This page tells you about the chemotherapy drug procarbazine and its possible side effects. There is information about
Procarbazine is a chemotherapy drug. It is a treatment for
- Hodgkin lymphomas in children and young people
- Some types of non Hodgkin lymphomas
- Some types of brain tumour
It may also be used to treat some other types of cancer.
Procarbazine comes as ivory coloured 50mg capsules. Keep them in a tightly closed container, out of the reach of children.
You usually have procarbazine chemotherapy as a course of several cycles of treatment. It may be combined with other cancer drugs. The treatment plan depends on which type of cancer you have.
For Hodgkin lymphoma you normally take the capsules every day, for 10 to 14 days at a time and then have around 2 to 4 weeks with no treatment. You may need to take different numbers of capsules on alternate days to get the correct total dose. Sometimes the treatment starts with a small dose and your doctor then gradually increases it.
It is very important that you take capsules according to the instructions your doctor or pharmacist gave you. Swallow the capsules whole with plenty of water. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
If you take too many capsules by accident contact your doctor, pharmacist or the nearest hospital straight away as this can make you very ill.
If you miss a dose, take it as soon as you remember unless your next dose is due within a couple of hours. In this case you need to skip the missed dose and let your doctor know. Don't take a double dose to make up for a forgotten capsule.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.
We've listed the side effects associated with procarbazine below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having procarbazine with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick may start in the first few days of your treatment and usually gets better as you go through your course of treatment. You usually have anti sickness tablets to take half an hour before you take your chemotherapy tablets. Tell your doctor or nurse if these don't control your sickness
- Loss of appetite
- Flu like symptoms when you first start taking procarbazine – you may have a high temperature (fever), chills, a blocked nose, sweating, and aches and pains. Taking paracetamol can help
- Depression, difficulty sleeping or nightmares happens in 1 to 3 out of every 10 people (10 to 30%) – these go away when the treatment ends
- Effect on the nerves – numbness and tingling in hands and feet, or shaking hands, happens in 1 or 2 out of every 10 people (10 to 20%)
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
Between 1 and 10 in every 100 people have one or more of these.
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or lasts more than a couple of days
- Hair loss affecting all body hair – your hair will grow back when the treatment ends
- Drowsiness and a lack of enthusiasm
- Skin changes, such as darkening of the skin, or a rash, which may be itchy
- A sore mouth
- Changes in lung tissue that may cause a cough or breathlessness
- Liver changes – you are unlikely to notice any symptoms and your liver function will almost certainly go back to normal when treatment is finished. Let your doctor or nurse know straight away if you have yellowing of the skin or whites of the eyes
Fewer than 1 in 100 people have these.
- Very rarely, fits (seizures) or unconsciousness
- An allergic reaction, with an itchy rash, flushed face and difficulty breathing – tell your doctor or nurse straight away if you have any of these effects
- There is a small risk that you may get a second cancer some years after procarbazine treatment
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
Alcohol and foods
Procarbazine can interact with alcohol and some foods, causing sickness, headaches, difficulty breathing, sweating, faintness or drowsiness. It is best not to drink alcohol while having procarbazine treatment. Reactions to foods are rare but if you want to try one of these foods, you should have a little at a time until you are sure it won't upset you
- Mature cheeses (including processed cheeses)
- Yeast or meat extracts (Marmite, Oxo, Bovril)
- Salami and pepperoni
- Overripe fruit, broad bean pods
- Foods which have been fermented, pickled, smoked, hung or matured
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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