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Procarbazine

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Procarbazine
180px
180px
Systematic (IUPAC) name
N-Isopropyl-4-[(2-methylhydrazino)methyl]benzamide
Clinical data
Trade names Matulane
AHFS/Drugs.com monograph
MedlinePlus a682094
  • AU: D
  • US: D (Evidence of risk)
  • (Prescription only)
Oral (Gel Capsule), intravenous
Pharmacokinetic data
Metabolism Hepatic, Renal
Half-life 10 minutes
Excretion Renal
Identifiers
671-16-9 7pxY
L01XB01
PubChem CID 4915
DrugBank DB01168 7pxY
ChemSpider 4746 7pxY
UNII 35S93Y190K 7pxY
KEGG D08423 7pxY
ChEBI CHEBI:71417 7pxN
ChEMBL CHEMBL1321 7pxY
Chemical data
Formula C12H19N3O
221.299 g/mol
 14pxN (what is this?)  (verify)

Procarbazine (Matulane (US), Natulan (Canada), Indicarb (India) is an antineoplastic chemotherapy drug for the treatment of Hodgkin's lymphoma and certain brain cancers (such as glioblastoma multiforme).

It is a member of a group of medicines called alkylating agents. The drug is metabolized and activated in the liver. It also inhibits MAO thus increasing the effects of sympathomimetics, TCAs, and tyramine.

It gained FDA Approved in July 1969. It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]

Medical uses

When used to treat Hodgkin's lymphoma, it is often delivered as part of the BEACOPP regimen that includes bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine (tradename Oncovin), prednisone, and procarbazine. The first combination chemotherapy developed for Hodgkin's lymphoma (HL), MOPP also included procarbazine (ABVD has supplanted MOPP as standard first line treatment for HL, with BEACOPP as an alternative for advanced/unfavorable HL). Alternatively, when used to treat certain brain tumors (malignant gliomas), it is often dosed as PCV when combined with lomustine (often called CCNU) and vincristine.

Side effects

When combined with ethanol, procarbazine may cause a disulfiram-like reaction in some patients. It also inhibits the liver's CYP450 microsomal system, which leads to an increased effect of barbiturates, phenothiazenes, and narcotics normally metabolized by the CYP450 enzymes. Has monamine oxidase inhibition properties (MAOI), and should not be taken with most antidepressants and certain migraine medications.

Inhibits MAO in the gastrointestinal system thus can cause hypertensive crises if associated with the ingestion of tyramine-rich foods such as aged cheeses.

Procarbazine rarely causes chemotherapy-induced peripheral neuropathy,[2] a progressive, enduring, often irreversible tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs.[3]

Pharmacology

Its mechanism of action is not fully understood. Metabolism yields azo-procarbazine and hydrogen peroxide[citation needed] which results in the breaking of DNA strands.

Dose

Dose should be adjusted for renal (kidney) disease or hepatic (liver) disease.

References

  1. ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014. 
  2. ^ Lisa M. DeAngelis and Jerome B. Posner (2003). "Nonmetastatic Complications". In Kufe DW, Pollock RE, Weichselbaum RR et al. Holland-Frei Cancer Medicine (6th ed.). Hamilton (ON): BC Decker. 
  3. ^ del Pino BM. Chemotherapy-induced Peripheral Neuropathy. NCI Cancer Bulletin. Feb 23, 2010;7(4):6.

External links