Procarbazine (MATULANE)

Brain cancer, adjuvant or recurrent

Hodgkin lymphoma, all stages

Brain cancer, adjuvant or recurrent

• Dose - Oral: Many dosing regimens, please refer to specific chemotherapy protocol
• Given as monotherapy or in combination with other chemotherapy agents

Hodgkin lymphoma, all stages

• Dose - Oral: 100 mg/m2 on days 1 to 7 every 21 days for 6-8 cycles
• Given in combination with other chemotherapy agents

Available as 50 mg capsules. Capsules should NOT be opened. Store at room temperature.

Alkylating Agent

Take with or without food

If a dose is missed, patients should be instructed to seek guidance from their healthcare team on how to proceed.

Common: Bone marrow suppression, Nausea, Vomiting.

Less Common: Hypertension, Rash, Secondary malignancies, Acute ovarian failure, Acute amenorrhea, Menopause, Azoospermia and sterility.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelet count, ALT, bilirubin, serum creatinine, serum glucose (for patients on dexamethasone).

During treatment: CBC & differential, platelet count, ALT, bilirubin.

• Since procarbazine exhibits some MAO inhibitory activity, it may theoretically interact with drugs that are normally affected by MAOI. Ensure patient is assessed by pharmacy for potential interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Patients should avoid foods rich in tyramine, dopamine, tyrosine, phenylalanine, tryptophan, or caffeine, as they may cause sudden and severe high blood pressure (hypertensive crisis or serotonin syndrome).
• Tyramine-containing foods include aged or matured cheese, air-dried or cured meats including sausages and salamis. Patients should be referred to a nutritionist or dietician for education.
• Patients should be warned not to drink alcoholic beverages while on procarbazine as a disulfiram‑like reaction may occur.
• Myelosuppression - Leukopenia, anemia and thrombocytopenia are common.

BC Cancer. BC Cancer Drug Manual. Procarbazine. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Procarbazine_monograph_1Dec2011_formatted.pdf.  Updated December 1, 2011. Accessed January 22, 2024.

Lexicomp. Procarbazine Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/7558?cesid=83fhF6q2niK&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dprocarbazine%26t%3Dname%26acs%3Dtrue%26acq%3Dprocarbazine. Updated December 5, 2023. Accessed January 31, 2024.

Cancer Care Ontario. Procarbazine Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44016 . Updated June 2019. Accessed January 22, 2024

Sigma-tau Pharmaceutical Inc. MATULANE® Product Monograph. Scarborough, Ontario. Updated August 9, 2017.