which can cause symptoms of headache, difficulty breathing, nausea, vomiting, sweating and a decrease in blood pressure.
  • Do not smoke tobacco products (like cigarettes or cigars) while taking this medication. Smoking tobacco products while receiving treatment with procarbazine may increase your risk of developing lung cancer after completing therapy
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
 

Patient specific precautions

  It is not known if this medication is safe and effective in children. Toxic side effects such as tremors (shaking), convulsions and coma have been reported in a few cases. Very close monitoring by your health care provider is mandatory if this medication is used in children.

Pregnancy and Breastfeeding Precautions

 
  • This medication can cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Use of this medication has been associated with infertility in both men and women. Notify your doctor or healthcare provider if you want to have children in the future.
 

Medication and Food Interactions

  Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with procarbazine and the following foods or medications:
  • Alcohol (see Precautions To Be Aware Of Before Taking This Medication)
  • Antihistamines [ex. diphenhydramine (Benadryl®), loratadine (Claritin®), fexofenadine (Allegra®)]
  • Barbituates [ex. secobarbital (Seconal®), butabarbital (Butisol®)]
  • Digoxin, decreases the level of digoxin in the body
  • Foods which are high in tyramine (certain wines, yogurt, ripe cheese, bananas, bean curd)
  • Medications that lower blood pressure
  • Monoamine oxidase inhibitors [ex. phenelzine (Nardil®), tranylcypromine (Parnate®)]
  • Opioids [ex. hydrocodone (found in Lorcet®, Vicodin®), oxycodone (found in Percocet®, Percodan®) morphine (Kadian®, Avinza®)]
  • Phenothiazines [ex. prochlorperazine (Compazine®), perphenazine, fluphenazine (Prolixin®), trifluoperazine (Stelazine®)]
  • Sympathomimetic drugs [ex. pseudoephedrine (Sudafed®), phenylpropanolamine, ephedra alkaloids]
  • Tricyclic antidepressants [ex. imipramine (Tofranil®), amitriptyline]
NOTE: This list may not include all medications that can have interactions with procarbazine.

Side Effects

 
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when procarbazine is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with procarbazine alone.
 

More common side effects

 
  • Decreased platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Nausea, vomiting
  • Depression, difficulty sleeping
  • Flu–like symptoms (tiredness, headache, muscle aches, fever, stuffy nose)
 

Rare side effects

  This is not a complete list of the rare side effects reported with procarbazine. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Diarrhea 
  • Tremors (shaking), coma, convulsions 
  • Hallucinations, apprehension, nightmares, nervousness 
  • Numbness and tingling in hands and feet that lead to difficulty walking
  • Hypotension (decreased blood pressure), Tachycardia (rapid heart rate) 
  • Cough, pleural effusion (fluid around the lungs) 
  • Visual changes,(sensitivity to sunlight), retinal hemorrhage, diplopia (double vision), inability to focus 
  • Hair loss, rash, darkening of skin, itching 
  • Second cancers such as acute leukemia, lung cancer where the risk is increased in tobacco users
  How To Take This Medication  
  • This medication is taken by mouth (orally). Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you.
  • Antiemetics, which are medications to help prevent and control nausea and vomiting, may be given before procarbazine either by mouth (orally) or by injection into a vein (IV).
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage  
  • Store this medication at room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.