Medication Guide App

Procarbazine Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hodgkin's Disease

For administration as a single agent: To minimize the nausea and vomiting experienced by a high percentage of patients beginning procarbazine therapy, single or divided doses of 2 to 4 mg/kg/day for the first week are recommended. Daily dosage should then be maintained at 4 to 6 mg/kg/day until maximum response is obtained or until the white blood count falls below 4000 or the platelets fall below 100,000. When maximum response is obtained, the dose may be maintained at 1 to 2 mg/kg/day. Upon evidence of hematologic or other toxicity, the drug should be discontinued until there has been satisfactory recovery. After toxic side effects have subsided, therapy may then be resumed at the discretion of the physician, based on clinical evaluation and appropriate laboratory studies, at a dosage of 1 to 2 mg/kg/day.

When used in combination with other anticancer drugs, the procarbazine dose should be appropriately reduced, e.g., in the MOPP regimen, the procarbazine dose is 100 mg/m2/day for 14 days.

Usual Adult Dose for Anaplastic Astrocytoma

60 mg/m2 orally once a day on days 8 through 21, when administered as a part of the regimen which also includes lomustine (CeeNU) and vincristine. The PCV regimen may be continued for 29 days.

Usual Adult Dose for Glioblastoma Multiforme

60 mg/m2 orally once a day on days 8 through 21, when administered as a part of the regimen which also includes lomustine (CeeNU) and vincristine. The PCV regimen may be continued for 29 days.

Renal Dose Adjustments

Some clinicians have recommended the use of decreased dosages in patients with renal dysfunction. However, no specific guidelines have been established.

Liver Dose Adjustments

Some clinicians have recommended the use of decreased dosages in patients with hepatic dysfunction. However, no specific guidelines have been established.

Dose Adjustments

When used as single agent therapy, the initial dosage recommended above is used in order to minimize the nausea and vomiting experienced by a high percentage of patients beginning therapy. The daily dosage may then be maintained at 4 to 6 mg/kg/day administered in single or divided doses, until a maximum response is obtained or until the event(s) listed in the paragraph below occur(s).

Prompt cessation of therapy is recommended if any one of the following occurs:
central nervous system signs or symptoms such as paresthesias, neuropathies, or confusion
leukopenia (WBC under 4,000)
thrombocytopenia (platelets under 100,000)
hypersensitivity reaction
stomatitis (the first small ulceration or persistent spot soreness around the oral cavity is a signal for cessation of therapy)
diarrhea (frequent or watery stools)
hemorrhage or bleeding tendencies

Bone marrow depression often occurs from 2 to 8 weeks after the start of treatment. If leukopenia occurs, hospitalization of the patient may be needed to prevent systemic infection.

After toxic side effects have subsided (based on clinical evaluation and appropriate laboratory studies), and at the discretion of the physician, therapy may be resumed at a dosage of approximately 1 to 2 mg/kg/day.

Precautions

If radiation or a chemotherapeutic agent known to have marrow depressant activity has been used, an interval of one month or longer without such therapy is recommended before starting treatment with procarbazine. The length of this interval may also be determined by evidence of bone marrow recovery based on successive bone marrow studies.

Other Comments

All dosages are based on the patient's actual weight. However, the estimated lean body mass (dry weight) is used if the patient is obese or if there has been a spurious weight gain due to edema, ascites or other forms of abnormal fluid retention.

Baseline laboratory data should be obtained prior to the initiation of therapy. The hematologic status as indicated by hemoglobin, hematocrit, white blood cell count, differential, reticulocytes and platelets should be monitored no less frequently than every 3 or 4 days. Hepatic and renal evaluation including urinalysis, transaminase, alkaline phosphatase, and blood urea nitrogen tests, should be repeated at least weekly.

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