Hydrazine alkylating cytotoxic
Procarbazine (Specialist drug)
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: per protocol
Clinical pearls
- Hodgkin lymphoma (BEACOPP/escalated regimens); high-grade glioma (PCV)
- Specialist haem-onc; avoid tyramine
Contraindications
- Severe myelosuppression
- Severe hepatic/renal impairment
- Pregnancy
Side effects
- Severe myelosuppression
- Nausea/vomiting
- Hypersensitivity
- MAOI-like effects (avoid tyramine)
- Pulmonary fibrosis
- Secondary malignancy
Interactions
- Tyramine-rich foods
- Sympathomimetics
- TCAs
- Alcohol (disulfiram-like)
- Other MAOIs
Monitoring
- FBC
- LFTs
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/procarbazine-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH