Procarbazine

Procarbazine hydrochloride

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Introduction

Name

  • Procarbazine.

Class of drug

  • Procarbazine hydrochloride is a hydrazine derivative.
  • It acts as an alkylating agent.

Uses

Action

  • Inhibits protein, RNA, and DNA synthesis.
  • May directly damage DNA by cross-linking (alkylating agent).

Indications

  • In humans used in combination with other anticancer drugs (MOPP) for treatment of Hodgkin's disease.
  • In dogs used in combination with other anticancer drugs for treatment of lymphoma and part of the MOPP protocol. This protocol includes mechlorethamine (nitrogen mustard) (M) combined with vincristine (O) and prednisone (P) [Prednisolone].
  • No information is available on the use of procarbazine used as a single agent in dogs.
  • The MOPP protocol is used primarily for treatment of relapsed canine lymphoma .
  • Not FDA-approved for use in dogs.

Adverse reactions

Effects of overdosage

  • Anorexia, vomiting, or diarrhea occurred in 28% of dogs in one study of the MOPP protocol at the recommended dosage (Rassnick), about half required hospitalization and dose reduction - signs would be similar but worse for overdosage.

Other reported reactions

  • Gastrointestinal toxicity, especially nausea and vomiting.
  • Anorexia and lethargy.
  • Myelosuppression after 2-3 weeks.
  • Alopecia in some breeds.
  • Fever or sepsis associated with neutropenia.

Investigation of adverse reaction

  • Check an additional CBC if fever occurs.

Reporting of reactions

  • Not applicable.

Treatment

  • IV fluids, antiemetics, antidiarrheal medications as needed for gastrointestinal toxicity.
  • Prophylactic antiemetics may prevent recurrence with future doses.
  • Antibiotics if fever and neutropenia occur.

Antidote for overdose

  • None.
  • Could consider G-CSF (Neupogen, Amgen, Thousand Oaks, CA) to minimize myelosuppression.
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