Hodpro

Procarbazine (Procarbazine) instructions

Common name: Procarbazine hydrochloride

Trade name: Natulan

All names: Procarbazine, procarbazine, procarbazine, procarbazine hydrochloride, procarbazine isopropylamine , Procarbazine, Natulan, PCZ

Indications:

Hodgkin's disease: 1/3 to 1/2 of the patients can be completely relieved. The MOPP regimen composed of nitrogen mustard, vincristine, and prednisone is one of the basic regimens for the treatment of Hodgkin's disease.

It also has certain effects on non-Hodgkin lymphoma, malignant histiocytosis (malignant histiocytosis), mycosis fungoides (mycosis fungoides), multiple myeloma, melanoma, brain tumors, etc.

When combined with radiotherapy, the treatment shows beneficial effects on radioresistant bronchial adenocarcinoma.

Usage and dosage:

Oral administration: 150 to 300 mg per day, divided into 3 to 4 times, or 150 to 200 mg before going to bed for 2 weeks, repeated after 4 weeks. The total dose of a course of treatment is determined according to the blood picture, usually 7 to 9g. When forming the MOPP regimen to treat Hodgkin's disease, 100mg/m2 is taken every day for 14 days.

Intravenous drip: 2 to 7 mg/kg, starting from a lower dose and gradually increasing, the total amount for one course of treatment is 7 to 10g.

Adverse reactions:

Common gastrointestinal reactions include nausea and vomiting, and occasionally stomatitis, dry mouth, dysphagia, diarrhea and constipation.

Myelosuppression can cause a decrease in white blood cells and platelets, a tendency to bleeding, and anemia.

Headache, fatigue, and drowsiness are more common, and occasionally dizziness, depression, insomnia, hallucinations, ataxia, diplopia, and nystagmus. Muscle pain and joint pain may also be seen. Coma and convulsions are rare.

Atopic dermatitis, herpes, prurigo, pigmentation and hair loss are occasionally seen.

Other symptoms include chills, fever and sweating, and occasionally tachycardia and drop in blood pressure.

Use with caution or reduce the dosage in patients with poor liver and kidney function. Pregnant women should not use it.

Contraindications:

Contraindicated for those with severe liver and kidney damage and pregnant women.

Precautions:

Use with caution in patients with organic encephalopathy, cardiopulmonary insufficiency, liver and kidney dysfunction, and respiratory failure.

Safety for the elderly, children, pregnant and lactating women: The elderly and children are prone to abnormal reactions such as irritability, anxiety, nervousness, etc., so the dosage should be halved. Use with caution by breastfeeding women.

Drug overdose and treatment: Drug overdose and treatment include drowsiness, panic, decreased or disappeared reflex reactions, weakened breathing, low blood pressure, etc., and even coma. Treatment includes monitoring of blood pressure, heart rate, etc., gastric lavage, infusion, and oxygen inhalation. Hemodialysis has no effect.

Whether the dose needs to be adjusted in case of liver or renal insufficiency: When liver function is damaged, the elimination t1/2 is slightly prolonged, and in case of renal insufficiency (or damage), the dose needs to be adjusted.

Others: It is not advisable to engage in dangerous jobs such as driving and climbing while taking medication.

Storage:

Shade from light, seal and store at room temperature.

Mechanism of action:

PCZ can inhibit the synthesis of DNA and protein. After entering the human body, it oxidizes itself to form H2O2 and OH- radicals, which can cause effects similar to ionizing radiation, especially the methylation of the 3rd position of guanine and the 1st position of adenine. It has a variety of biological effects, such as inhibiting cell mitosis, disordering chromosome arrangement, teratogenesis, carcinogenesis, immunosuppression, cytotoxicity, etc. PCZ can inhibit cell mitosis, cause chromosome arrangement disorder, and have various biological effects such as teratogenesis, carcinogenesis, and cytotoxicity. It releases methyl cations in the body, combines with DNA to depolymerize it, and is a non-specific drug of the cell cycle. It mainly acts on the G1/S boundary and has a delaying effect on the S phase. It has no cross-resistance with alkylating agents, vincristine, and corticosteroids, and can significantly improve the efficacy when combined with the above drugs.

Safety and efficacy:

Procarbazine is mainly used for Hodgkin's disease, and 1/3 to 1/2 of the patients can achieve complete remission, with a remission period of 3 to 6 months or longer. It also has certain effects on other malignant lymphomas, multiple myeloma and lung cancer.