Procarbazine

Procarbazine is a chemotherapy medicine used to treat cancer, such as Hodgkin’s Disease, a cancer of the lymph glands. It is occasionally used to treat liver and brain tumours.

How is procarbazine given?

Procarbazine is given by mouth in the form of capsules, usually in two to three doses a day.

What are the side effects of procarbazine?

Nausea and vomiting 

Anti-sickness medicines can be given to reduce or prevent these symptoms. Please tell your doctor or nurse if your child’s sickness is not controlled or persists.

Loss of appetite 

It is possible that your child may ‘go off’ food and their appetite may reduce while having treatment. The dietitians may be able to suggest ways of making food more attractive to your child.

Bone marrow suppression 

There will be a temporary reduction in how well your child’s bone marrow works. This means your child may become anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising or bleeding, or any signs of infection, especially a high temperature.

Fertility

Depending on the combination of medicines and the dose that your child is given, his or her fertility may be affected. If you feel you would like more information, please discuss this with your doctor.

Skin rash 

Please tell your doctor or nurse if your child develops a skin rash. They will advise you on the appropriate treatment to use.

Flu-like symptoms 

Your child may have headaches and tiredness, aching joints and muscles, a high temperature and chills. Paracetamol may be given to relieve these symptoms only if your child is not neutropenic.

Procarbazine and interactions with other medicines

Some medicines can react with procarbazine, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines. Cough and cold medicines (other than paracetamol) should be particularly avoided.

Certain foods and drinks may cause an unpleasant reaction if your child eats them while being treated with procarbazine or for two weeks after the course has finished. The main foods and drinks that could cause a reaction include: mature cheeses, yeast or meat extracts, like Marmite®, Oxo® and Bovril®, salami, pepperoni sausage, broad bean pods, overripe fruits, other foods which are not fresh, particularly if they have been fermented, pickled, smoked, hung or matured. These reactions are extremely rare so if your child want to eat something on the list, try a small amount first until it is clear that it does not make your child feel ill.

Important information you should know about procarbazine

  • Keep all medicines in a safe place where children cannot reach them.
  • Procarbazine should be kept in a cool, dry place away from direct sunlight or heat.
  • You should handle these medicines with care, avoiding touching them where possible. If you are pregnant or think you could be pregnant, please discuss handling instructions with your doctor, nurse or pharmacist. Please see our Special handling requirements information sheet for further details.
  • If your child vomits after taking the dose, inform the doctor or nurse. Do not give them another dose.
  • If you forget to give your child their dose, do not give them a double dose. Inform your doctor or nurse and keep to your child’s regular dose schedule.
  • If your child cannot swallow capsules, you can make them into a mixture as follows:
    • You will need a pair of rubber gloves, a mask, a glass and an oral syringe. ‘Duck’ masks are available from Day Care – please use a new mask for each dose.
    • Put on your gloves and mask.

    • Put a little water into the glass.

    • Empty the contents of the required number of capsules onto the water.

    • Draw up the dose using the oral syringe and give to your child.

    • Wash the syringe, gloves and glass in warm, soapy water and do not use for any other purpose.

    • If you accidentally spill the capsules or mixture, wash the area thoroughly with plenty of water.

  • If the mixture accidentally gets into your eyes, wash with plenty of running water for five to 10 minutes.
  • Empty capsules, used paper towels, masks, vomit and dirty disposable nappies should be placed inside two rubbish bags and disposed of along with your normal rubbish.
  • If your doctor decides to stop treatment with procarbazine or the medicine passes its expiry date, return any remaining medicine to the pharmacist. Do not flush it down the toilet or throw it away.
Compiled by: 
The Pharmacy department in collaboration with the Child and Family Information Group
Last review date: 
April 2013
Ref: 
2013F0732

Disclaimer

Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.

For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.  

For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.