Procarbazine

Procarbazine is a hydrazine derivative and is a member of the alkylating agents, thereby preventing tumour cells from dividing. The exact mechanism is unclear.

• In combination with other chemotherapeutic agents in Hodgkin's disease.
• There is some recent research looking at the role of procarbazine in other neoplasms, such as, malignant gliomas.¹

• Avoid in severe hepatic impairment
• Renal impairment

• Concomitant use of alcohol must be avoided as a disulfiram-like reaction occurs.²
• Inhibits monoamine oxidase - but diet modification to avoid foods containing tyramine is not needed.³
• Can cause excessive sedation with other sedative medications e.g. antidepressants.
• Possible reduction in phenytoin absorption

• Myelosuppression
• Abdominal symptoms: including abdominal pain, nausea, vomiting and diarrhoea
• Loss of appetite
• Dry mouth
• Headache
• Peripheral neuropathy⁴
• Hypersensitivity reactions ranging from anaphylaxis to urticaria - prevents further use

The only method of administration is orally.

• In patients with pre-existing hepatic or renal impairment these parameters need to be closely monitored.
• BM suppression may occur which may be enhanced by prior chemotherapy or radiotherapy and thus full blood counts need to be watched.
• Hydrazine derivatives can also rarely cause haemolysis with Heinz-Ehrlich inclusion bodies appearing in red cells again requiring monitoring of the full blood count.