Procarbazine

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. It gained FDA Approved in July 1969. The drug is metabolized and activated in the liver. It also inhibits MAO thus increasing the effects of sympathomimetics, TCAs and tyramine.

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Pharmacology

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

Indications

When used to treat Hodgkin's Lymphoma, it is often delivered as part of the MOPP regimen that includes Mechlorethamine, Vincristine (tradename Oncovin), Prednisone, and Procarbazine. 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/ Adverse Reactions

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. It is also highly carcinogenic - patients have a 5-10% risk of developing acute leukemia, especially in combination with radiation therapy.

Pricing

Procarbazine is manufactured by Sigma-Tau Pharmaceuticals, Inc. and is generally priced at $50/capsule in the United States.^[1].

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