Matulane
Matulane (procarbazine) is taken by mouth and used along with other anticancer drugs to treat Stage III and IV Hodgkin’s lymphoma. It’s convenient because you typically take it once a day. But it can cause a lot of nausea and vomiting, and make you more likely to get infections and bleeds since it can lower your blood counts. Matulane (procarbazine) also interacts with alcohol and certain types of food, so you’ll have to watch what you eat to avoid serious side effects.
What is Matulane (procarbazine)?
What is Matulane (procarbazine) used for?
- Stage III and IV Hodgkin’s lymphoma, in combination with other medications
How Matulane (procarbazine) works
The exact way that Matulane (procarbazine) works on cancer cells isn’t clearly known. It’s thought to prevent the cancer cells from making the proteins and genetic material they need to grow and survive. Matulane (procarbazine) is also thought to directly damage the cancer cells’ genetic material, which leads to cell death.
Drug facts
Side effects of Matulane (procarbazine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Vomiting
Less Common Side Effects
- Diarrhea
- Constipation
- Lack of appetite
- Stomach pain
- Dry mouth
- Nerve pain
- Headache
- Fast heart rate
- Eye problems
- Rash
- Hair loss
- Muscle or joint pain
- Mood changes
Matulane (procarbazine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Change in mental status (central nervous system toxicity): coma, tremors, convulsions, seizures, confusion
- Serious infections: repeated fevers, chills, sweating, cough, trouble breathing, sore throat, stuffy nose, severe diarrhea, vomiting, painful or frequent urination
- Serious bleeds: bleeding or bruising that doesn’t stop or go away, large amount of bleeding, blood in the urine, throwing up blood, bloody or black and tarry stool
The following Matulane (procarbazine) side effects have also been reported
Along with their needed effects, medicines like procarbazine can sometimes cause unwanted effects such as blood problems, loss of hair, high blood pressure reactions, and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Although not all of these side effects may occur, if they do occur they may need medical attention.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Rare
Chest pain (severe)
enlarged pupils of eyes
fast or slow heartbeat
headache (severe)
increased sensitivity of eyes to light
increased sweating (possibly with fever or cold, clammy skin)
stiff or sore neck
Check with your doctor immediately if any of the following side effects occur:
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Confusion
convulsions (seizures)
hallucinations (seeing, hearing, or feeling things that are not there)
missing menstrual periods
shortness of breath
thickening of bronchial secretions
tiredness or weakness (continuing)
Less common
sores in mouth and on lips
tingling or numbness of fingers or toes
unsteadiness or awkwardness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Drowsiness
muscle or joint pain
muscle twitching
nervousness
nightmares
trouble in sleeping
unusual tiredness or weakness
Less common
darkening of skin
difficulty in swallowing
dizziness or lightheadedness when getting up from a lying or sitting position
feeling of warmth and redness in face
headache
loss of appetite
mental depression
This medicine may cause a temporary loss of hair in some people. After treatment with procarbazine has ended, normal hair growth should return.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Matulane (procarbazine)
Pros
- Oral pill
- Can be used in children
- Available as a lower-cost generic medication
Cons
- Can cause a lot of nausea and vomiting
- Can raise your risk for infections or bleeding and bruising
- Has many food and medication interactions
Pharmacist tips for Matulane (procarbazine)
- Depending on the treatment regimen, your provider might have you start by splitting up the daily dose of Matulane (procarbazine) into several smaller doses and taking those throughout the day. Doing so can help with the nausea and vomiting you might experience while taking this medication. As always, follow your provider’s instructions on how to take Matulane (procarbazine).
- Avoid alcohol and products with alcohol in them while taking Matulane (procarbazine). Drinking alcohol while taking this medication can cause stomach upset, flushing, nausea, vomiting, and headaches.
- You’ll have to avoid certain foods while taking Matulane (procarbazine) because they can raise your blood pressure, potentially to dangerous levels. You should avoid foods with high amounts of tyramine, such as wine, yogurt, aged cheese, fermented soy products (soy sauce, miso), aged meats (salami, pepperoni), and bananas.
- You should avoid over-the-counter medications that contain antihistamines, like common allergy medications, and nasal decongestants, such as pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE). These medications can also raise your blood pressure when taken with Matulane (procarbazine). Talk to your pharmacist about other ways to treat your allergies, cold, or flu symptoms.
- You’ll need to get labs frequently to monitor your blood cell counts since Matulane (procarbazine) can lower your blood cell counts and make you at risk for bleeding or developing infections. Follow the lab schedule given to you by your provider.
- Ask your healthcare provider or pharmacist about the best way to handle and throw away Matulane (procarbazine) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.
Common questions about Matulane (procarbazine)
There are several chemotherapy regimens that are recommended for treating Hodgkin’s lymphoma. Matulane (procarbazine) is used in one of these treatments in combination with other chemotherapy medications. Your provider will choose the most appropriate option for you depending on many factors, including your age, stage of Hodgkin’s lymphoma, and how well you will tolerate chemotherapy. Talk with your provider if you have any questions about the benefits and risk for any of the treatment options.
Matulane (procarbazine) is only approved by the FDA to treat Hodgkin’s lymphoma in combination with the MOPP regimen. But according to the National Comprehensive Cancer Network (NCCN) guidelines, it can be used off-label in Hodgkin’s lymphoma as a part of the BEACOPP regimen, which involves other chemotherapy medications. BEACOPP can cause more side effects, so it’s only used in people who are able to tolerate stronger, more aggressive, chemotherapy. The dose of procarbazine in BEACOPP is different compared with the dose that’s used in MOPP. Talk with your provider if you have any questions about other treatment options for Hodgkin’s lymphoma.
Please take Matulane (procarbazine) as instructed by your provider. Matulane (procarbazine) is usually taken for certain days during each chemotherapy cycle, so it’s important to follow the directions your provider gives you. The amount of time you need to take Matulane (procarbazine) depends on things like how well the medication is working to treat your cancer, what chemotherapy treatment regimen you're taking, and how well you tolerate the side effects. Don’t stop taking Matulane (procarbazine) without first discussing with your provider.
If you have liver or kidney problems, you’re at higher risk for side effects because your body might have a more difficult time breaking down Matulane (procarbazine). Let your provider know if you have problems with your liver or kidney, as you’ll need to be monitored more closely. You might need to be hospitalized during your first round of chemotherapy so your provider can give you medical care if needed. Seek medical help right away if you experience serious side effects due to higher levels of the medication in your body, such as confusion, seizures, tremors, or coma.
Matulane (procarbazine) isn’t recommended during pregnancy or breastfeeding. It can cause harm to your unborn baby and shouldn’t be used in pregnancy unless your provider thinks the benefit is greater than the risk for both you and your unborn baby. It might also cause harm to nursing babies because there’s a risk that it can get passed along in breast milk. Let your provider know right away if you become pregnant while taking Matulane (procarbazine), or if you have any questions about pregnancy or breastfeeding while taking Matulane (procarbazine)
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Risks and warnings for Matulane (procarbazine)
Matulane (procarbazine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Must be given by a trained healthcare provider
Matulane (procarbazine) must be give by or under the supervision of your healthcare provider who's trained in caring for people taking chemotherapy medications. You must receive treatment at a clinic, hospital, or care facility that can monitor you for side effects and give you medical care, if needed.
Nervous system (brain, spinal cord, nerves) problems
- Risk factors: Taking Matulane (procarbazine) with other medications that can cause extreme sleepiness
Taking Matulane (procarbazine) alone or with sedatives (e.g. barbiturates), opioids, antihistamines, certain antipsychotics, or medications that can lower your blood pressure, can cause extreme drowsiness, tiredness, difficulty breathing, and can even result in death. If you’re taking medications like these, have a discussion with your provider to make sure the combination is as safe as possible or if other medication options are available. If you have difficulty breathing or feel extremely drowsy, get medical help right away. Let your provider know if you suddenly get confused, have a tingling or “pins and needles” sensation in your body, or nerve pain, as you might need to stop taking Matulane (procarbazine).
Low blood cell counts
- Risk factors: Previous radiation or chemotherapy agents that can cause low blood cell counts
Matulane (procarbazine) can cause your white blood cells, red blood cells, and platelets to drop, usually within the first 2 months of starting Matulane (procarbazine) treatment. When these cell counts are lower than normal, you can feel more tired, and also have a higher risk of bleeding, bruising, and developing infections. If you’ve previously been treated with radiation or chemotherapy that can also lower your blood cell counts, you should wait at least 1 month before starting Matulane (procarbazine) so that your cells have a chance to recover. Your provider will closely monitor your blood counts while you’re taking Matulane (procarbazine). Let your provider know right away if you experience fevers, chills, or bleeding and bruising that doesn’t stop or go away because you might need to stop this medication.
High blood pressure (from food and medication interactions)
- Risk factors: Foods containing high tyramine levels | Taking Matulane (procarbazine) with certain stimulant and mood medications
Certain foods and medications can cause your blood pressure to go up while you're taking Matulane (procarbazine). You should avoid caffeine and fermented or smoked foods like aged cheese, alcohol, soy sauce, fish sauce, pickles, and dried sausage.
Let your provider or pharmacist know what other medications you’re taking before starting Matulane (procarbazine) because you might not be able to take it with certain medications, such as amitriptyline, imipramine (Tofranil), or amphetamine salt combo (Adderall). Talk to your healthcare provider or pharmacist if you have questions. If you experience any severe headaches, neck stiffness or soreness, nausea or vomiting, sweating, and vision issues while you are taking this medication, seek medical help right away as this raise in blood pressure can be deadly.
Effects on fertility
Matulane (procarbazine) can affect your ability to have a baby when used in combination with other chemotherapy agents. It can also cause birth defects during pregnancy. If you or your partner are thinking about having a child in the future, talk to your provider about your different options before starting Matulane (procarbazine), such as sperm banking or egg freezing.
Risk for developing other cancers
While rare, secondary cancers, such as lung cancer and blood cancers, have been reported in people with Hodgkin’s lymphoma who received treatment with Matulane (procarbazine) and other chemotherapy or radiation. It’s unknown whether taking Matulane (procarbazine) alone has the same risk. Your risk of developing lung cancer is higher if you also smoke. Talk to your provider if you are concerned about your risk for other cancers.
Matulane (procarbazine) dosage
Typical dosage for Matulane (procarbazine)
Your provider will calculate your dose of Matulane (procarbazine) using your body surface area (BSA), which takes into account your body weight and height.
Matulane (procarbazine) is typically given in combination with other anticancer medications as part of the MOPP regimen (in combination with a nitrogen mustard, vincristine, and prednisone).
- Hodgkin’s lymphoma (in MOPP regimen): The typical dose is 100 mg/m2 by mouth daily for 2 weeks per cycle. Each cycle of MOPP is 4 weeks long.
Please note: Matulane (procarbazine) might be used with other anticancer medications, besides the MOPP regimen. Please see FAQ for more details.
Interactions between Matulane (procarbazine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Amitriptyline
- Amphetamine
- Apraclonidine
- Atomoxetine
- Benzphetamine
- Brimonidine
- Bupropion
- Carbamazepine
- Carbidopa
- Carbinoxamine
- Citalopram
- Clomipramine
- Codeine
- Cyclobenzaprine
- Cyproheptadine
- Desipramine
- Desvenlafaxine
- Deutetrabenazine
- Dexfenfluramine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan
- Diethylpropion
- Doxylamine
- Duloxetine
- Entacapone
- Escitalopram
- Fenfluramine
- Fluoxetine
- Fluvoxamine
- Guanadrel
- Guanethidine
- Hydroxytryptophan
- Imipramine
- Isocarboxazid
- Isometheptene
- Levodopa
- Levomethadyl
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Maprotiline
- Mazindol
- Measles Virus Vaccine, Live
- Meperidine
- Methamphetamine
- Methyldopa
- Methylphenidate
- Milnacipran
- Mirtazapine
- Mumps Virus Vaccine, Live
- Nefopam
- Nortriptyline
- Opipramol
- Ozanimod
- Paroxetine
- Phendimetrazine
- Phenelzine
- Phenmetrazine
- Phentermine
- Phenylalanine
- Phenylephrine
- Phenylpropanolamine
- Pseudoephedrine
- Rasagiline
- Reserpine
- Rizatriptan
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Safinamide
- Selegiline
- Serdexmethylphenidate
- Sertraline
- Sibutramine
- Solriamfetol
- Sumatriptan
- Tapentadol
- Tetrabenazine
- Tramadol
- Tranylcypromine
- Trazodone
- Trimipramine
- Tryptophan
- Varicella Virus Vaccine, Live
- Venlafaxine
- Vilazodone
- Viloxazine
- Vortioxetine
- Zolmitriptan
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetophenazine
- Adenovirus Vaccine
- Alfentanil
- Amoxapine
- Atropine
- Bacillus of Calmette and Guerin Vaccine, Live
- Benzhydrocodone
- Buprenorphine
- Buspirone
- Butorphanol
- Chlorpromazine
- Cholera Vaccine, Live
- Clovoxamine
- Dengue Tetravalent Vaccine, Live
- Difenoxin
- Dihydrocodeine
- Diphenoxylate
- Dixyrazine
- Dolasetron
- Dothiepin
- Doxepin
- Droperidol
- Ephedrine
- Epinephrine
- Ethchlorvynol
- Ethopropazine
- Femoxetine
- Fentanyl
- Fluphenazine
- Frovatriptan
- Granisetron
- Guarana
- Hydrocodone
- Hydromorphone
- Influenza Virus Vaccine, Live
- Iobenguane I 123
- Iobenguane I 131
- Kava
- Lasmiditan
- Levorphanol
- Licorice
- Lithium
- Lofepramine
- Lorcaserin
- Ma Huang
- Mate
- Mesoridazine
- Metaxalone
- Methadone
- Methotrimeprazine
- Methylene Blue
- Metoclopramide
- Midodrine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Naratriptan
- Nefazodone
- Norepinephrine
- Ondansetron
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Palonosetron
- Pentazocine
- Perazine
- Periciazine
- Perphenazine
- Pipotiazine
- Poliovirus Vaccine, Live
- Prochlorperazine
- Promazine
- Promethazine
- Propiomazine
- Protriptyline
- Reboxetine
- Remifentanil
- Smallpox Vaccine
- St John's Wort
- Sufentanil
- Thiethylperazine
- Thioridazine
- Tolcapone
- Trifluoperazine
- Triflupromazine
- Typhoid Vaccine, Live
- Tyrosine
- Valbenazine
- Warfarin
- Yellow Fever Vaccine
- Ziprasidone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Chlorpropamide
- Ginseng
- Glimepiride
- Glipizide
- Glyburide
- Insulin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Metformin
- Methotrexate
- Nateglinide
- Repaglinide
- Tolazamide
- Tolbutamide
Matulane (procarbazine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Matulane (procarbazine) will not be safe for you to take.
- Not having enough red blood cells and white blood cells in the bone marrow