Procarbazine: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the local prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Hodgkin's disease

Adult: Monotherapy: Initially, 50 mg/day, increased by 50 mg daily to 250-300 mg daily in divided doses. Continue doses until max response is achieved or appearance of signs of toxicity. Maintenance: 50-150 mg/day or 1-2 mg/kg daily until a cumulative dose of at least 6 g. Combination Therapy: 100 mg/m² on days 1-14 of each 4- or 6-wk cycle.
Child: Initially, 50 mg/m² daily, up to 100 mg/m² adjust according to response.

Contraindications

Pregnancy. Lactation. Myelosuppression. Severe hepatic and renal impairment.

Special Precautions

May increase blood glucose in diabetics. Monitor peripheral blood counts regularly. Monitor hepatic and renal function wkly. Pheochromocytoma, epilepsy, CV or cerebrovascular disease., hepatic or renal impairment Discontinue use if hypersensitivity occurs.

Adverse Reactions

GI disturbances, anorexia, nausea and vomiting; bone marrow depression; leukopenia and thrombocytopaenia; anaemia, haemolysis and bleeding tendencies; neurotoxicity, lethargy, ataxia and sleep disorders. Fever, myalgia, pulmonary fibrosis or pneumonitis, haematuria, urinary frequency, skin reactions, tachycardia, orthostatic hypotension, ocular defects, infertility and hepatic impairment.

Pregnancy Category (US FDA)

PO: D

Drug Interactions

Increased risk of hypersensitivity reactions when used with enzyme-inducing antiepileptics. Potentiation of sedative effects with CNS depressants. Increased risk of agranulocytosis with clozapine. Disulfiram-like reaction with alcohol. May enhance the anithypertensive effects of antihypertensive agents.

Action

Description: Procabazine, an alkylating agent, damages DNA, inhibits DNA, RNA and protein synthesis. It is able to block the MAO action in the CNS. It is not cross-resistant with other alkylating agents and is S-phase specific.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract.
Distribution: Crosses the blood-brain barrier and diffuses into the CSF.
Metabolism: Rapidly metabolised mainly in the liver and kidneys.
Excretion: About 5% excreted unchanged in urine.

Storage

Protect from light.

MIMS Class

Cytotoxic Chemotherapy

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