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an antineoplastic drug used to treat Hodgkins disease

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/15 17:02:03」(JST)

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Procarbazine (Matulane (US), Natulan (Canada), Indicarb (India) is an antineoplastic chemotherapy drug for the treatment of Hodgkin's lymphoma and certain brain cancers (such as Glioblastoma multiforme). It is a member of a group of medicines called alkylating agents. It gained FDA Approved in July 1969. The drug is metabolized and activated in the liver. It also inhibits MAO thus increasing the effects of sympathomimetics, TCAs, and tyramine.

Pharmacology[edit]

Its mechanism of action is not fully understood. Metabolism yields azo-procarbazine and hydrogen peroxide^{[citation needed]} which results in the breaking of DNA strands.

Indications[edit]

When used to treat Hodgkin's Lymphoma (HL), it is often delivered as part of the BEACOPP regimen that includes Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine (tradename Oncovin), Prednisone, and Procarbazine. The first combination chemotherapy developed for Hodgkin's Lymphoma, MOPP also included Procarbazine (ABVD has supplanted MOPP as standard first line treatment for HL, with BEACOPP as an alternative for advanced/unfavorable HL). Alternatively, when used to treat certain brain tumors (malignant gliomas), it is often dosed as PCV when combined with Lomustine (often called CCNU) and Vincristine.

Side effects[edit]

When combined with ethanol, procarbazine may cause a disulfiram-like reaction in some patients. It also inhibits the liver's CYP450 microsomal system, which leads to an increased effect of barbiturates, phenothiazenes, and narcotics normally metabolized by the CYP450 enzymes. Has monamine oxidase inhibition properties (MAOI), and should not be taken with most antidepressants and certain migraine medications.

Inhibits MAO in the gastrointestinal system thus can cause hypertensive crises if associated with the ingestion of tyramine-rich foods such as aged cheeses.

Procarbazine rarely causes chemotherapy-induced peripheral neuropathy,^[1] a progressive, enduring, often irreversible tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs.^[2]

Dose[edit]

Adult: as part of the BEACOPP chemotherapy regimen: 100 mg/m²/day given for 7 days. Dose should be adjusted for renal (kidney) disease or hepatic (liver) disease.

Dosage form[edit]

50 mg capsules.

References[edit]

^ http://www.ncbi.nlm.nih.gov/books/NBK12946/
^ del Pino BM. Chemotherapy-induced Peripheral Neuropathy. NCI Cancer Bulletin. Feb 23, 2010;7(4):6.

External links[edit]

Medline Plus Drug Information
MOPP Treatment Regimen
PCV Information
Procarbazine Drug Information Provided by Lexi-Comp - Merck Manual
RX Listing for Matulane

UpToDate Contents

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1. 成人の古典的ホジキンリンパ腫生存者に対するアプローチの概要 overview of the approach to the adult survivor of classical hodgkin lymphoma
2. 進行性（ステージIII～IV）の古典型ホジキンリンパ腫の初期治療 initial treatment of advanced stage iii iv classical hodgkin lymphoma
3. 肝疾患を有する患者における化学療法による肝毒性および用量調整 chemotherapy hepatotoxicity and dose modification in patients with liver disease
4. 乏突起膠腫の治療 treatment of oligodendroglial tumors
5. 悪性神経膠腫に対する補助化学療法 adjuvant chemotherapy for malignant gliomas

English Journal

Comparison of chemotherapy including escalated BEACOPP versus chemotherapy including ABVD for patients with early unfavourable or advanced stage Hodgkin lymphoma.

Bauer K, Skoetz N, Monsef I, Engert A, Brillant C.SourceCochrane Haematological Malignancies Group, Department I of Internal Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany, 50924.
Cochrane database of systematic reviews (Online).Cochrane Database Syst Rev.2011 Aug 10;(8):CD007941.
BACKGROUND: There are two different international standards for the treatment of early unfavourable and advanced stage Hodgkin lymphoma (HL): chemotherapy with escalated BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone) regimen and chemotherapy with ABVD
PMID 21833963

Management of fertility in patients treated for Hodgkin lymphoma.

Harel S, Ferme C, Poirot C.SourceFrance;
Haematologica.Haematologica.2011 Aug 9. [Epub ahead of print]
The risk of developing premature ovarian failure and azoospermia is a major concern in long-term survivors treated for Hodgkin lymphoma. Alkylating chemotherapy containing procarbazine and/or cyclophosphamide, causes prolonged azoospermia in 90-100% of men and premature ovarian failure in 5-25% of w
PMID 21828120

Japanese Journal

抗癌剤による化学療法が若年女性癌患者の妊孕性に及ぼす影響(<特集>妊娠分娩と脳神経外科疾患)

鈴木直,石塚文平
脳神経外科ジャーナル 18(5), 361-366, 2009-05-20
抗癌剤による卵巣機能不全は化学療法誘発性無月経と称されており,稀発月経や無月経また無排卵症を呈し,その発生頻度は患者の年齢や抗癌剤の種類,抗癌剤の投与量などに依存すると考えられている.若年女性癌患者における抗癌剤による化学療法後の卵巣機能維持は,妊孕性温存という観点のみならず,女性としてのQOL保持に欠かせないものとなる.悪性度の高い乏突起膠腫は,特にアルキル化剤を基準とした化学療法が有効であると …
NAID 110007227556

Chemical carcinogenesis studies in nonhuman primates

TAKAYAMA Shozo,THORGEIRSSON Unnur P.,ADAMSON Richard H.
Proceedings of the Japan Academy, Series B 84(6), 176-188, 2008
… Results were inconclusive in many cases but unequivocal carcinogenicity was demonstrated for IQ, procarbazine, methylnitrosourea and diethylnitrosamine. …
NAID 130000093934

Related Pictures

★リンクテーブル★

リンク元	「プロカルバジン」
拡張検索	「procarbazine hydrochloride」

「プロカルバジン」

Procarbazine
Systematic (IUPAC) name
	N-isopropyl-4-[(2-methylhydrazino)methyl]benzamide
Clinical data
Trade names	Matulane
AHFS/Drugs.com	monograph
MedlinePlus	a682094
Pregnancy cat.	D (AU) D (US)
Legal status	℞ Prescription only
Routes	Oral (Gel Capsule), intravenous
Pharmacokinetic data
Bioavailability	?
Metabolism	Hepatic, Renal
Half-life	10 minutes
Excretion	Renal
Identifiers
CAS number	671-16-9
ATC code	L01XB01
PubChem	CID 4915
DrugBank	DB01168
ChemSpider	4746
UNII	35S93Y190K
KEGG	D08423
ChEBI	CHEBI:71417
ChEMBL	CHEMBL1321
Chemical data
Formula	C12H19N3O
Mol. mass	221.299 g/mol
	SMILES O=C(c1ccc(cc1)CNNC)NC(C)C;
	InChI InChI=1S/C12H19N3O/c1-9(2)15-12(16)11-6-4-10(5-7-11)8-14-13-3/h4-7,9,13-14H,8H2,1-3H3,(H,15,16) ; Key:CPTBDICYNRMXFX-UHFFFAOYSA-N ;
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