Procarbazine (Matulane)

Article Translations: (Spanish)

How does this medicine work?

Procarbazine (pro-kar-ba-zeen) is a chemotherapy medicine used in the treatment of Hodgkin's disease, non-Hodgkin's lymphoma, brain tumors, and lung cancer. It destroys cancer cells by interfering with a specific phase of cell life.

How is it given?

Procarbazine is given by mouth. It comes in capsule form, usually given once a day. It should be given at regular times to keep a steady level in the blood stream. Your child should be awake and alert when taking any medicine.

___ For children who cannot swallow capsules:

1. Put on gloves.
2. Open capsule inside a clear plastic bag.
3. Mix the powder with a very small amount (1 teaspoon) of soft food, such as applesauce or jelly. Make sure your child takes all of the mixture.
4. Wash spoons and container right after use. Discard the plastic bag and gloves.

Are there any precautions about food or other medicines?

Avoid giving antihistamines, barbiturates, narcotics, or antidepressants. Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

It is best to give procarbazine with food or after meals to avoid stomach upset. Do not give foods containing tyramine while your child is taking procarbazine and for 2 weeks after stopping it. Tyramine interacts with procarbazine causing a serious increase in blood pressure.

To avoid tyramine:

• Use fresh, frozen, or canned foods. 
• Avoid all foods that are aged, cured, dried, fermented, pickled, or smoked.
• Store foods properly to prevent spoiling. 
• Do not eat leftovers. 
• Use caution with herbal treatments and protein supplements, since they may contain high tyramine.
• Check food labels carefully.

Some tyramine-containing foods are listed below. Please talk to the dietitian if you have any questions.

Beverages to avoid:

•  alcoholic beverages, beer

Bread/grains to avoid:

• cheese bread
• homemade yeast leavened breads
• coffee cakes
• sourdough bread

Dairy products to avoid:

• aged or hard cheeses, such as cheddar, swiss, and blue cheese (but processed cheese slices, cream cheese, cottage cheese, and ricotta cheese are okay)

Meat, fish and protein foods to avoid:

• sausage, pepperoni, salami 
• commercial soups, gravy, meat extracts

Fruits and vegetables to avoid:

• any overly ripe fruit 
• banana peels 
• fava beans
• lentils, lima beans 
• sauerkraut
• snowpeas 
• soy sauce
• miso 
• tofu

What should I do if a dose is missed?

If a dose is missed, give it as soon as you remember that day. Never give a double dose.

If your child vomits within 30 minutes after receiving a dose, give it again. If your child vomits after 30 minutes, do not repeat the dose. Call the oncology clinic if more than one dose is missed or vomited.

What are the side effects?

Common

• low blood cell counts
• nausea or vomiting
• loss of appetite

Occcasional

• dry mouth, mouth sores
• diarrhea
• fatigue (tiredness)
• dizziness
• head or muscle aches
• fever, chills
• hair loss
• numbness or tingling of hands or feet
• reddened face
• rash or itchy skin
• decreased fertility

Rare 

• eye irritation
• sterility
• secondary cancer

When should I call the doctor?

• mouth sores
• continued vomiting 
• reddened face 
• bleeding or bruising 
• black, tarry stool
• blood in urine, stool, or vomit
• coughing or hoarseness 
• fever or chills
• severe headache 
• stiff neck
• sore throat 
• tightness in chest or throat 
• fast, pounding heartbeat

What else do I need to know?

All caregivers should wear gloves when handling urine, stool, and vomit while your child is receiving the chemotherapy and for 48 hours afterward. Urine, stool, and vomit can be safely disposed of in septic tanks and the sewer system.

Any clothing or bed linens that are contaminated with urine, stool, or vomit should be washed separately from other laundry in hot water and detergent. Anyone handling the contaminated laundry should wear gloves.

Blood samples may be needed to check the effects of the procarbazine. Blood counts may drop about 28 days after starting therapy, but should be normal by 42 days.

Nausea and vomiting should decrease as your child gets used to the medicine.

Good mouth care helps prevent mouth sores.

You and your child should know the names of all the medicines he or she is taking.  Share this information with anyone involved in your child's care.

Make sure you have enough medicine on hand. Each time you refill your prescription, check to see how many refills are left. If no refills are left the pharmacy will need 2 or 3 days to contact the clinic to renew the prescription.

Before giving the first dose, read the label. Be sure it is what was prescribed. After a refill, if the medicine looks different to you, ask your pharmacist or call the oncology clinic before giving it.

Check the label for the expiration date. Check with your clinic or pharmacy on how to dispose. Do not flush them down the toilet or throw them in the garbage.

Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of chemotherapy medicine is taken, call the oncology clinic right away. If your child is unconscious or has a seizure, call 911.

Questions?

This is not specific to your child but provides general information. If you have any questions, please call the oncology clinic or pharmacy.

Children's Hospitals and Clinics of Minnesota
Last reviewed 8/2015

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