Procarbazine is a chemotherapy drug used to treat Hodgkin lymphoma and other types of cancer.

HOW IS PROCARBAZINE ADMINISTERED?

Procarbazine comes in capsules. It is sometimes given in combination with other chemotherapy medications. You can have procarbazine at home or during a hospital stay.

Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.

You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy.

Taking procarbazine tablets

Always take your procarbazine capsules exactly as you are indicated. It is important to take your medicines at the right time in order to ensure that they work as well as possible. Do not open up the capsules; they should be swallowed whole with a full glass of water.

If you vomit right after taking the capsules, get in touch with your hospital. You may have to take another dose. If you forget to take a capsule, do not take a double dose. Keep your normal schedule and tell your doctor or nurse.

Other things to keep in mind regarding your tablets:

• Keep them in their original packaging.
• Keep them at room temperature and away from heat and direct sunlight.
• Keep them safe and out of the reach of children.
• Return the remaining capsules to the hospital if the treatment is discontinued.

The chemotherapy is usually given as part of a course or cycle, consisting of several treatment sessions and lasting several months. The length of the treatment and the number of cycles you have will depend on the type of cancer you have. Your nurse or doctor will explain your treatment plan to you.

POSSIBLE SIDE EFFECTS OF PROCARBAZINE

You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.

Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.

RISK OF INFECTION

Procarbazine may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.

Contact your hospital immediately if any of the following happens:

• your temperature goes above 38 ° C
• you suddenly feel unwell, even if your temperature is normal.
• You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.

BRUISING AND BLEEDING

Procarbazine may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.

ANEMIA

Procarbazine may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.

TIREDNESS

Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.

NAUSEA

This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.

If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.

LOSS OF APPETITE

You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They can give you nutritional supplements or good-tasting meal-replacement drinks.

DIARRHEA

Your doctor can prescribe medicines to control diarrhea. Let them know if your diarrhea is severe or if it doesn't get better. Make sure you drink at least two liters of fluids each day if you have diarrhea.

MUSCLE AND/OR JOINT PAIN

You may have pain in your joints or muscles for a few days after chemotherapy. Tell your doctor if this happens so they can prescribe you some painkillers. Let them know if your pain doesn't go away. Try to get lots of rest. Taking warm baths on a regular basis can help.

TINGLING IN THE HANDS OR FEET

These symptoms are caused by the effect of procarbazine on the nerves. It is called peripheral neuropathy. It may also be hard for you to press buttons and it can make other tasks more uncomfortable. You may also feel a certain degree of pain at your nerve endings.

Tell your doctor if you have these symptoms. It is sometimes necessary to lower the drug dose. The symptoms normally get better slowly once the treatment is over, though in some people they never go away. Talk to your doctor if you are worried about this.

SORENESS OF THE MOUTH

You may have a sore mouth or mouth ulcers, which could make you more prone to getting a mouth infection. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.

Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.

SKIN CHANGES

Chemotherapy can affect your skin. Procarbazine can produce a rash, which may cause itchiness. If your skin is dry, try to use a fragrance-free moisturizing cream every day. Always tell your doctor about any change to your skin. These changes can be temporary, improving once the treatment is over.

CHANGES IN THE LIVER

Procarbazine can affect the functioning of your liver. These changes are normally mild and return to normal after the treatment. You will have blood tests done to see how your liver is working.

LESS COMMON SIDE EFFECTS OF PROCARBAZINE

ALLERGIC REACTIONS

On rare occasions, procarbazine can cause allergic reactions. The signs of a reaction may include the following: rash, itchiness, breathlessness, swelling in the face or lips, or feeling unwell. Tell your nurse immediately if you have any of these symptoms. If you have any of these symptoms after you get home, contact your contact your hospital or go to the emergency room.

EFFECTS ON THE LUNGS

Procarbazine can cause changes in the lungs. Always let your doctor know if you have wheezing, coughing, fever, or if you are out of breath. If necessary, tests can be done to check your lungs.

EFFECTS ON THE NERVOUS SYSTEM

Procarbazine can affect the nervous system. You may feel anxious or restless pr have trouble sleeping. Tell your doctor or nurse immediately if you have any of these symptoms. They can make changes in your treatment if they become a problem for you. It is important not to drive or operate machinery if you notice these effects. In rare cases, this treatment can cause seizures.

SECOND CANCER

In rare cases, procarbazine can increase the risk of developing a second cancer such as leukemia years down the road. Overall, however, the benefits of the treatment far outweigh this risk. Your doctor can talk to you about this.

MORE INFORMATION ABOUT PROCARBAZINE

INTERACTION WITH ALCOHOL AND SOME FOODS

When taking procarbazine, it is best to avoid certain foods, alcohol, non-alcoholic beer, and wine. These may cause a reaction that makes your feel dizzy and develop headaches, sweating, drowsiness, and problems breathing. Avoid foods such as cured cheese, salami, and yeast or beef extracts. Your nurse or doctor will give you further advice on what foods to avoid.

BLOOD CLOT RISK

Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.

OTHER DRUGS

Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.

ALCOHOL

Your doctor will advise you against drinking alcohol while taking procarbazine, as it can interact with the medication.

FERTILITY

Procarbazine may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.

CONTRACEPTION

Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.

SEX

If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.

BREASTFEEDING

Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.

MEDICAL AND DENTAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.

Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.