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Procarbazine is a chemotherapeutic drug that is used as a part of the MOPP (mechlorethamine, vincristine, procarbazine and prednisone) protocol to treat relapsed lymphoma in dogs and cats. There are also studies that indicate that procarbazine may be useful as a sole, long-term treatment for granulomatous menigoencephalomyelitis in dogs.
Procarbazine is an atypical-alkylating agent that inhibits
RNA, DNA and protein synthesis. It is used in human medicine to treat
brain tumors, such as oligodendroglioma and glioblastoma, and Hodgkin's
disease. Based on information extrapolated from human research, procarbazine
is well-absorbed orally and equilibrates rapidly between the plasma and
cerebral spinal fluid (CSF). Procarbazine is metabolized by the liver
and kidney and excreted in the urine. Urinary metabolites are cytotoxic.
Procarbazine is used as a part of the MOPP protocol for relapsed lymphoma in dogs. In one study, which looked at the MOPP protocol in a group of dogs with advanced lymphoma, the median survival with treatment was 10 months. The only prognostic indicator for poor outcome in this group was inappetance at the time of diagnosis. The majority of dogs tolerated the MOPP protocol well.
The MOPP protocol is used both as first-line chemotherapy and as rescue chemotherapy in cats with lymphoma. Cats that were eating well and not "sick" at the time of diagnosis tended to respond better to chemotherapy.
Procarbazine has been studied as a sole treatment for
granulomatous menigoencephalomyelitis (GME) in dogs. GME is the second
most-common inflammatory disease of the central-nervous system of dogs.
It is more commonly seen in toy breeds. Left untreated, the survival time
for dogs with GME is less than a month. GME was traditionally treated
with prednisone, but recent studies have looked at treatment with procarbazine
or cyclosporin. The procarbazine study showed an improved survival time
of 14 months.
The most common side effects are gastrointestinal (GI),
including anorexia, vomiting and diarrhea. In one study, GI toxicity occurred
in 28 percent of treated animals. Bone-marrow suppression, central-nervous
system (CNS) depression and peripheral neuropathy are less common but
significant side effects.
• Humans should wear gloves when handling procarbazine
and avoid contact with the animal's saliva and urine due to cytotoxic
metabolites.
• Weekly monitoring of peripheral blood counts, hepatic and renal
function should be performed for the first month of treatment and regularly
thereafter.
• Procarbazine should be avoided or used with extreme caution in
animals with pre-existing bone-marrow suppression.
• Procarbazine should be used with caution in animals with decreased
liver or kidney function.
• Procarbazine should not be used in pregnant or lactating animals.
Procarbazine has been shown to adversely affect spermatogenesis. There
are studies in the human literature discussing protocols to diminish testicular
toxicity.
• Procarbazine should only be used with extreme caution with other
CNS depressant drugs, including barbiturates, opiates, antihistamines
and tranquilizers.
• Procarbazine should not be used with tricyclic antidepressant drugs
or sympathomimetics. Ingestion of alcohol may cause severe nausea and
vomiting.
• Animals receiving procarbazine should not be fed foods with high
tyramine content (yogurt and some cheeses) due to adverse effects on blood
pressure.
• Overdose with procarbazine should be treated aggressively. If recognized promptly, gut-emptying protocols should be employed. Supportive care for GI upset, bone-marrow suppression and CNS depression may be warranted.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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of the products shown, nor is the information intended as medical advice or
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risks and benefits of using a particular product. You should consult your doctor
about diagnosis and treatment of any health problems. Information and statements
have not been evaluated by the Food and Drug Administration ("FDA"),
nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood compounded veterinary preparations are not intended for use in food and food-producing animals.
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