Procarbazine with Lofepramine Interaction Details
Brand Names Associated with Procarbazine
- Matulane®
- Procarbazine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 29, 2023
Interaction Effect
Neurotoxicity, seizures
Interaction Summary
Concomitant tricyclic antidepressant and more potent MAOI use has resulted in hyperpyrexia, convulsions, and death. Procarbazine has relatively weak MAOI actions, so while the potential for drug interactions between tricyclic antidepressants and procarbazine exists, clinical data are lacking at this time. Concurrent use is not recommended .
Severity
Major
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
Concomitant use is not recommended and should probably be initiated only under close medical supervision, and then only if other antidepressant class agents have proven unsuccessful. With more potent MAOIs, recommendations for concurrent use of TCAs have included avoiding large doses of the TCA, using only oral tricyclics, and avoiding imipramine, clomipramine, and desipramine. Procarbazine therapy should not begin until seven days following discontinuation of tricyclic antidepressants and 14 days following the discontinuation of other MAO inhibitors.
Mechanism Of Interaction
Altered catecholamine uptake and metabolism
Literature Reports
A) Procarbazine is primarily used as an antineoplastic agent, but was originally investigated as a monoamine oxidase inhibitor . Animal studies have indicated that procarbazine is a monoamine oxidase inhibitor (MAOI) but appears to be a relatively weak MAOI in man . Hypertensive reactions may still result from concomitant administration of tricyclic antidepressants, sympathomimetics, and tyramine containing foods .
B) Concomitant administration of monoamine oxidase (MAO) inhibitors with tricyclic antidepressants has been considered an absolute contraindication in the past and still is listed as such by some manufacturers. Reports of excitation, hyperpyrexia, convulsions, and possible death have been attributed to the combination . Careful examination of such reports indicate unusual circumstances in most cases such as parenteral administration of a tricyclic. The mechanism may relate to the combined inhibition of catecholamine reuptake into the central nervous system and inhibition of catecholamine metabolism .
C) Procarbazine therapy should not begin until 7 days following discontinuation of tricyclic antidepressants and 14 days following the discontinuation of other MAO inhibitors .
Procarbazine Overview
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Procarbazine is used in combination with other medications to treat certain types of Hodgkins disease (types of cancer that begin in a type of white blood cells that normally fights infection). Procarbazine is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.