Procarbazine
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-PROCARBAZINE |
|---|---|
| Type | Drug |
| Aliases | IndicarbMatulaneNatulanПрокарбазин |
| Status | reviewed 2026-04-26 | pending_clinical_signoff |
| Diseases | DIS-GLIOMA-LOW-GRADE DIS-PCNSL |
| Sources | SRC-NCCN-BCELL-2025 |
Drug Facts
| Class | alkylating_agent — hydrazine derivative (oral non-classic alkylator) |
|---|---|
| Mechanism | Methylhydrazine prodrug undergoing hepatic CYP-mediated oxidation (CYP1A and CYP2B) to azoprocarbazine and ultimately to a methyldiazonium cation that methylates DNA at O6 and N7 of guanine, generating mono- adducts and inhibiting DNA, RNA, and protein synthesis. Lipophilic and crosses the blood-brain barrier — basis of its central role in PCNSL (R-MPV) and Hodgkin (BEACOPP) regimens. Reversibly inhibits monoamine oxidase (weak MAOI activity → tyramine and sympathomimetic interaction syndrome). |
| Typical dosing | PCNSL R-MPV (DeAngelis): 100 mg/m² PO daily × 7 days every 14 days, cycles 1-5 with rituximab + HD-MTX + vincristine; continued in consolidation arms. Hodgkin BEACOPP escalated: 100 mg/m² PO days 1-7 every 21 days × 6 cycles (with bleomycin + etoposide + adriamycin + cyclophosphamide + vincristine + prednisone). PCV (oligodendroglioma): 60 mg/m² PO days 8-21 every 6 weeks. |
| Ukraine registered | False |
| NSZU reimbursed | False |
| Ukraine last verified | 2026-04-27 |
Warnings
- Myelosuppression — delayed nadir 4-6 weeks; cumulative
- Secondary malignancies — well-documented AML / MDS risk in long-term Hodgkin survivors (alkylator class)
- Hypertensive crisis with tyramine / sympathomimetic interaction (MAOI mechanism)
Notes
Patient counseling on MAOI diet (avoid aged cheese, cured/smoked meats, fermented soy, broad beans, tap beer, draft wine, marmite) is mandatory and must be documented at every cycle. Avoid all SSRIs (fluoxetine, sertraline) and decongestants for 2 weeks after last dose. R-MPV (PCNSL) and BEACOPP-escalated (Hodgkin advanced-stage IPI≥3) are the principal modern uses; both are restricted to specialist centers in UA. AML risk is the dominant late toxicity in Hodgkin survivors and a key reason ABVD remains preferred over BEACOPP in early-stage / lower-IPI disease.
Used By
Regimens
REG-R-MPV- R-MPV (Rituximab + HD-Methotrexate + Procarbazine + Vincristine), 5 cycles q14dREG-R-MPV-SALVAGE-PCNSL- Salvage HD-MTX-based re-induction for relapsed PCNSLREG-RT-PCV-LGG- Radiotherapy + PCV (procarbazine/lomustine/vincristine) — high-risk low-grade glioma