Procarbazine

Procarbazine is a chemotherapy drug used to treat brain tumours, Hodgkin's disease and non Hodgkin's lymphomas. It disrupts the growth of cancer cells by stopping the cells from making proteins and DNA. Cancer cells need to make proteins and DNA so they can grow and multiply.

Procarbazine comes as ivory coloured 50mg capsules. Keep them in a tightly closed container, out of the reach of children. You normally take the capsules every day, for 10 to 14 days at a time. You may need to take different numbers of capsules on alternate days to get the correct total dose. Swallow the capsules whole with plenty of water. You should take any unused capsules back to the pharmacy. You should only get supplies of these capsules from your cancer specialist.

It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. Whether you have a full or empty stomach, for example, can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

You usually have procarbazine chemotherapy as a course of several cycles of treatment. The treatment plan depends on which type of cancer you have. There is more about planning chemotherapy in CancerHelp UK.

The side effects associated with procarbazine are listed below. You can use the links to find out more about each side effect. Or go to the cancer drug side effects section.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• 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, sore throat, pain passing urine or feel cold and shivery 
• 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, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

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

Other common side effects include

• Fatigue (tiredness) 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 – do tell your doctor or nurse if these don't control your sickness as you can try other types
• Loss of appetite
• Procarbazine reacts with some other drugs – tell your doctor about all the other medicines you take before starting your course of tablets and don't take over the counter medicines (such as hay fever pills, herbal or alternative medicines) without checking with your doctor first
• Flu like symptoms when you first start taking procarbazine – you may have fever, chills, a blocked nose, sweating, and aches and pains
• Procarbazine may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception to your doctor before having the treatment if there is any chance that you or your partner could become pregnant
• Depression, difficulty sleeping or nightmares happens in 1 to 3 out of every 10 people (10 to 30%) and goes 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%) treated
• Loss of fertility – you may not be able to get pregnant or father a child after treatment with this drug, so it is important to talk to your doctor before starting treatment if having a baby is important to you
• Women may stop having periods (amenorrhoea) but this may only be temporary
• You should not breastfeed while having this drug as it may come through in the breast milk

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
• Skin changes, such as darkening of the skin, or a rash, which may be itchy
• A sore mouth

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
• There is a small risk that you may get a second cancer some years after procarbazine treatment

The side effects above 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)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Return any unused capsules to the hospital pharmacy. Don't throw them in the bin or down the sink or toilet.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.