Chemotherapy Patient Resource Area

Procarbazine/Matulane^®

Drug
Procarbazine (generic name) is manufactured as Matulane^® (trade name) (Sigma-Tau Pharmaceuticals, Gaithersburg, MD).

Action
Procarbazine is a methylhydrazine derivative. Although its mechanism of action is uncertain, it interferes with the growth of cancerous cells by disrupting their cellular components. Procarbazine is most often given in combination with other drugs, namely nitrogen mustard, vincristine, and prednisone as part of the "MOPP" regimen to treat Hodgkin's disease.

What does the drug look like?
Procarbazine is supplied in ivory-colored, 50-mg capsules.

How long will I take the drug?
The length of treatment depends on how well your body responds to the treatment.

How do I take the drug?
Procarbazine is taken by mouth once or twice a day (your doctor will advise you on how often to take this drug). It usually is given for 14 days and repeated every 28 days. The dose of procarbazine is based on your weight or body size and is determined by your doctor. Your doctor and pharmacist will tell you how many capsules to take each day. Swallow each capsule whole; do not chew or open them. If a capsule accidentally opens or breaks, be careful not to get the contents in your eyes, nose, or mouth. Wash your hands thoroughly if a capsule opens or breaks. If you miss a dose of procarbazine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you accidentally take too many capsules or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature. Do not store it in the bathroom, near the kitchen sink, or in other damp places because moisture may cause this medication to break down. Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Procarbazine temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination. You will need to have a complete blood count (CBC) drawn on specific days.
• Procarbazine lowers the number of red blood cells in your blood, which carry oxygen, and may cause you to feel tired and lack energy. Conserve your energy, get adequate rest, and enlist help in carrying out daily activities (such as meal preparation) as needed. If you feel unusually tired, if your skin and mucous membranes (lining of eyes and mouth) appear unusually pale, or if you experience unusual or heavy bleeding, contact your doctor immediately, as these may be signs of anemia (low red blood cell count).
• Procarbazine also lowers the number of platelets in your blood, which are necessary for proper blood clotting. Call your doctor immediately 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. Use a soft toothbrush, and use care when flossing. Your healthcare providers may give you suggestions on how to care for your mouth, and these directions should be followed carefully.
• Procarbazine commonly causes nausea and vomiting. Eat small frequent meals and bland foods, and report moderate to severe vomiting to your doctor. medications for nausea can be prescribed to help with this side effect.
• Procarbazine interferes with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you must use a reliable method of birth control and not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or would like to become pregnant must discuss this with their doctors before taking this drug.
• Boys in the prepuberty phase or early puberty taking procarbazine may experience gynecomastia (breast swelling and tenderness).
• Secondary cancers, such as acute myeloid leukemia and malignant myelosclerosis, have been reported to occur (rarely) in patients with Hodgkin's disease treated with procarbazine (in combination with other chemotherapy agents and/or radiation therapy).

Drug and food interactions
Let your doctor know what medications you are taking. To minimize the central nervous system effects of procarbazine, other drugs with sedative properties should be used with caution (e.g., barbiturates, antihistamines, pain medications, phenothiazines). Avoid drinking alcohol, because alcohol taken in combination with procarbazine can cause a disulfiram-like reaction (headache, respiratory difficulties, chest pain, nausea and vomiting, mental status changes). Because procarbazine has some monoamine oxidase (MAO) inhibitory activity, tricyclic antidepressants (e.g., amitriptyline, imipramine) and other drugs and foods with known high tyramine content, such as wine, yogurt, ripe cheeses, and bananas, should be avoided. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stools
• Unusual bruising
• Pinpoint red spots on your skin
• Moderate to severe nausea and vomiting