Procarbazine
MATULANE
What it isAlkylating agent generating methyl radicals; Hodgkin lymphoma and brain tumors.
Why this oneIt penetrates the CNS well, which is why it persists in brain tumor regimens.
What limits it⚑ It is a weak MAO inhibitor — tyramine and serotonergic interactions apply. Disulfiram-like reaction with alcohol; secondary leukemia.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hodgkin lymphoma (single agent) | Adult | 2-4 mg/kg/day x1 week | 4-6 mg/kg/day until response | maintenance 1-2 mg/kg/day |
| Hodgkin lymphoma (single agent) | Pediatric | 50 mg/m²/day x1 week | 100 mg/m²/day until response | maintenance 50 mg/m²/day |
Renal Undefined
Hepatic Undefined
Instructions
- Base dose on actual weight (use lean body mass if obese/edematous)
- Discontinue if WBC <4000/cmm or platelets <100,000/cmm, then resume at 1-2 mg/kg/day after recovery
- In MOPP combination, dose is 100 mg/m²/day x14 days
- Avoid tyramine-rich foods, alcohol, and sympathomimetics (MAOI activity)
Contraindications
- Inadequate bone marrow reserve (by bone marrow aspiration)
Cautions
- Myelosuppression (leukopenia, thrombopenia, anemia)
- MAOI activity — hypertensive reactions with tyramine/sympathomimetics; disulfiram-like reaction with alcohol
- CNS toxicity (tremors, coma, convulsions)
- Secondary malignancies and azoospermia
- Hepatic dysfunction
Adverse reactions
- Leukopenia, anemia, thrombocytopenia, pancytopenia
- Nausea and vomiting
- Neurologic: coma, convulsions, neuropathy, ataxia, paresthesia
- Hepatic dysfunction, jaundice
- Dermatologic: dermatitis, alopecia, hyperpigmentation
Pregnancy Can cause fetal harm; teratogenic; advise women of childbearing potential to avoid pregnancy
Lactation Undefined
⚠ BOXED WARNING
- Administer under supervision of an experienced physician
Cost, est. cash$5,000–$30,000+/month or cycle
Generic entryNo US generic
Classes and tags
Clinical profile
Legacy pregnancy categoryD
Defining liabilityMyelosuppression and agent-specific hepatic, cardiac, pulmonary, neurologic or reproductive toxicity require oncology monitoring.
Mechanism of action: Procarbazine ballicule
