Procarbazine

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Pharmacokinetics 5 Monitor 6 Adverse-effects 7 Drug-interactions 8 Test-interactions 9 Mechanism-of-action 10 More General Terms 11 Internet Database 12 References

Indications

• brain tumors ( astrocytoma)
• Hodgkin's disease ( MOPP) & non-Hodgkins lymphoma
• lung cancer ( bronchogenic carcinoma)
• multiple myeloma

Contraindications

• bone marrow aplasia
  

• pregnancy category = d

Dosage

• oral: 50-200 mg/m2/day for 10-20 days every 3-4 weeks
• MOPP: 100 mg/m2/day for 14 days every 4 weeks

• Capsule: 50 mg.

Pharmacokinetics

• well absorbed orally
• CNS levels approximately equal to serum levels
• metabolized by the liver
• eliminated in the urine
• 1/2life 1 hour
  

• elimination via kidney
• 1/2life = 8-12 hours

Monitor

• complete blood count ( CBC)

Adverse-effects

• common (> 10%)

• pleural effusion, cough, amenorrhea, paresthesia, neuropathy, depression, manic reactions, hallucinations, dizziness, headache, nervousness, insomnia, nightmares, nystagmus, ataxia, disorientation, foot drop, decreased reflexes, tremors, confusion, seizures nausea/vomiting*, anorexia, abdominal pain, stomatitis, dysphagia, diarrhea, constipation, myelosuppression

• less common (1-10%)

• alopecia, hepatotoxicity, hyperpigmentation

• uncommon (< 1%)

• orthostatic hypotension, hypertensive crisis, nervousness, irritability, dermatitis, hypersensitivity rash, arthralgia, myalgia, nystagmus, diplopia, photophobia, flu-like syndrome, jaundice, hoarseness, somnolence, disulfiram-like reaction with alcohol, cessation of menses

• other

• prolonged myelosuppression

• WBC & platelets moderate
• onset 14 days
• nadir 21 days
• recovery 28 days

• urinary frequency

• * severe nausea/vomiting occur frequently & may be dose- limiting; use non- phenothiazine anti-emetic when possible emetic potential 60-90%
  

• drug adverse effects of alkylating agents

Drug-interactions

• tricyclic antidepressants, benzodiazepines in combination lead to increased CNS toxicity
• tyramine-rich foods lead to MAO reactions, hypertension
• CNS-active agents
• meperidine
• dextromethorphan
• local anesthetics

Test-interactions

• increases serum K+

Mechanism-of-action

• alkylating agent
• interferes with DNA & RNA synthesis
• S phase & G2 cell cycle-specific
• MAO inhibitor properties

More General Terms

• benzamide
• alkylating agent
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 4915
PubChem: 9703
PubChem: 441273

References

1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
3. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 529

procarbazine (Matulane, Natulan, ibenzmethyzin)