Procarbazine, Oral

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KEY POINTS

• This medicine is taken by mouth to treat certain forms of Hodgkin's disease. Take it exactly as directed.
• Do NOT smoke while you are taking this medicine. Smoking while taking this medicine greatly increases your changes for getting lung cancer.
• You may get infections more easily when you are taking this medicine.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Do NOT take any other medicines unless your healthcare provider approves.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: procarbazine hydrochloride, oral; Matulane

What is this medicine used for?

This medicine is taken by mouth to treat certain forms of Hodgkin's disease. It is usually prescribed along with other medicines taken by mouth or given by injection. It may also be used to treat other types of cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Bone marrow problems
• Diabetes
• Epilepsy or a seizure disorder
• Heart disease or a recent heart attack
• Kidney or liver disease
• Problems with alcohol abuse
• Thyroid problems

Tell your healthcare provider if you smoke. Smoking while taking this medicine greatly increases your changes for getting lung cancer.

Also tell your provider if you have recently had any kind of infection or if you are taking radiation therapy.

This medicine may make you sterile (unable to have children) whether you are a man or a woman. If you plan to have children someday, talk with your healthcare provider before you start treatment.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine and any other medicines exactly as your healthcare provider prescribes. Do not stop taking this medicine without your healthcare provider's approval.

Check with your healthcare provider before using this medicine in children.

Your dosage may be changed based on your response and on the results of blood tests and other tests. Keep all your appointments.

You may take this medicine with or without food. Taking it with meals may lessen the chance the medicine will upset your stomach. Take the medicine with a full glass of water. Do not chew, break, or crush the capsules. Swallow them whole

What if I miss a dose?

If you miss a dose or vomit right after taking your dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, diarrhea, dizziness, fainting, tremors, seizures, coma.

What should I watch out for?

This is a very strong medicine. Only healthcare providers experienced with this medicine should prescribe it. Make sure you understand what the risks and benefits of treatment are.

You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments.

Do NOT take any other medicines unless your healthcare provider approves.

This medicine may increase your risk of other cancers, especially if you are taking other cancer medicines or if you use tobacco. Do NOT smoke while you are taking this medicine. Talk with your provider if you need help to quit smoking.

Do NOT drink alcohol or liquids with large amounts of caffeine in them such as coffee, tea, or soda pop while taking this medicine. Drinking these liquids can cause flushing, headache, vomiting, chest pain, or stomach pain.

This medicine may cause drowsiness, dizziness, slower reflexes, and vision problems. Do not drive or operate machinery unless you are fully alert and can see clearly.

Children may be more sensitive to this medicine. Watch children for signs of shaking or seizures and contact your healthcare provider right away if your child has these symptoms.

This medicine may make your skin more sensitive to the sun and may cause you to sunburn more easily. While you are taking this medicine, avoid long exposure to the sun. While you are in the sun, wear protective clothing and sunscreen lotion until you know how you will react to the sun. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away. Also, wear sunglasses when you are outdoors during the day.

This medicine may cause nausea and vomiting. Your healthcare provider may prescribe medicine to keep you from feeling sick and throwing up. If this medicine does not help, tell your healthcare provider.

This medicine may lower the number of certain types of blood cells in your body. You may get infections or bleed more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Do not have any vaccines without getting your healthcare provider's approval first. If you develop a fever or other signs of infection, or have any unusual bruising or bleeding, contact your healthcare provider right away.

This medicine may make your mouth sore. Use a soft bristle brush or mouth swab to brush your teeth.

Adults over the age of 65 may be more sensitive to the action of this medicine. Talk with your provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Fever, chills, sore throat, unusual bruising or bleeding, unusual tiredness or weakness, shortness of breath, sores in your mouth, cough, vomiting blood, black tarry bowel movements, yellowing of your skin or eyes, severe nausea or vomiting, shaking, seizures, numbness or tingling, severe or ongoing diarrhea, chest pain, fast heartbeat, trouble walking, severe dizziness or fainting, vision or hearing changes, confusion, unusual mood or behavior changes, hallucinations (seeing or hearing things that are not there).

Other: Mild nausea or vomiting, mild diarrhea, muscle or joint pain, mild tiredness, sweating, constipation, trouble swallowing, headache, loss of appetite, hair loss, trouble sleeping, dry mouth, mild dizziness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Allergy, cold, or cough medicines such as dextromethorphan, naphazoline, oxymetazoline (Afrin, Dristan), phenylephrine (Neo-Synephrine, Sudafed PE), pseudoephedrine (Sudafed), and tetrahydrozoline (Tyzine, Visine)
• Alpha blockers such as doxazosin (Cardura) and prazosin (Minipress)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antidepressants such as amitriptyline, citalopram (Celexa), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), mirtazapine (Remeron), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton), cyproheptadine, diphenhydramine (Benadryl), hydroxyzine (Vistaril), and meclizine (Dramamine)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa), pimozide (Orap), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Atomoxetine (Strattera)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bromocriptine (Cycloset, Parlodel)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Buspirone
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Clonidine (Catapres, Kapvay)
• Cyclobenzaprine (Amrix)
• Diabetes medicines such as glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• Dicyclomine (Bentyl)
• Diethylpropion (Tenuate)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Ephedrine
• Epinephrine (Adrenalin, Asthmanefrin, Auvi-Q, EpiPen)
• Eye medicines such as apraclonidine (Iopidine) and brimonidine (Alphagan P)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), pimecrolimus (Elidel), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Linezolid (Zyvox)
• Lithium (Lithobid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat breathing or lung problems such as albuterol (ProAir, Proventil, Ventolin), ipratropium (Atrovent), metaproterenol, salmeterol (Serevent), and tiotropium (Spiriva)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Methyldopa
• Metoclopramide (Metozolv, Reglan)
• Midodrine
• Migraine medicines such as almotriptan (Axert), dihydroergotamine (D.H.E. 45, Migranal), eletriptan (Relpax), ergotamine/caffeine (Cafergot), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, Sumavel), and zolmitriptan (Zomig)
• Milnacipran (Savella)
• Natalizumab (Tysabri)
• Natural remedies such as echinacea, ephedra, SAMe, St. John's wort, tryptophan, and yohimbe
• Nausea medicines such as granisetron (Sancuso), ondansetron (Zofran), prochlorperazine (Compro), and promethazine
• Pain medicines such as buprenorphine (Buprenex, Butrans), codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), pentazocine (Talwin), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Parkinson’s disease medicines such as amantadine (Symmetrel), entacapone (Comtan), levodopa/carbidopa (Duopa, Rytary, Sinemet), rasagiline (Azilect), and tolcapone (Tasmar)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Products that contain methylene blue (Hyophen, Prosed DS, Urophen, Uta)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sleeping pills such as flurazepam, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Stimulants such as caffeine, dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), and methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
• Tetrabenazine (Xenazine)
• Vaccines

While you are taking this medicine, do not take any prescription or nonprescription medicines unless they are approved by the healthcare provider who prescribed this one.

When taken with certain foods or drinks, this medicine can cause an increase in blood pressure. To avoid this, do not eat large amounts of foods or drink beverages that have a high tyramine content. This includes foods that are aged, fermented, pickled, or smoked, such as aged cheeses; yogurt, dried fruits, smoked fish, meat, or poultry; sauerkraut; soy sauce; red wine; or tap beer. Talk with your healthcare provider about this.

Do not drink alcohol while taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.