[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Alkylating agents](https://durgical.com/en/pharmacology/classes/alkylating-agents/) › Procarbazine # Procarbazine ## Alkylating agents? Alkylating agents ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. Oral methylating drug for Hodgkin lymphoma and brain tumours. A weak MAO inhibitor with a disulfiram-like alcohol reaction, so food and drug rules apply. Updated Nov 1, 2026 ## Quick facts **Group** [Alkylating agents](https://durgical.com/en/pharmacology/classes/alkylating-agents/) **Target** DNA (methylated by activated procarbazine metabolites) **Used for** Hodgkin lymphoma · Some brain tumours **Key effects** Leukopenia and thrombocytopenia · Nausea · Drowsiness **Monitor** Blood counts · Blood pressure **ATC** L01XB01 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action Procarbazine is a methylhydrazine that must be activated in the liver. Liver oxidation produces highly reactive species that methylate DNA and cause chromosome breaks. It is also a weak monoamine oxidase inhibitor and has disulfiram-like effects, which explain its food, alcohol and drug interactions. - The liver activates procarbazine - Its reactive metabolites methylate DNA - Chromosome breaks lead to cell death - It also weakly inhibits monoamine oxidase ## Indications - Hodgkin lymphoma, in combination regimens. [Hodgkin lymphoma →](https://durgical.com/en/conditions/hodgkin-lymphoma/) - Some brain tumours, in combination regimens. ## Adverse effects ### Common - Leukopenia and thrombocytopenia - Nausea, vomiting, diarrhoea, rash - Drowsiness, confusion and other behavioural changes - Numbness or tingling in hands and feet ### Serious (rare, important) - Hypertensive reactions with tyramine-rich foods or sympathomimetic drugs (MAO inhibition) - Seizures, hallucinations - Second cancers, notably acute leukaemia - Infertility, especially in men; strong immunosuppression ## Contraindications - Hypersensitivity to procarbazine ## Key interactions **Alcohol** Disulfiram-like reaction: flushing, vomiting, headache; avoided. **Very tyramine-rich foods (certain cheeses, yogurt, bananas)** Blood pressure can rise sharply because tyramine breakdown is blocked. **Sympathomimetics and other drugs whose breakdown depends on monoamine oxidase** Risk of hypertension. **Sedatives and other CNS depressants** Stronger sedation. ## What is monitored - Blood counts - Blood pressure - Mental state and neurological symptoms ## Administration and safety - Oral capsules taken exactly on the regimen's schedule; hazardous drug handled with gloves or clean hands. - The patient receives a list of foods and medicines to avoid before starting. - Any new medicine, including over-the-counter and herbal products, is checked with the team before use. ## Pregnancy and breastfeeding Can harm the fetus; pregnancy and breastfeeding are avoided during treatment. ## Nursing care - Review the patient's medicines, including decongestants and antidepressants, before each cycle. - Teach the diet: avoid very high-tyramine foods and all alcohol. - Check blood pressure and ask about headache, palpitations, confusion or tingling. - Teaching: contraception; report fever or bleeding. ## Pharmacokinetics **Absorption** Oral capsules. **Metabolism** Activated in the liver; its pharmacokinetics are not fully characterised. ## Memory aid «PROCARBAZINE: no CHEESE, no BEER»: a weak MAO inhibitor with a disulfiram-like reaction; Hodgkin lymphoma and brain tumours. ## Test yourself Think of the answer, then tap the question to see it. ## Why must patients on procarbazine avoid tyramine-rich foods? Procarbazine weakly inhibits monoamine oxidase, so tyramine can cause a hypertensive reaction. ## What happens if a patient on procarbazine drinks alcohol? A disulfiram-like reaction (flushing, vomiting, headache). ## Which lymphoma regimens classically include procarbazine? Hodgkin lymphoma regimens. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/procarbazine/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. ## Connections ## Related drugs 3 - [Dacarbazine](https://durgical.com/en/pharmacology/dacarbazine/) - [Temozolomide](https://durgical.com/en/pharmacology/temozolomide/) - [Lomustine](https://durgical.com/en/pharmacology/lomustine/) ## Related conditions 1 - [Hodgkin lymphoma](https://durgical.com/en/conditions/hodgkin-lymphoma/) [← Back to the class: Alkylating agents](https://durgical.com/en/pharmacology/classes/alkylating-agents/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Procarbazine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a682094.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01XB01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/procarbazine/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/procarbazine/