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The drug procarbazine, also known as Matulane, is on the World Health Organization's list of essential drugs. This is a specialized chemotherapy drug for cancer patients such as: Hodgkin lymphoma, glioblastoma multiforme...
1. How does Procarbazine work?
Procarbazine is a chemotherapy drug, belonging to the group of alkylating agents, used to treat Hodgkin lymphoma and brain cancer. The drug works by slowing or stopping the growth of cancer cells.
To treat Hodgkin's disease, Procarbazine is often used in combination with certain other drugs such as Chlormethine, Vincristine, and Prednisone. To treat brain cancer, Procarbazine is used in combination with Lomustine and Vincristine.
2. Dosage of Procarbazine
Single use:
For adults, small doses should be used at first, then gradually increase the dose until 250 to 300 mg are set. 1st day: 50mg, 2nd day: 100mg, 3rd day 150mg, 4th day: 200mg, 5th day: 250mg, 6th day: 250-300 mg, then 250-300mg 300 mg/day until remission, then a maintenance dose of 50 to 150 mg/day. For children: A doctor's consultation is required, can refer to a dose of 50mg/day for a period of time, then a maintenance dose of 100mg/m2/day (approximately 50mg) until the phenomenon occurs. leukopenia, thrombocytopenia. When used in combination with other chemotherapeutic drugs:
Procarbazine is usually given in combination with other chemotherapeutic agents in repeat cycles of 4 to 6 weeks. Most will follow the combination regimen MOPP (Mustin, Vincristin, Procarbazin, Prednisone). The recommended daily dose is 100 mg/m2 body surface area, used during the first 10 to 14 days of the cycle. Patients will be treated with a minimum of 6 cycles or more depending on their condition. Usual Adult Dose for Hodgkin's Disease:
Use by injection: During the first week of treatment, patients should only use a single dose or divided into 2-4 mg/kg/day to minimize nausea and vomiting. . Subsequent doses can be maintained at 4-6mg/kg/day until the white blood cell count falls below 4000 or the platelet count falls below 100,000. After a period of monitoring of hematological indicators and the toxicity of the drug acting on the body. The doctor will advise the patient on whether to continue using or stop using the drug for a period of time to allow the body to recover. When the body can respond to the maximum absorption of the drug, it can be maintained at 1-2mg/kg/day. When used in combination with other anticancer drugs, Procarbazine will be adjusted at the appropriate dosage level. For adults with astrocytoma:
The recommended dose is 60mg/m2 once daily on days 8 to 21 For adults with Glioblastoma Multiforme type primary brain tumor :
The dose response is 60mg/m2 once daily on days 8 to 21.
3. Overdose and how to handle it
When patients use an overdose of Procarbazine, they will experience some manifestations such as hypotension, coma, convulsions, enteritis, nausea and vomiting, and diarrhea.
To handle this condition, the patient will receive systemic supportive treatment such as intravenous fluids. Because Procarbazine mainly causes toxicity on blood and liver. Therefore, the patient should be regularly checked for blood and liver counts until recovery.
4. Side effects of the drug Procarbazine
Some common side effects:
Thrombocytopenia, leukopenia, anemia and bone marrow failure; Vomiting and nausea. Uncommon side effects:
Liver failure, stomatitis, vomiting blood, diarrhea, loss of appetite, constipation, dry mouth, abdominal pain, jaundice. Decreased blood cells, experiencing bleeding conditions such as hemoptysis, nosebleeds or purpura. Low blood pressure, rapid pulse. Effects on vision such as retinal bleeding, photophobia... Pneumonia, pleural effusion, cough. Systemic allergy, dermatitis, itching, alopecia, urticaria, rash. Muscle pain, joint pain. Coma, decreased reflexes, headache, dizziness. For boys and girls when using the drug will experience early puberty. Frequent urination, nocturia. Affects fertility, reduces sperm count and ovarian failure.
5. Drug interactions
Procarbazine has the potential to change the way some other medicines you are taking or increase side effects. Therefore, to avoid drug interactions, patients need to inform their doctors about all the drugs they are using, including prescription and non-prescription drugs, including dietary supplements or herbs.
When using procarbazin in combination with drugs such as Opiat, Phenothiazine, antihypertensive drugs, Histamine, Barbiturates need to be careful because Procarbazin can increase the side effects of these drugs, cause depression of the nervous system center. Concomitant use of Procarbazine with other MAO inhibitors (which are capable of inhibiting monoamine oxidase enzyme activity) may result in a more serious drug interaction that can be fatal. Therefore, it is necessary to avoid combining Procarbazine with sympathomimetic drugs, antidepressants, anesthetics, foods containing tyramine such as alcoholic beverages, cheese. When using Procarbazine in combination with herbal medicines such as ephedra/ma huang, decongestants, certain stimulants (amphetamine, ephedrine, epinephrine, phenylalanine) may increase the risk of high blood pressure.
6. Some notes when using the drug Procarbazine
Using the drug requires the direction of a doctor usually will be 1 or 2 times / day according to the treatment cycle. The drug was used for a period of 2 weeks, then stopped for a short time and continued as prescribed. To avoid high blood pressure, patients need to have a special diet recommended by a doctor or nutritionist. In particular, do not use foods containing tyramine, fermented foods, alcohol... during the course of drug use. Patients should not stop taking Procarbazine on their own, even if vomiting occurs. If you vomit right after using the drug, you should consult a doctor for advice. For pregnant women, doctors recommend not taking Procarbazine because it can harm the fetus. Procarbazine is not recommended in patients with severe liver or kidney problems. Before using Procarbazine you need to tell your doctor if:
Allergy to the ingredients of the drug. Have had blood-related diseases, infections, kidney or liver disease, or radiation treatment. Because the drug has side effects such as dizziness and nausea, the patient should not drive or use machinery without waiting for the body to be awake. Do not use tobacco, smoking increases the risk of developing lung cancer. Should limit sun exposure, regularly wear sunscreen or use sunscreen when going out because using Procarbazine skin will be more sensitive to sunlight. When using Procarbazine, users are more likely to get infections or make infections worse. Therefore, we should limit contact with people who are suffering from contagious infections such as chickenpox, flu, measles. Children when using Procarbazine are more sensitive to the side effects of the drug with the most common manifestation being convulsions or loss of consciousness. Above is the complete information about the drug Procarbazine. For safety, you need to read the user manual carefully before use.
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