II. Indications

  1. FDA Approved
    1. Hodgkin Lymphoma (stage 3-4, MOPP Protocol)
  2. Off-Label
    1. Non-Hodgkin Lymphoma
    2. Cutaneous T-Cell Lymphoma
    3. CNS Neoplasms (advanced disease, e.g. glioblastoma multiforme)

III. Mechanism

  1. See Alkylating Agent
  2. Triazene alkylating antineoplastic (Methylhydrazine derivative) active in the S phase of the Cell Cycle (DNA duplication)
  3. Inhibits trans-methylation of Methionine into Transfer RNA, blocking Protein synthesis
  4. As an Alkylating Agent, also forms cytotoxic free radicals which damage DNA

IV. Medications

  1. Capsule: 50 mg

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Bone Marrow Suppression
  2. Secondary Malignancy
  3. Hemolysis (with RBC Heinz bodies)
  4. Impaired future fertility
  5. Alopecia
  6. Hypersensitivity
  7. Neurologic effects (children)
    1. Seizures
    2. Tremors
    3. Altered Mental Status

VII. Safety

  1. Avoid in Lactation
  2. Avoid in Pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function tests
    4. Urinalysis

VIII. Drug Interactions

  1. High Tyramine Intake
    1. Risk of Hypertensive Emergency
  2. Alcohol
    1. Disulfiram reaction
  3. Procarbazine decreases other drug levels
    1. Digoxin
  4. Procarbazine increases other drug levels
    1. Opioids
    2. Sympathomimetics
    3. Tricyclic Antidepressants

X. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Ontology: Procarbazine (C0033223)

Definition (NCI_NCI-GLOSS) The active ingredient in a drug that is used to treat advanced Hodgkin lymphoma and is being studied in the treatment of other types of cancer. Procarbazine blocks cells from making proteins and damages DNA. It may kill cancer cells. It is a type of antineoplastic agent and a type of alkylating agent.
Definition (NCI) A methylhydrazine derivative with antineoplastic and mutagenic activities. Although the exact mode of cytotoxicity has not been elucidated, procarbazine, after metabolic activation, appears to inhibit the trans-methylation of methionine into transfer RNA (t-RNA), thereby preventing protein synthesis and consequently DNA and RNA synthesis. This agent may also undergo auto-oxidation, resulting in the formation of cytotoxic free radicals which damage DNA through an alkylation reaction.
Definition (MSH) An antineoplastic agent used primarily in combination with mechlorethamine, vincristine, and prednisone (the MOPP protocol) in the treatment of Hodgkin's disease.
Definition (CSP) antineoplastic agent specific for the S phase of the cell cycle, used in combination with mechlorethamine, vincristine, and prednisone (MOPP protocol) in the treatment of Hodgkin's disease, and in treatment of other neoplasms.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D011344
SnomedCT 387474003, 81583003, 10174003
English Procarbazine, procarbazine, Benzamide, N-(1-methylethyl)-4-((2-methylhydrazino)methyl)-, Procarbazin, N-(1-methylethyl)-4-[(2-methylhydrazino)methyl]benzamide, p-(N'-methylhydrazinomethyl)-N-isopropylbenzamide, Benzethyzin, N-4-isopropylcarbamoylbenzyl-N'-methylhydrazine, N-isopropyl-alpha-(2-methylhydrazino)-p-toluamide, N-Methylhydrazine, Procarbazine [Chemical/Ingredient], mih, PROCARBAZINE, Ibenzmethyzin, Procarbazine (product), Procarbazine (substance), MIH, PCZ, PCB
Swedish Prokarbazin
Czech prokarbazin
Finnish Prokarbatsiini
Russian PROKARBAZIN, ПРОКАРБАЗИН
Japanese プロカルバジン
Spanish procarbazina (producto), procarbacina (producto), procarbacina, Procarbazina, Procarbacina, ibenzmeticina, ibenzmetizina, procarbacina (sustancia), procarbazina (sustancia), procarbazina
Polish Prokarbazyna
French Procarbazine
German Procarbazin
Italian Procarbazina
Portuguese Procarbazina