Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Procarbazine hydrochloride may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for Procarbazine is one of the group of medicines known as alkylating agents, which interfere with the growth of certain types of cells in the body. Procarbazine is used as one of the chemotherapy drugs in the treatment of some cancers. In adults, Procarbazine is used on its own or in combination with other drugs in the treatment of cancers such as Hodgkin's disease (a cancer of the lymph glands). In children (aged 2-18 years), Procarbazine is used in combination with other drugs in the treatment of Hodgkin's disease.
e Procarbazine 50mg Capsules Do not take Procarbazine 50mg Capsules:
Procarbazine 50mg Capsules PIL UK 008
• • • • •
if you have anything wrong with your blood, in particular, too few white cells or platelets (your doctor will be able to advise you). if you suffer from any severe kidney or liver disorder if you have a non-cancerous tumour if you are in the first trimester of pregnancy if you are breast-feeding
Make sure your doctor knows if any of the above applies to you. Warnings and precautions Talk to your doctor before taking Procarbazine 50mg Capsules:
Procarbazine 50mg Capsules PIL UK 008
•
clozapine (an anti-psychotic medication)
It is safe to use plain Paracetamol or Aspirin without speaking to your pharmacist. Procarbazine 50mg Capsules with food, drink and alcohol Certain foods, drinks and medicines may cause an unpleasant reaction if taken whilst you are being treated with Procarbazine 50mg Capsules or during the two weeks after the course of treatment is completed. The most important foods and drinks that might cause such an effect are: Mature cheeses (including processed cheeses), yeast or meat extracts (such as Marmite, Oxo and Bovril), broad bean pods, pickled herring, salami sausage, pepperoni sausage, bologna sausage, overripe fruit, alcoholic drinks (especially heavy red wines such as Chianti), non-alcoholic beers, lagers and wines and other foods which are not fresh, particularly if they have been fermented, pickled, smoked, 'hung' or 'matured'. These reactions are extremely rare and if you want to eat or drink anything on the list you could try a little at a time, until you are sure that it does not upset you. However, it is best to avoid alcohol altogether. Pregnancy, breast-feeding and fertility If you are pregnant, think you might be pregnant, are planning to become pregnant or are breast-feeding, you should tell your doctor. Pregnancy Procarbazine should not be taken during the first trimester of pregnancy. Its use should also be avoided throughout the remainder of the pregnancy period. Breast-feeding Do not take Procarbazine if you are breast-feeding. Fertility Procarbazine may cause infertility which might mean that you are not able to have children. Ask your doctor or pharmacist for advice before taking any medicine. Driving and using machines Procarbazine can cause drowsiness. If affected you should not drive or use machinery.
Procarbazine 50mg Capsules Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Procarbazine 50mg Capsules PIL UK 008
Procarbazine is usually given in combination with other drugs and it is important that you (or your child) take each medicine at the right time. Sometimes treatment starts with a small dose (1 capsule per day) and is increased each day up to a maximum of six capsules per day. If you take more Procarbazine 50mg Capsules than you should If you swallow too many capsules or someone else accidentally takes your medicine, contact your doctor, pharmacist or nearest hospital straight away. Overdose can cause severe vomiting and feeling sick, dizziness, imagining sensations (hallucinations), depression, fits, low blood pressure and increased pulse rate. If you forget to take Procarbazine 50mg Capsules If you miss a dose, take it as soon as you remember unless your next dose is due within a couple of hours. In this case you should skip the missed dose, go back to your regular dosing schedule and check with your doctor. Do not take a double dose to make up for a forgotten capsule. The same applies if you forget to give a dose to your child at the right time. After taking Procarbazine 50mg Capsules Patients and carers should use gloves when handling urine or vomit produced for up to 48 hours after a dose of procarbazine has been taken. If you have any further questions on the use of this medicine, ask your doctor or pharmacist. 4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. All medicines can cause allergic reactions although serious allergic reactions are very rare. Any sudden wheeziness, difficulty in breathing, swelling in any part of the body, rash or itching (especially affecting your whole body) should be reported to a doctor immediately. Procarbazine may cause the following side effects:
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• • • •
skin or the whites of the eyes (jaundice) you should stop treatment and contact your doctor immediately Loss of appetite, especially at the start of treatment. This usually improves after a few days Lowering of your white blood cell count. Common symptoms include infections, lack of energy, headache, fever and irritability Drowsiness and a lack of enthusiasm Inflammation of lung tissue. Symptoms include shortness of breath, cough, and a burning sensation in the chest.
Procarbazine in combination with other chemotherapy drugs has been associated with an increased occurrence of a rare cancer of the blood cells. It is very important that you keep all hospital appointments whilst taking procarbazine so that your progress can be checked. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any
not listed in this leaflet. You can also report side effects directly via the internet at www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
Procarbazine 50mg Capsules Keep this medicine out of the sight and reach of children – preferably in a locked cupboard or medicine cabinet. Do not use this medicine after the expiry date which is stated on the carton and blister. The expiry date refers to the last day of that month. In order that Procarbazine 50mg Capsules are always clearly identified they should not be removed from their blister packaging until you are ready to take them. Do not mix loose Procarbazine 50mg Capsules with other loose capsules or tablets. Store in the original container in order to protect from moisture. Do not store above 25 ̊C. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
What Procarbazine 50mg Capsules contain The active substance is procarbazine hydrochloride. There is 50mg of procarbazine in each capsule. The other ingredients are mannitol, maize starch, talc and magnesium stearate. The capsule shells are made from gelatin, and also titanium dioxide (E171), shellac, propylene glycol, ammonium hydroxide and black iron oxide (E172). What Procarbazine 50mg Capsules look like and contents of pack
Procarbazine 50mg Capsules PIL UK 008
Procarbazine 50mg Capsules are white, with 'CL50' on one half. They are produced in blister strips, each pack contains 50 capsules. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder: Alliance Pharmaceuticals Limited, Avonbridge House, Bath Road, Chippenham, Wiltshire, SN15 2BB, UK. Manufacturer: EirGen Pharma Ltd., Westside Business Park, Old Kilmeaden Road, Waterford, Ireland. This leaflet was last revised in December 2013. Alliance, Alliance Pharmaceuticals and associated devices are registered trademarks of Alliance Pharmaceuticals Limited © Alliance Pharmaceuticals Limited, 2013
Procarbazine 50mg Capsules PIL UK 008
Procarbazine 50mg Capsules PIL UK 008
Procarbazine Capsules 50mg comes as capsule containing 50mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Procarbazine Capsules 50mg is procarbazine hydrochloride.
This leaflet reproduces the patient information leaflet approved for Procarbazine Capsules 50mg, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
The main indication is Hodgkin's disease (lymphadenoma).Procarbazine may also be useful in other advanced lymphomata and a variety of solid tumours which have proved resistant to other forms of therapy.ChildrenProcarbazine is indicated in the treatment of Hodgkin's lymphoma in children aged 2-18, when associated with other antineoplastic drugs in an appropriate protocol.
In combination chemotherapeutic regimens: Procarbazine is usually administered concomitantly with other appropriate cytostatic drugs in repeated four- to six-weekly cycles. In most such combination chemotherapy regimens currently in use (eg. the so-called MOPP schedule with mustine, Vincristine and Prednisone) Procarbazine is given daily on the first 10 - 14 days of each cycle in a dosage of 100mg per sq. metre of body surface (to nearest 50mg).As sole therapeutic agent: Adults:Treatment should begin with small doses which are increased gradually up to a maximum daily dose of 250 or 300mg divided as evenly as possible throughout the day.Initial dosage scheme 1st day: 50mg 4th day: 200mg
2nd day: 100mg 5th day: 250mg
3rd day: 150mg 6th day et seq: 250-300mg
Further procedure:Treatment should be continued with 250 or 300mg daily until the greatest possible remission has been obtained, after which a maintenance dose is given.Maintenance dose:50 -150mg daily. Treatment should be continued until a total dose of at least 6g has been given. Otherwise, a negative result is not significant.Elderly:Procarbazine should be used with caution in the elderly. Patients in this group should be observed very closely for signs of early failure or intolerance of treatment.Children:The pro m2 dose used in most published trials was analogous to the dose used in adults (100 mg/ m2 for up to 14 days).The dose should be adjusted according to:• The chemotherapy protocol used• The functional state of the bone marrow• Previous chemo- and radiotherapy cycles• The myelosuppressive effect of other cytostatics usedThe treatment and the maintenance doses of Procarbazine should be determined only by a physician experienced in the use of potent antineoplastic drugs in children.Procarbazine capsules are for oral administration.
Pre-existing severe leucopenia or thrombocytopenia from any cause; severe hepatic or renal damage.Procarbazine should not be used in the management of non-malignant disease.Procarbazine is contraindicated during the first trimester of pregnancy and during breast-feeding (see section 4.6).Hypersensitivity to the active substance (Procarbazine) or to any of the excipients listed in section 6.1.
Procarbazine should be given only under the supervision of a physician who is experienced in cancer chemotherapy and having facilities for regular monitoring of clinical and haematological effects during and after administration.Introduction of therapy should only be effected under hospital conditions.Caution is advisable in patients with hepatic or renal dysfunction and Procarbazine should be avoided in patients with severe hepatic or renal disease. Its use should be avoided if creatinine clearance is less than 10mL/min. Caution is also advised in cardiovascular or cerebrovascular disease, phaeochromocytoma, or epilepsy.Regular blood counts are of great importance due to the possibility of bone-marrow suppression. If during the initial treatment the total white cell count falls to 3,000 per mm3 or the platelet count to 80,000 per mm3, treatment should be suspended temporarily until the leucocyte and/or platelet levels recover, when therapy with the maintenance dose may be resumed.Treatment should be interrupted on the appearance of allergic skin reactions.Live vaccines should not be given during or within at least 6 months of treatment with immunosuppressive chemotherapy or radiotherapy for malignant disease.
Procarbazine is a weak MAO inhibitor and therefore interactions with certain foodstuffs and drugs, although very rare, must be borne in mind. Thus, owing to possible potentiation of the effect of barbiturates, narcotic analgesics (especially Pethidine), drugs with anticholinergic effects (including phenothiazine derivatives and tricyclic antidepressants), other central nervous system depressants (including anaesthetic agents) and anti-hypertensive agents, these drugs should be given concurrently with caution and in low doses. Cytotoxics may reduce the absorption of phenytoin and cardiac glycosides.Concomitant use of clozapine may increase the risk of agranulocytosis. Use with enzyme-inducing antiepileptics is associated with an increased risk of hypersensitivity reactions to procarbazine. Intolerance to alcohol (Disulfiram-like reaction) may occur.
Pregnancy
Use of Procarbazine is contraindicated during the first trimester of pregnancy, and should be avoided throughout the remainder of the gestational period.Studies in animals have shown reproductive toxicity (see 5.3). The potential risk for humans is unknown. There are no adequate data from the use of Procarbazine in pregnant women, however isolated human foetal malformations have been reported following MOPP combination therapy. Breast-feeding
Procarbazine is contraindicated during breast-feeding. Fertility
Procarbazine has been reported to cause azoospermia and ovarian failure, which may be irreversible. It is extremely important that the patient is provided with appropriate information and advice, particularly as men may wish to have semen saved for use after Procarbazine treatment (see section 4.8).
Patients should be warned of the possibility of lethargy (see section 4.8 Undesirable effects).
Tabulated list of adverse reactions
Undesirable effects are listed by MedDRA System Organ Classes.Assessment of undesirable effects is based on the following frequency groupings:Very common: ≥ 1/10 Common: ≥ 1/100 to <1/10 Uncommon: ≥ 1/1,000 to <1/100 Rare: ≥ 1/10,000 to <1/1,000 Very rare: <1/10,000 Not known: cannot be estimated from the available data Infections and infestations Not known: Infections (see section 4.4)
Blood and lymphatic systems disorders Not known: Leucopenia Thrombocytopenia Neutropenia
Immune system disorders Not known: Severe hypersensitivity reactions with angioedema, urticaria and a precipitous drop in serum complement
Psychiatric disorders Not known: Lethargy
Respiratory, thoracic and mediastinal disorders Not known: Pneumonitis
Gastrointestinal disorders Very common: Loss of appetite Nausea Vomiting
Hepatobiliary disorders Not known: Hepatic complications including jaundice and abnormal liver function tests
Skin and subcutaneous tissue disorders Not known: Allergic skin reactions
Reproductive system and breast disorders Not known: Azoospermia Ovarian failure
Description of selected adverse reactions
Leucopenia and thrombocytopenia are almost always reversible and seldom require complete cessation of therapy.Loss of appetite, nausea and vomiting are usually confined to the first few days of treatment and then tend to disappear.Azoospermia and ovarian failure may be irreversible. It is extremely important that the patient is provided with appropriate information and advice, particularly as men may wish to have semen saved for use after Procarbazine treatment. Procarbazine is carcinogenic and an increased incidence of acute myelogenous leukaemia has been reported in patients receiving MOPP chemotherapy for Hodgkins disease. Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard.
Signs of overdosage include severe nausea and vomiting, dizziness, hallucinations, depression and convulsions; hypotension or tachycardia may occur.The benefit of gastric decontamination is uncertain. Consider activated charcoal if the patient presents within 1 hour of ingestion of any amount (because of risk of myelosuppression at all doses).General supportive treatment should be performed, with prophylactic treatment against possible infection, and frequent blood counts weekly for at least 3 weeks, or more frequently if unwell or clinically symptomatic from myelosuppression (evidence of bleeding or infection).Consider further haematological monitoring after 3 weeks only if white cells and platelets not recovering (discuss with haematologist/oncologist).
Medicines sold in Romania with the same active substance: Cunoscut în România ca
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
Ask anything about Procarbazine Capsules 50mg. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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