Procarbazine is an alkylating chemotherapy drug used along with other chemotherapy drugs to treat Hodgkin's disease (also known as Hodgkin's lymphoma). It works by preventing cancer cells from growing and from creating new cancer cells. Because procarbazine also affects the growth of normal body cells, you will most likely experience side effects while using this drug.
Procarbazine also acts as a monoamine oxidase inhibitor. (See also Drug Interactions for cautions regarding use of procarbazine with other drugs and the need to limit the amount of tyramine in your diet.)
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This drug may also be used to treat other cancers such as brain tumors.
This is a strong medication and is used in combination with other medicines. Use them exactly as directed by your doctor.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
Do not stop taking this medication, even if you feel nauseated or experience vomiting. However, if you vomit shortly after a dose, contact your doctor right away.
Nausea, vomiting, loss of appetite, constipation, dry mouth, difficulty swallowing, drowsiness, dizziness, headache, trouble sleeping, muscle/joint pain, or darkening of the skin may occur. Nausea and vomiting can be severe. In some cases, drug treatment may be needed to prevent or relieve nausea and vomiting. Not eating before your treatment may help relieve vomiting. Changes in diet and lifestyle, such as eating several small meals and limiting activity, may help lessen some of these effects. If any of these effects continue or worsen, tell your doctor or pharmacist.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Some people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: black/bloody stools, bloody/pink urine, vomit that is bloody or looks like coffee grounds, stomach pain, yellowing eyes/skin, unsteadiness, fainting.
Seek immediate medical attention if any of these unlikely but very serious side effects occur: chest pain, vision problems, fast or slow heartbeat, severe headache, seizures, stiff/sore neck, increased sweating (with or without fever), cold/clammy skin, mental/mood changes, tingling/numbness of hands/feet, unusual bleeding/bruising, diarrhea, mouth/lip sores.
This medication can lower your body's ability to fight an infection. Tell your doctor if you develop any signs of an infection such as: fever, sore throat, chills, unusual tiredness, lower back or side pain, difficult urination, cough, breathing difficulty, thick mucus/phlegm.
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.
Very rarely, people with cancer who are treated with this type of medication have developed other cancers (e.g., secondary leukemia). Your risk is greater if you have received certain types of chemotherapy or radiation therapy. Consult your doctor for more details.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before taking procarbazine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: history of alcohol use.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart/blood vessel problems, recent chickenpox, shingles (Herpes zoster), diabetes, seizures, liver disease, kidney disease, severe/frequent headaches, current infection, overactive thyroid (hyperthyroidism), current or past tobacco use, radiation therapy, blood diseases (e.g., bone marrow depression, low platelet counts).
Avoid alcoholic beverages or alcohol-containing products/foods (e.g., cough and cold syrups, mouthwash, aftershave, sauces, vinegars) while taking this medication. When procarbazine is combined with alcohol, a severe reaction (disulfiram/alcohol-like reaction) may occur, with symptoms such severe nausea, vomiting, flushing, blurred vision, headache, dizziness, severe tiredness, difficulty breathing, fast/pounding heartbeat, increased sweating, or seizures. Contact your doctor right away if you drink alcohol or have any of the above symptoms while taking procarbazine.
Avoid smoking while using this medication. Smoking increases the risk of developing lung cancer while using this drug. Consult your doctor or pharmacist for more details.
This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Before having surgery or emergency treatment, tell the doctor or dentist that you have been receiving this medication.
This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.
To lower the chance of getting cut, bruised or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports.
Wash your hands well and often to prevent the spread of infections. Also, avoid touching your eyes or inside your nose without first washing your hands.
Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.
Caution is advised when using this drug in children because they may be more sensitive to its effects, especially the risk of shaking (tremors), loss of consciousness, or seizures.
This medication is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the use of reliable forms of birth control (such as condoms, birth control pills) with your doctor.
It is not known whether this drug passes into breast milk. Because this drug may harm a nursing infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: antidepressants (including maprotiline, mirtazapine, nefazodone, TCAs such as amitriptyline/nortriptyline), appetite suppressants (such as diethylpropion), drugs for attention deficit disorder-ADD (such as atomoxetine, methylphenidate), apraclonidine, bupropion, buspirone, carbamazepine, cyclobenzaprine, dextromethorphan, digoxin, herbal products (such as ephedra/ma huang), drugs for high blood pressure (such as guanethidine, methyldopa, beta blockers such as atenolol, clonidine, rauwolfia alkaloids such as reserpine, "water pills"/diuretics such as hydrochlorothiazide), other MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine), methotrexate, certain narcotic medications (fentanyl, meperidine, methadone, tapentadol), certain drugs for Parkinson's (entacapone, levodopa, tolcapone), papaverine, street drugs (such as LSD, mescaline), stimulants (such as amphetamines, cocaine, dopamine, epinephrine, phenylalanine), tetrabenazine, "triptan" migraine drugs (such as sumatriptan, rizatriptan), tramadol, tryptophan.
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/ "ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are using any of these medications before, during, or within 2 weeks after treatment with procarbazine. Tell your doctor or pharmacist if you have taken fluoxetine during at least 5 weeks before starting procarbazine. Discuss with your doctor how much time to wait between starting or stopping any of these drugs and taking procarbazine.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (such as diphenhydramine), anti-seizure drugs (such as phenytoin), medicine for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (such as codeine), psychiatric medicines (such as chlorpromazine, lithium, risperidone, trazodone).
Check the labels on all your medicines (such as allergy, cough-and-cold products, decongestants, diet pills) because they may contain dextromethorphan, decongestants, stimulants, or drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.
To prevent a very serious high blood pressure reaction, it is very important that you follow a special diet recommended by your doctor or dietician in order to limit your intake of tyramine while you are taking this medicine. Avoid foods and beverages that are high in tyramine, including: aged cheeses (such as bleu, cheddar, parmesan), dried/aged/fermented meats and sausages (such as salami, liverwurst), preserved fish (such as pickled herring), products containing large amounts of yeast (such as concentrated yeast extract, bouillon cubes, powdered soup/gravy, homemade or sourdough bread), fermented foods (such as sauerkraut, kim chee), most soybean products (such as soy sauce, tofu), broad/fava beans, red wine, sherry, tap beers, vermouth. Limit or avoid foods that are moderate in tyramine, including: avocados, bananas, eggplant, green beans, raisins, raspberries, red plums, spinach, tomatoes, chocolate, cultured dairy products (e.g., buttermilk, yogurt, sour cream), fish eggs, pate, peanuts, coffee, cola, alcohol-free beer, bottled beer, distilled spirits, port, white wine.
Consult your doctor or dietician for more details and a complete list of other tyramine-containing foods you should limit or avoid.
Seek immediate medical attention if you notice symptoms of very high blood pressure such as unusually fast/slow heartbeat, vomiting, unexplained sweating, headache, chest pain, sudden vision changes, weakness on one side of the body, slurred speech.
If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include nausea, vomiting, diarrhea, shakiness, severe dizziness, seizures, and loss of consciousness.
Do not share this medication with others.
Keep all medical appointments. Laboratory and/or medical tests (e.g., complete blood counts, kidney function, liver function) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Keep below 104 degrees F (40 degrees C). Do not store in the bathroom. Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.
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