Hydrazine alkylating cytotoxic

Procarbazine (Specialist drug)

Procarbazine is an oral cytotoxic agent used chiefly as part of combination chemotherapy for Hodgkin lymphoma and some brain tumours.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is metabolised to reactive species that alkylate and methylate DNA, inhibiting nucleic acid synthesis in dividing cells.

Prescribing in practice

Procarbazine has weak monoamine oxidase inhibitory activity, so tyramine-rich foods, sympathomimetics, and interacting drugs can provoke a hypertensive reaction and must be avoided.
A disulfiram-like reaction can occur with alcohol, which should therefore be avoided.
Myelosuppression is dose-limiting, predisposing to infection and bleeding, and the drug is highly emetogenic.

Monitoring

Monitor full blood count regularly, along with hepatic and renal function, during treatment.

Counselling the patient

Avoid alcohol and tyramine-rich foods such as mature cheese, as serious reactions can occur.
Report fever, infection, or unusual bruising or bleeding promptly.
Effective contraception is required during and after treatment, and fertility may be affected.

Evidence & guidelines

Procarbazine is a long-established component of combination regimens for Hodgkin lymphoma and is supported by extensive clinical use.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways