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Matulane Side Effects

Generic Name: procarbazine

Note: This document contains side effect information about procarbazine. Some of the dosage forms listed on this page may not apply to the brand name Matulane.

For the Consumer

Applies to procarbazine: oral capsule


Oral route (Capsule)

Adequate clinical and laboratory facilities should be available to patients treated with procarbazine for proper monitoring of treatment.

Along with their needed effects, medicines like procarbazine (the active ingredient contained in Matulane) 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 procarbazine and get emergency help immediately if any of the following effects occur:


  • 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 while taking procarbazine:

Less Common

  • Black, tarry stools
  • blood in urine or stools
  • bloody vomit
  • cough or hoarseness
  • fever or chills
  • lower back or side pain
  • painful or difficult urination
  • pinpoint red spots on skin
  • unusual bleeding or bruising

Check with your doctor as soon as possible if any of the following side effects occur while taking procarbazine:

More Common

  • Confusion
  • convulsions (seizures)
  • cough
  • 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

  • Diarrhea
  • sores in mouth and on lips
  • tingling or numbness of fingers or toes
  • unsteadiness or awkwardness
  • yellow eyes or skin


Some side effects of procarbazine 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

Less Common

  • Constipation
  • darkening of skin
  • difficulty in swallowing
  • dizziness or lightheadedness when getting up from a lying or sitting position
  • dry mouth
  • 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.

For Healthcare Professionals

Applies to procarbazine: oral capsule


Hematologic side effects are dose limiting and recovery may be delayed. Leukopenia, anemia, and thrombocytopenia have been reported to occur frequently. Pancytopenia, eosinophilia, hemolytic anemia, and bleeding tendencies including petechiae, purpura, epistaxis, hematuria and hemoptysis have also been reported.[Ref]

Hematologic toxicity, common to many hydrazine derivatives, include hemolysis, eosinophilia, anisocytosis, poikilocytosis, lymphocytosis and the appearance of Heinz-Ehrlich inclusion bodies in erythrocytes.[Ref]


Gastrointestinal side effects including nausea and vomiting are the most commonly reported. Hepatic dysfunction, jaundice, stomatitis, hematemesis, melena, diarrhea, dysphagia, anorexia, abdominal pain, constipation, and dry mouth have also been reported.[Ref]

Most of the nausea and vomiting occur with initial drug administration. In one study, 15 of 43 patients suffered severe gastrointestinal toxicity.[Ref]

Nervous system

In one study, peripheral neuropathy with paresthesia of the extremities and depressed deep tendon reflexes were reported to occur in 17% of patients. These effects, as well as ataxia, have been known to be reversible in some patients even as administration of the drug was continued.[Ref]

Nervous system side effects including leukoencephalopathy, coma, convulsions, neuropathy, ataxia, paresthesia, nystagmus, diminished reflexes, falling, foot drop, headache, dizziness, chills, weakness, fatigue, hallucinations and unsteadiness have been reported.[Ref]


Cardiovascular side effects including hypotension, tachycardia, and syncope have been reported.[Ref]


Ocular side effects including retinal hemorrhage, papilledema, photophobia, diplopia and inability to focus have been reported.[Ref]


Respiratory side effects including pneumonitis, pleural effusion, and cough have been reported.[Ref]


If a rash develops that is self limiting, it may be prevented during subsequent courses of therapy by administration of steroids.[Ref]

Dermatologic side effects including herpes, dermatitis, pruritus, alopecia, hyperpigmentation, rash, urticaria, and flushing have been reported.[Ref]


Hypersensitivity side effects have been reported.[Ref]

In one study, 12 of 68 patients receiving procarbazine experienced a hypersensitivity reaction. Other studies have reported less frequent occurrences. One study noted 2 rashes out of 24 patients and another study noted 1 rash and 1 case of urticaria out of 129 patients.[Ref]


Genitourinary side effects including hematuria, urinary frequency, and nocturia have been reported.[Ref]


Musculoskeletal side effects including pain (myalgia and arthralgia) and tremors have been reported.[Ref]


Psychiatric side effects including hallucinations, depression, apprehension, agitation, psychosis, nervousness, confusion, mania and nightmares have been reported.[Ref]


Endocrine side effects including gynecomastia in prepuberal and early puberal boys have been reported.[Ref]


Oncologic side effects with instances of a secondary nonlymphoid malignancy, including lung cancer, acute myelocytic leukemia, and malignant myelosclerosis have been reported in patients with Hodgkin's disease treated with procarbazine (the active ingredient contained in Matulane) in combination with other chemotherapy and/or radiation.[Ref]

The risks of secondary lung cancer from treatment appear to be multiplied by tobacco use.

The carcinogenicity of procarbazine in mice, rats, and monkeys has been reported in a considerable number of studies.[Ref]


Other side effects including azoospermia, intercurrent infections, hearing loss, pyrexia, diaphoresis, lethargy, weakness, fatigue, edema, chills, insomnia, slurred speech, hoarseness, hyperpyrexia, and drowsiness have been reported.[Ref]


1. DeConti RC "Procarbazine in the management of late Hodgkin's disease." JAMA 215 (1971): 927-30

2. Hadjiyanni M, Valianatou K, Tsilianos M, Seitanidis B "Prolonged thrombocytopenia after procarbazine "overdose"." Eur J Cancer 28A (1992): 1299

3. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.

4. Carpenter JT Jr, Raney M, Logan T "Phase II evaluation of procarbazine in metastatic breast cancer: a Southeastern Cancer Study Group Trial." Cancer Treat Rep 70 (1986): 679-80

5. Spivack SD "Drugs 5 years later: procarbazine." Ann Intern Med 81 (1974): 795-800

6. Ecker MD, Jay B, Keohane MF "Procarbazine lung." AJR Am J Roentgenol 131 (1978): 527-8

7. Andersen E, Videbaek A "Procarbazine-induced skin reactions in Hodgkin's disease and other malignant lymphomas." Scand J Haematol 24 (1980): 149-51

8. Carney MW, Ravindran A, Lewis DS "Manic psychosis associated with procarbazine." Br Med J (Clin Res Ed) 284 (1982): 82-3

9. Horvath W, Black C, Keller J, Nemire R, Pipoly G, Krupp K "MOOD DISORDERS FROM PROCARBAZINE (PZ) IN 4 MOPP-TREATED HODGKIN'S DISEASE (HD) PATIENTS (PTS) (MEETING ABSTRACT)." Proc Annu Meet Am Soc Clin Oncol 11 (1992): a2981992

10. Lee IP, Dixon RL "Mutagenicity, carcinogenicity and teratogenicity of procarbazine." Mutat Res 55 (1978): 1-14

11. Akyol H, Sarialioglu F, Buyukpamukcu M, Akyuz C "Cytotoxic drug-induced fever: a report on procarbazine-induced hyperpyrexia." Med Pediatr Oncol 18 (1990): 173-5

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.