Procarbazine is a chemotherapy drug that has been used for decades to treat specific cancers, primarily in combination with other antineoplastic drugs. While the generic name is procarbazine, it is known by several other names depending on the brand and location. Understanding these names and the drug's purpose is vital for both patients and healthcare providers.
Common Alternative Names for Procarbazine
The brand name Matulane is the most widely recognized alternative name for procarbazine, particularly in the United States. Beyond this primary brand, the medication has also been marketed under other names in different regions.
Commonly used names for procarbazine:
- Matulane: The main US brand name.
- Natulan: A brand name used internationally.
- Natulanar and Natunalar: Other related brand names.
- Ibenzmethyzin: A synonym or former name for the drug.
- Procarbazine Hydrochloride: The chemical name for the form of the drug used in capsules.
Therapeutic Uses and Combination Regimens
Procarbazine is not typically used on its own but is a crucial component of several combination chemotherapy regimens. These regimens are designed to leverage the different mechanisms of action of multiple drugs to more effectively target and destroy cancer cells.
Hodgkin's Lymphoma
In the treatment of Hodgkin's lymphoma, procarbazine is a key ingredient in several well-known regimens. The drug is most effective when the dose is tailored based on the patient's body surface area.
- MOPP Regimen: One of the earliest combination chemotherapy treatments, MOPP includes Mechlorethamine, Oncovin (vincristine), Procarbazine, and Prednisone.
- BEACOPP Regimen: For advanced or unfavorable Hodgkin's lymphoma, the more intensive BEACOPP regimen is sometimes used, which adds Bleomycin, Etoposide, and Adriamycin to the procarbazine-containing combination.
Brain Tumors
Procarbazine can also cross the blood-brain barrier, making it effective in treating certain brain cancers.
- PCV Regimen: In this combination, procarbazine is used along with CCNU (lomustine) and Vincristine to treat malignant gliomas like glioblastoma multiforme, astrocytomas, and oligodendrogliomas.
Mechanism of Action and Alkylating Effect
As an alkylating agent, procarbazine's mechanism of action involves damaging the DNA of cancer cells to prevent them from replicating. However, it is a prodrug, meaning it is not active until metabolized by the liver.
The metabolic process and its effects:
- Metabolic Activation: The liver metabolizes procarbazine into active intermediates.
- DNA Methylation: These intermediates methylate the DNA of cancer cells, specifically at the O-6 position of guanine.
- DNA Damage and Cell Death: This methylation causes DNA strand breaks, which triggers a process called apoptosis, or programmed cell death, in the rapidly dividing cancer cells.
This unique mechanism, which differs from many other alkylating agents, is a key reason for its continued use in modern oncology, especially in combination therapies.
Significant Side Effects and Patient Management
Like all potent chemotherapy drugs, procarbazine has a range of side effects that require careful management by a physician experienced in antineoplastic drugs. Some side effects, like nausea and vomiting, are very common, while others are more serious and potentially life-threatening.
- Common Side Effects: Nausea, vomiting, loss of appetite, fatigue, hair loss, muscle or joint pain, and darkening of the skin.
- Hematologic Toxicity: Procarbazine can cause myelosuppression, leading to low blood cell counts (leukopenia, anemia, thrombocytopenia) and an increased risk of infection or bleeding.
- Central Nervous System (CNS) Effects: The drug can cause neurologic issues, such as confusion, depression, paresthesia (tingling), seizures, and vision changes.
- Increased Risk of Secondary Cancers: Long-term use in combination with other treatments can increase the risk of developing secondary cancers, such as leukemia.
Important Drug and Food Interactions
Procarbazine has weak monoamine oxidase inhibitor (MAOI) activity, which leads to critical drug and food interactions that must be avoided.
- Alcohol: Can cause a disulfiram-like reaction with symptoms such as flushing, sweating, headache, and nausea.
- Tyramine-rich foods: Certain foods, particularly aged, fermented, or smoked items, contain tyramine. Consuming these can lead to a dangerous hypertensive crisis.
- Central Nervous System (CNS) Depressants: Combining procarbazine with antihistamines, narcotics, barbiturates, or certain antidepressants can cause increased CNS depression.
Comparison of Procarbazine Combinations
| Feature | MOPP Regimen | BEACOPP Regimen | PCV Regimen |
|---|---|---|---|
| Primary Use | Hodgkin's Lymphoma | Advanced Hodgkin's Lymphoma | Brain Tumors (gliomas) |
| Key Components | Mechlorethamine, Vincristine, Procarbazine, Prednisone | Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine, Procarbazine, Prednisone | Procarbazine, CCNU (Lomustine), Vincristine |
| Intensity | Less intensive than BEACOPP | High-intensity | Moderate-intensity |
| Mode of Administration | Often a 28-day cycle, with procarbazine taken orally. | Typically more complex, with intravenous components and oral procarbazine. | Follows a specific schedule for oral and IV components. |
Conclusion
While the search for what is another name for procarbazine? primarily leads to the brand name Matulane, the significance of this medication extends far beyond its nomenclature. As a critical component of powerful combination chemotherapy protocols for cancers like Hodgkin's lymphoma and malignant brain tumors, procarbazine works by chemically disrupting the DNA of rapidly dividing cancer cells. Its use requires careful supervision and monitoring due to its side effect profile, particularly its interactions with certain foods and other medications. For anyone undergoing treatment with this drug, being fully informed about its properties and restrictions is essential for safe and effective therapy.
For further reading, see the National Center for Biotechnology Information's article on procarbazine.
Keypoints
- Brand Name: The most common alternative name for the generic chemotherapy drug procarbazine is Matulane, especially in the US.
- Primary Function: Procarbazine acts as an alkylating agent, inhibiting DNA, RNA, and protein synthesis to kill cancer cells,.
- Cancer Treatments: It is a key component of several combination chemotherapy regimens used for Hodgkin's lymphoma (MOPP, BEACOPP) and certain brain tumors (PCV),.
- Drug Interactions: Due to its mild MAOI activity, procarbazine requires patients to avoid alcohol and foods high in tyramine to prevent a dangerous hypertensive crisis.
- Serious Side Effects: Potential adverse effects include myelosuppression, neurotoxicity, and an increased risk of secondary cancers with long-term use,.
