Procarbazine belongs to the group of cancer-fighting medications known as antineoplastics. Procarbazine prevents the growth of cancer cells by interfering with their reproduction. Procarbazine is used in combination with other cancer medications to treat Hodgkin's disease and other types of cancers.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Procarbazine is taken by mouth under medical supervision. The recommended dose and dosing schedule of procarbazine varies according to body size. The dose is usually given for 14 days and is repeated every 4 weeks.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Procarbazine should only be prescribed by health care professionals familiar with the use of cancer chemotherapy.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

As well as interfering with the genetic material (DNA) of cancer cells, procarbazine can interfere with some of your normal cells. This can cause a number of side effects. Keep track of any side effects and report them to your doctor as suggested in the section "What side effects are possible with this medication?"

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

50 mg
Each No. 2 ivory gelatin capsule contains procarbazine 50 mg (as procarbazine HCl). Nonmedicinal ingredients: cornstarch, gelatin, mannitol, methylparaben, potassium sorbate, propylparaben, quinoline yellow WS, sunset yellow FCF, talc, and titanium dioxide.

Procarbazine should not be taken by anyone who:

• is allergic to procarbazine or to any of the ingredients of the medication
• has severe depletion of neutrophils (white blood cells), platelets, or red blood cells

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• dizziness or lightheadedness when getting up from a lying or sitting position
• drowsiness
• dry mouth
• feeling of warmth and redness in face
• headache
• increased skin sensitivity to sunlight
• loss of appetite
• muscle or joint pain
• nervousness
• nightmares
• sweating
• temporary hair loss
• trouble sleeping
• unusual tiredness or weakness
• upset stomach (nausea) and vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• changes in blood pressure
• chills
• confusion
• cough
• diarrhea
• fainting
• fever
• fast, slow, or pounding heartbeat
• hallucinations (hearing or seeing things that aren't there)
• missing menstrual periods
• shortness of breath
• signs of bleeding (e.g., unusual bruising or bleeding, pinpoint red spots on skin, black tarry stools, bloody nose, blood in urine, coughing blood, cuts that don't stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• lung infection (e.g., difficulty breathing, shortness of breath, wheezing)
• skin rash, hives, or itching
• sores in mouth and on lips
• symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
• tingling or numbness of fingers or toes
• tiredness or weakness (continuing)
• unusual infections (symptoms may include fever or chills, sore throat, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, painful or difficult urination, or listlessness)
• vision changes (e.g., blurred vision, increased sensitivity to sunlight)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain (severe)
• coma
• confusion
• convulsions (seizures)
• enlarged pupils
• fast or slow heartbeat
• headache (severe)
• increased sweating (possibly with fever or cold, clammy skin)
• signs of a blood clot (i.e., sudden change in vision, shortness of breath, chest pain, leg pain, warmth and swelling)
• signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a severe skin reaction (i.e., peeling, blistering, sloughing of skin)
• stiff or sore neck

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Avoid drinking alcohol while using this medication and for a few days after stopping the medication. Drinking alcohol while using procarbazine can lead to unpleasant symptoms such as nausea, flushing, racing heartbeat, and feelings of faintness. This reaction appears 5 to 10 minutes after drinking alcohol and can last from 30 minutes to several hours.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly as usual. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding. Your doctor will do blood tests regularly to monitor the number of platelets in your blood.

Damage to cells: This medication can potentially cause other forms of cancer, such as lung cancer and acute myelocytic leukemia (AML), when given in combination with other anticancer medications. The risk of developing lung cancer is increased with tobacco use. Birth defects and temporary or permanent fertility problems in both men and women may also occur. Permanent nerve damage has also occurred with procarbazine use.

Dietary precautions: Severe reactions including sudden headache, flushed face, rapid, pounding heartbeat, nausea, vomiting, and dangerously high blood pressure may occur when foods with a high tyramine content are eaten while taking this medication. Examples of these foods include wine, yogurt, ripe cheese, and bananas. Ask your doctor or pharmacist for a list of foods that should be avoided.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people who have contagious infections. Tell your doctor immediately if you begin to notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Kidney function: Procarbazine is removed from the body by the kidneys. If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Procarbazine is removed from the body by the liver. If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: There is a possibility of birth defects if either the father or mother is taking procarbazine at the time of conception, or if it is taken during pregnancy. This medication should not be used during pregnancy unless the benefits outweigh the risks. Use effective birth control while you are being treated with this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if procarbazine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. Children may be at an increased risk of side effects and must be monitored closely by the doctor.

There may be an interaction between procarbazine and any of the following:

• alcohol
• amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
• antihistamines (e.g., diphenhydramine, chlorpheniramine)
• antipsychotics (e.g., aripiprazole, clozapine, haloperidol, risperidone)
• apraclonidine
• atomoxetine
• atropine
• baricitinib
• barbiturates (e.g., phenobarbital, secobarbital)
• BCG
• beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
• beta-blockers (e.g., acebutolol, metoprolol, propranolol)
• brimonidine
• bromocriptine
• buprenorphine
• bupropion
• buspirone
• calcium channel blockers (e.g., amlodipine, nifedipine)
• carbamazepine
• cyclobenzaprine
• dextromethorphan
• diabetes medications (e.g., chlorpropamide, glyburide, insulin, metformin, rosiglitazone)
• digoxin
• diphenoxylate
• disopyramide
• disulfiram
• domperidone
• echinacea
• entacapone
• epinephrine
• ergot alkaloids (e.g., ergotamine, dihydroergotamine)
• fingolimod
• guanethidine
• lanreotide
• leflunomide
• levodopa
• linezolid
• lithium
• methadone
• methyldopa
• methylphenidate
• metoclopramide
• mifepristone
• mirtazapine
• monoamine oxidase inhibitors (MAOIs; e.g., methylene blue, moclobemide, rasagiline, selegiline, tranylcypromine)
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
• natalizumab
• nefazodone
• nivolumab
• norepinephrine
• octreotide
• other cancer medications or radiation therapy
• other medications used to lower blood pressure (e.g., furosemide, hydralazine, hydrochlorothiazide, ramipril)
• pasireotide
• pentamidine
• pimecrolimus
• pindolol
• pseudoephedrine
• quinine
• roflumilast
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, , fluoxetine, paroxetine, sertraline)
• serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• sunitinib
• tacrolimus
• tapentadol
• tetrabenazine
• tofacitinib
• tolcapone
• tramadol
• trastuzumab
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, imipramine)
• "triptans" (e.g., sumatriptan, rizatriptan, zolmitriptan)
• tryptophan
• vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.