Pronunciation:

(proe KAR ba zeen)

U.S. Brand Names:

Synonyms:

Generic Available:

Canadian Brand Names:

Use:

Use - Unlabeled/Investigational:

Pregnancy Risk Factor:

Lactation:

Contraindications:

Warnings/Precautions:

Adverse Reactions:

Central nervous system: Reports of neurotoxicity with procarbazine generally originate from early usage with single agent oral (continuous) or I.V. dosing; CNS depression is commonly reported to be additive with other CNS depressants

Hematologic: Myelosuppression, hemolysis in patients with G6PD deficiency

Gastrointestinal: Nausea and vomiting (60% to 90%); increasing the dose in a stepwise fashion over several days may minimize this

Genitourinary: Reproductive dysfunction >10% (in animals, hormone treatment has prevented azoospermia)

Respiratory: Pulmonary toxicity (<1%); the most commonly reported pulmonary toxicity is a hypersensitivity pneumonitis which responds to steroids and discontinuation of the drug. At least one report of persistent pulmonary fibrosis has been reported, however, a higher incidence (18%) of pulmonary toxicity (fibrosis) was reported when procarbazine was given prior to BCNU (BCNU alone does cause pulmonary fibrosis).

Miscellaneous: Second malignancies (cumulative incidence 2% to 15% reported with MOPP combination therapy)

Overdosage/Toxicology:

Drug Interactions:

Procarbazine exhibits weak monoamine oxidase (MAO) inhibitor activity; foods containing high amounts of tyramine should, therefore, be avoided (ie, beer, yogurt, yeast, wine, cheese, pickled herring, chicken liver, and bananas). When a MAO inhibitor is given with food high in tyramine, a hypertensive crisis, intracranial bleeding, and headache have been reported.

Sympathomimetic amines (epinephrine and amphetamines) and antidepressants (tricyclics) should be used cautiously with procarbazine.

Barbiturates, narcotics, phenothiazines, and other CNS depressants can cause somnolence, ataxia, and other symptoms of CNS depression

Ethanol has caused a disulfiram-like reaction with procarbazine; may result in headache, respiratory difficulties, nausea, vomiting, sweating, thirst, hypotension, and flushing

Ethanol/Nutrition/Herb Interactions:

Ethanol: Use ethanol and ethanol-containing products cautiously.

Food: Clinically severe and possibly life-threatening elevations in blood pressure may occur if procarbazine is taken with tyramine-containing foods.

Stability:

Mechanism of Action:

Pharmacodynamics/Kinetics:

Absorption: Rapid and complete

Distribution: Crosses blood-brain barrier; distributes into CSF

Metabolism: Hepatic and renal

Half-life elimination: 1 hour

Excretion: Urine and respiratory tract (<5% as unchanged drug, 70% as metabolites)

Dosage:

Children:

BMT aplastic anemia conditioning regimen: 12.5 mg/kg/dose every other day for 4 doses

Hodgkin's disease: MOPP/IC-MOPP regimens: 100 mg/m²/day for 14 days and repeated every 4 weeks

Neuroblastoma and medulloblastoma: Doses as high as 100-200 mg/m²/day once daily have been used

Adults: Initial: 2-4 mg/kg/day in single or divided doses for 7 days then increase dose to 4-6 mg/kg/day until response is obtained or leukocyte count decreased <4000/mm³ or the platelet count decreased <100,000/mm³; maintenance: 1-2 mg/kg/day

Dosing in renal/hepatic impairment: Use with caution, may result in increased toxicity; decrease dose if serum creatinine >2 mg/dL or total bilirubin >3 mg/dL

Monitoring Parameters:

Patient Education:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Oncology: Emetic Potential:

Dosage Forms:

International Brand Names: