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Matulane Procarbazine Hydrochloride
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What is Matulane?

Matulane (procarbazine hydrochloride) is a medication used in combination with other anticancer drugs to treat Stage III and IV Hodgkin lymphoma. 

Stage III Hodgkin’s disease involves cancer in lymph nodes above and below the diaphragm or nodes above the diaphragm and spleen; Stage IV shows cancer spread to organs beyond the lymph system, such as the liver, bone marrow, or lungs.

Matulane is part of the MOPP treatment plan, which includes nitrogen mustard, vincristine, procarbazine, and prednisone. Procarbazine hydrochloride, found in Matulane, is an anticancer agent available in capsule form. MOPP is no longer a first-line standard regimen in modern practice due to toxicity.

Before starting Matulane, it’s important to ensure normal kidney and liver functions to minimize side effects. Bone marrow depression, a common side effect, typically occurs a few weeks into treatment, necessitating careful monitoring to prevent infections.

Dosage Information and Usage

Dosage Form and Strengths of Matulane

Matulane is available in capsule form containing 50 mg of procarbazine hydrochloride.

Usage

Matulane is administered based on the patient’s weight, starting with 2 to 4 mg per kilogram of body weight per day to minimize initial nausea and vomiting. 

The daily dose is then adjusted to 4 to 6 mg/kg/day until the desired response is achieved or certain blood counts drop. 

Maintenance doses can be reduced to 1 to 2 mg/kg/day once maximum response is attained. 

Treatment needs close monitoring for blood-related and other toxic side effects. Therapy can restart once any adverse effects are resolved, following clinical assessment and lab tests.

Side Effects

Common Side Effects

  • Leukopenia (low white blood cells)
  • Anemia (low red blood cells)
  • Thrombocytopenia (low platelets)
  • Nausea and vomiting

Serious but Rare Side Effects

  • Coma and convulsions
  • Neurological issues like neuropathy (damage to nerves) and ataxia (loss of coordination)
  • Liver problems and jaundice yellowing of the skin and eyes due to liver dysfunction)
  • Bleeding tendencies such as petechiae (small red or purple spots on the skin due to bleeding under the skin) and hemoptysis (coughing up blood)
  • Respiratory issues like pneumonitis (inflammation of lung tissue)
  • Dermatological issues such as rash and alopecia (hair loss)
  • Psychiatric symptoms like hallucinations and depression

Warnings and Precautions

  • To reduce the risk of central nervous system depression and increased effects, be cautious when using medications such as barbiturates, antihistamines, narcotics, hypotensive agents, or phenothiazines. Central nervous system depression slows brain activity, while potentiation amplifies the effects of another substance.
  • Avoid ethyl alcohol while taking Matulane to prevent an Antabuse-like reaction. An Antabuse-like reaction causes severe discomfort when alcohol is consumed, similar to the effects of disulfiram.
  • Due to its monoamine oxidase inhibitory activity, avoid sympathomimetic drugs, tricyclic antidepressants (e.g., amitriptyline, imipramine), and foods high in tyramine like wine, yogurt, ripe cheese, and bananas. Monoamine oxidase inhibitors affect neurotransmitters in the brain, potentially causing dangerous interactions with these medications and foods.
  • Hydrazine derivatives such as Matulane can cause hemolysis (breakdown of red blood cells) and the formation of Heinz-Ehrlich inclusion bodies in red blood cells. Hemolysis is the destruction of red blood cells, and Heinz-Ehrlich bodies are unusual structures found in red blood cells in specific circumstances.

Pregnancy Considerations:

  • Matulane may harm a fetus if used while pregnant. Women should be told about the risks and advised to avoid pregnancy during treatment.

Carcinogenic, Mutagenic, and Fertility Impairment:

  • Matulane has been linked to an increased risk of second cancers like lung cancer and leukemia in patients receiving intensive treatment regimens.
  • It has shown mutagenic effects in various test systems, suggesting it can cause genetic mutations.
  • Matulane may impair fertility in men, leading to conditions like azoospermia (lack of sperm in semen) and other reproductive issues.
  • Use Matulane cautiously in patients with kidney or liver impairment, as they may experience increased toxicity.
  • Patients who have recently undergone radiation or other bone marrow-depressant treatments should wait at least a month before starting Matulane to allow for bone marrow recovery.
  • Promptly discontinue Matulane if serious side effects occur, such as neurological symptoms, low blood counts, hypersensitivity reactions, or severe gastrointestinal issues.
  • Bone marrow depression can occur weeks after starting treatment, requiring close monitoring and potentially hospitalization to manage infections.

Overdosage

If someone takes too much Matulane, symptoms may include:

  • severe nausea,
  • vomiting,
  • stomach inflammation (enteritis),
  • diarrhea,
  • low blood pressure (hypotension),
  • shaking (tremors),
  • seizures (convulsions), and
  • unconsciousness (coma)

Treatment involves using medications to induce vomiting or washing out the stomach (gastric lavage). Patients should receive supportive care like intravenous fluids.

Since Matulane’s main risks relate to blood and liver issues, regular blood tests and liver function tests are crucial during recovery and for a minimum of two weeks after. Any abnormal results in these tests require prompt medical attention.

Cost & Discounts

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Frequently Asked Questions

Matulane is combined with other anticancer drugs to treat advanced stages of Hodgkin’s disease, a cancer impacting the lymphatic system. It is used in chemotherapy to reduce tumor size and inhibit cancer cell spread in the body.

Yes, Matulane is FDA-approved for use in treating stage III and IV Hodgkin lymphoma, typically in combination with other anticancer medications.

Matulane should not be used in patients with a known allergy or hypersensitivity to the drug. It’s also not recommended for patients with low bone marrow reserves, as seen in low counts of white blood cells (leukopenia), platelets (thrombocytopenia), or red blood cells (anemia) in bone marrow aspiration results. Before starting Matulane, doctors need to assess each patient’s marrow function carefully to prevent complications.

Yes, Matulane (procarbazine) can potentially cause seizures as a serious side effect. Seizures are listed among the rare but serious neurological complications associated with this medication.

No, there is currently no generic version of Matulane approved by regulatory authorities.

The Matulane (procarbazine) treatment duration for Hodgkin’s lymphoma, particularly in the MOPP regimen, includes taking it orally at a dose of 100 mg/m2 daily for 2 weeks per cycle. Each MOPP cycle lasts 4 weeks. The overall length of Matulane treatment varies depending on the individual’s response to therapy and the treatment plan from your healthcare provider.

Matulane is not safe during pregnancy or while breastfeeding. It can cause harm to the fetus, leading to birth defects or other complications.

Overdosing on Matulane (procarbazine) can lead to severe symptoms like nausea, vomiting, diarrhea, low blood pressure, tremors, seizures, or loss of consciousness. Seek immediate medical help by calling emergency services or heading to the nearest emergency room. Treatment may include inducing vomiting, gastric lavage, and providing supportive care like intravenous fluids.

Matulane is available as capsules that you swallow with water. It’s important to take the capsules whole and not chew or open them.

Here are some of the common side effects below:
  • Low white blood cells
  • Anemia
  • Low platelets
  • Nausea
  • Vomiting

Disclaimer

Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.

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Kenneth Fill, PharmD, MBA Fill

Kenneth Fill, PharmD, MBA, is a clinical pharmacist specialist and medical writer with a strong background in ambulatory care, pharmacogenomics, and medical content development. Based in the state of Michigan, he provides expert guidance on chronic disease state management. Kenneth completed his PharmD and MBA at the University of Toledo and pursued post-graduate residency training in ambulatory care and community-based pharmacy. His diverse background also includes academic detailing, clinical education, and interdisciplinary collaboration to enhance patient outcomes.