Your child needs to take the medicine called procarbazine (say: pro-KAR-ba-zeen). This information sheet explains what procarbazine does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is procarbazine?
Procarbazine is a medicine used to kill cancer cells. It stops cancer cells from dividing and making new cells.
You may hear procarbazine called by its brand names, Matulane or Natulan. Procarbazine comes in capsule form.
Before giving procarbazine to your child
Tell your doctor if your child has ever reacted badly to procarbazine or any other medication, food, preservative, or colouring agent.
Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- heart problems
- liver or kidney problems
- an infection or recent exposure to infection (for example chickenpox)
- diabetes mellitus or high blood sugars
- a history of seizures (convulsions or fits)
- headaches which are severe or frequent
- thyroid problems
- any mood or behaviour problems
How should you give your child procarbazine?
- Give your child procarbazine exactly as your doctor or your pharmacist tells you to. Talk to your child's doctor before you stop giving this medicine for any reason.
- Give your child procarbazine at the same time every day, exactly as your child's doctor or pharmacist tells you.
- Your child should swallow the capsule whole with a glass of water or other liquid. If your child is not able to swallow capsules or is taking a dose that is less than a whole capsule, review the best way to give procarbazine with the pharmacist.
- You may give procarbazine with food or without food.
- Wash your hands after handling procarbazine.
What should you do if your child misses a dose of procarbazine?
- Give the missed dose as soon as you remember.
- If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
- Do not give your child 2 doses to make up for 1 missed dose.
- If your child vomits 20 to 30 minutes after taking a dose, give another dose. If your child vomits again, do not give another dose. Contact the doctor or clinic nurse to let them know.
What are the possible side effects of procarbazine?
Your child may have some of these side effects while they take procarbazine. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:
- nausea and vomiting
- loss of appetite
- loose stools
- drowsiness or dizziness
- nervousness
- nightmares or trouble sleeping
- muscle or joint pain
- skin darkening on hands, elbows, or knees
- mouth sores
Call your child's doctor during office hours if your child has any of these side effects:
- changes in personality or confusion
- seeing, hearing, or feeling things that are not there (hallucinations)
- yellow skin or eyes
- skin rash or itchy skin
- tingling or numbness of the fingers or toes
- missed menstrual cycles (periods)
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- fever or chills
- cough or sore throat
- pain or burning with urination
- seizures (convulsions or fits)
- black, tarry stools
- blood in urine or stool
- pinpoint red spots on skin
- unusual bleeding or bruising
- severe chest pain
- severe headache
- enlarged pupils or sensitivity to light
- changes in heart rate (heart beating faster or slower)
- increased sweating or clammy skin
- stiff and sore neck
- swollen face or mouth
- tightness in the chest, wheezing, or trouble breathing
What safety measures should you take when your child is using procarbazine?
Keep all appointments at the clinic or doctor's office so that the doctor can check your child's response to procarbazine.
Your child may feel drowsy or dizzy when they start taking procarbazine. Watch carefully when your child is doing something that they need to be alert for, such as climbing stairs. This usually goes away after the first few doses.
Procarbazine commonly causes nausea and vomiting. If your child begins to feel ill, do not stop using this medicine without first checking with your doctor. Your child may be given a prescription for anti-nausea medicines to take at home. Ask your doctor for ways to lessen these effects.
Procarbazine may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store-bought mouthwash, as it may sting and cause dry mouth.
Procarbazine can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child should not touch your child's eyes or inside their nose without washing hands first.
- Your child's nurse will review with you what to do in case of fever.
Procarbazine can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking procarbazine.
- Your child should not receive a permanent tattoo or any kind of body piercing.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child and anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine.
There is a chance that procarbazine may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving procarbazine. Tell the doctor right away if your child may be pregnant.
After receiving procarbazine, your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with you/your child.
Some foods and drinks contain a substance called tyramine. Tyramine can cause a serious reaction when taken with procarbazine. This reaction leads to a very high blood pressure. Signs of the reaction are sudden, severe headache, upset stomach, and throwing up. Your child should avoid foods and drinks with tyramine when taking procarbazine. Your child should also avoid these foods for 14 days after stopping procarbazine. Please consult a dietitian for a list of tyramine-containing foods.
Caffeine can also interact with procarbazine to cause a dangerous reaction. Caffeine may be found in food, drinks, and some medicines. Your child should avoid coffee, tea, colas, and medications which include caffeine and limit the amount of chocolate they eat or drink.
Many medications, including medicines that can be bought without a prescription, also may interact with procarbazine. Medications including cough and cold remedies, decongestants, allergy treatments, sleeping aids, "stay awake" products, diet or weight loss pills, antidepressants, medication for attention-deficit/hyperactivity disorder (ADHD), and some pain medications may cause problems while taking procarbazine and for several weeks after procarbazine is stopped. Talk to your doctor or pharmacist before using any new prescription, non-prescription, vitamin, homeopathic, or herbal remedy.
Usually your child will need to wait at least 2 weeks after stopping procarbazine before they can take any of the above medicines. Check with the pharmacist or doctor if you are not sure.
What other important information should you know about procarbazine?
- Hair loss does not usually occur with procarbazine.
- Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Make sure you always have enough procarbazine to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills. Not all pharmacies will carry procarbazine.
- Keep procarbazine at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep procarbazine out of your child’s sight and reach and locked up in a safe place. If your child takes too much procarbazine, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.