Procarbazine

Procarbazine is a chemotherapy drug used to treat Hodgkin lymphoma. It may also be used to treat other cancers.

It is best to read this information with our general information about chemotherapy and the type of cancer you have.

Procarbazine is given as tablets. You may have it as an outpatient or during a hospital stay. Your cancer doctor or nurse will tell you how often you will have it.

Like all chemotherapy drugs, procarbazine can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.

Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:

  • have a temperature
  • feel unwell
  • have severe side effects, including any we do not mention here.

Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

What is procarbazine?

Procarbazine is a chemotherapy drug used to treat Hodgkin lymphoma and some other types of cancer. This information should ideally be read with our general information about chemotherapy and the type of cancer you have.


How procarbazine is given

Procarbazine comes in capsules. It is sometimes given in combination with other chemotherapy drugs. You can have procarbazine at home or during a stay in hospital. During treatment you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse in the outpatient clinic or in the ward. This is who we mean when we mention your doctor or nurse in this information.

Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that it is okay for you to have chemotherapy. 

You will also see a doctor or nurse before you have chemotherapy. They will ask you how you have been. If your blood results are alright on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.

You may be given anti-sickness tablets to take home as well. Your nurse or pharmacist will explain them to you.


Taking your capsules

Always take the procarbazine capsules exactly as explained. It's important to take your capsules at the right times. This is to make sure they work as well as possible for you. Don’t open the capsules. They should be swallowed whole with a large glass of water.

If you are sick just after taking the capsules, contact the hospital. You may need to take another dose. If you forget to take a capsule, do not take a double dose. Keep to your regular schedule and let your doctor or nurse know.

Other things to remember about your capsules:

  • Keep them in the original package.
  • Store them at room temperature away from heat and direct sunlight.
  • Keep them safe and out of the reach of children.
  • Return any remaining capsules to the pharmacist if your treatment is stopped.

Chemotherapy is usually given as a course of several sessions (cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer you're being treated for. Your nurse or doctor will discuss your treatment plan with you.


About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we haven’t listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for this drug. The leaflet lists all known side effects.


Common side effects of procarbazine

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine often.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cell count is low, your doctor may delay your treatment for a short time.

Bruising and bleeding

Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor or nurse if you have any bruising or bleeding that you can’t explain. This includes:

  • nosebleeds
  • bleeding gums
  • tiny red or purple spots on the skin that may look like a rash.

Some people may need a drip to give them extra platelets. This is called a platelet transfusion.

Anaemia (low number of red blood cells)

Chemotherapy can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Feeling tired

Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Feeling sick

You may feel sick in the first few days after chemotherapy. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluids and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.

Loss of appetite

This treatment can affect your appetite. Don’t worry if you don’t eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.

Diarrhoea

If you have diarrhoea, contact the hospital for advice. Try to drink at least two litres (three and a half pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

Muscle or joint pain

You may get pain in your muscles or joints for a few days after chemotherapy. If this happens, tell your doctor so they can give you painkillers. Tell them if the pain does not get better. Having warm baths and taking regular rests may help.

Numb or tingling hands or feet (peripheral neuropathy)

This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks.

Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug or delay treatment for a short time. The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.

Sore mouth

You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth.

Skin changes

Chemotherapy may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. Procarbazine can cause a rash, which may be itchy.

Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.

Effects on the liver

This treatment can affect how your liver works. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your liver is working.


Less common side effects of procarbazine

Allergic reaction

Rarely, this treatment can cause an allergic reaction. Signs of a reaction can include

  • a rash
  • feeling itchy
  • wheeziness
  • shortness of breath
  • swelling of your face or lips
  • feeling unwell.

Tell your nurse straight away if you have any of these symptoms. If you develop any of these symptoms after you get home, contact the hospital on the numbers you’ve been given immediately or go to the nearest accident and emergency department.

Effects on the lungs

This treatment can cause changes to the lungs. Tell your doctor if you develop: 

  • a cough
  • wheezing
  • a fever (high temperature)
  • breathlessness.

You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

Effects on the nervous system

Procarbazine can affect the nervous system. You may have pins and needles or feel tingling in your arms and legs. Some people feel drowsy or confused. You may feel dizzy or unsteady. Rarely procarbazine can cause you to have seizures (fits). Your doctor can prescribe drugs to prevent fits. They will explain more about this.

Tell your doctor or nurse straight away if you notice any of these symptoms. They may make some changes to your treatment if they become a problem for you. It’s important not to drive or operate machinery if you notice these effects.

Second cancer

Rarely, procarbazine can increase the risk of developing a second cancer, usually leukaemia, years later. But the benefits of treatment usually far outweigh this risk. Your doctor can talk to you about this.


Other information about procarbazine

Interaction with alcohol and some foods

It’s best to avoid certain foods, alcohol and alcohol-free beers and wines when you’re taking procarbazine. These can cause a reaction which can make you feel sick, and cause headaches, sweating, drowsiness and breathing problems. Avoid foods such as mature cheeses, salami, and yeast or beef extracts (Oxo®, Bovril® and Marmite®). Your nurse, doctor or pharmacist will give you more advice on foods to avoid.

Other medicines

Some medicines can affect chemotherapy or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.

Blood clot risk

Cancer and treatment with chemotherapy can increase the risk of a blood clot. Symptoms of a blood clot include:

  • pain, redness or swelling in a leg or arm
  • breathlessness
  • chest pain. 

If you have any of these symptoms, contact a doctor straight away. 

A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.

Fertility

Some chemotherapy drugs can affect whether you can get pregnant or father a child.

If you are worried about fertility, it is important to talk with your doctor before you start chemotherapy treatment. There may be ways to preserve fertility for men and women.

Contraception

Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception.

Sex

If you have sex in the first few days after chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.

Changes to your periods

Chemotherapy can sometimes stop the ovaries working. You may not get a period every month and they may eventually stop. In some women, this is temporary, but for others it is permanent and they start the menopause.

Breastfeeding

Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having chemotherapy.