The active ingredient in Matulane is procarbazine. Procarbazine is an alkylating agent and an antineoplastic agent. It interferes with how cancer cells make and use DNA, which slows or stops their growth. Cancer cells are more sensitive to this damage than normal cells, but healthy cells can also be affected, especially those in bone marrow, skin, and the digestive tract.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Matulane. However, the following is a synopsis of the general guidelines for the use of Matulane:

• Matulane is taken by mouth, usually once daily during specific days in a chemotherapy regimen.
• The dose is based on body weight or body surface area and may be adjusted depending on blood test results and side effects.
• Swallow the capsule whole with water. Do not open, crush, or chew the capsule.
• If Matulane upsets your stomach, your healthcare provider may suggest taking it with food or using anti-nausea medicine.
• Your healthcare provider will order regular blood tests to monitor white blood cells, platelets, and other blood cell counts.
• Avoid tyramine-rich foods and alcoholic beverages during treatment and for about two weeks after your last dose, unless your healthcare provider gives different instructions.
• Do not receive any vaccines, especially live vaccines, unless confirmed safe by your oncology team.
• If you miss a dose, take it as soon as you remember on the same day. If it is near the time of your next dose, skip the missed dose. Do not take two doses at once.

Some mild or common side effects of Matulane seen in clinical trials as compared to placebo include:

• Nausea.
• Vomiting.
• Loss of appetite.
• Diarrhea.
• Constipation.
• Mouth sores.
• Drowsiness or sleepiness.
• Headache.
• Temporary hair thinning.
• Mild nerve irritation or neuropathy.
• Low blood cell counts, including anemia, leukopenia, and thrombocytopenia.

Some individuals may experience serious side effects while using Matulane. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Signs of severe bone marrow suppression, such as fever, chills, sore throat, unusual bruising or bleeding, or extreme weakness.
• Very low white blood cells or platelets on blood tests.
• Severe allergic or hypersensitivity reactions with hives, swelling, trouble breathing, or widespread skin rash.
• Severe or blistering rash, peeling skin, or painful sores in the mouth or eyes.
• Signs of liver problems include yellowing of the skin or eyes, dark urine, or right-sided abdominal pain.
• Sudden high blood pressure symptoms like severe headache, chest pain, fast heartbeat, sweating, or vision changes, which may happen with tyramine food interactions.
• New cancers or blood disorders, which are rare but have been reported with procarbazine used in intensive regimens.

These are not all of the possible side effects of Matulane. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Matulane, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Low white blood cells, low platelets, or other bone marrow problems.
• Liver disease.
• Kidney disease.
• A history of seizures or central nervous system disorders.
• Past allergic reactions to procarbazine or similar chemotherapy drugs.
• Lung cancer treatment history or other types of cancer requiring chemotherapy.
• Any infections, because Matulane can lower your immune system response.
• Plans to receive vaccines.
• Use of prescription drugs, over-the-counter medicines, or supplements that may interact with Matulane.
• A diet that includes aged cheeses, cured meats, fermented foods, or other tyramine-rich foods.
• Matulane can cause strong bone marrow suppression. Your blood cell counts must be checked often, especially early in treatment and whenever the dose changes. If your white blood cells or platelets drop too low, your healthcare provider may pause or reduce treatment.
• Matulane also has mild monoamine oxidase (MAO) inhibitor activity. That is why tyramine-containing foods and some medicines can cause sudden, dangerous rises in blood pressure. Your healthcare provider may give you a specific food list to avoid.
• Because Matulane can raise sensitivity to alcohol, avoid alcoholic beverages. Alcohol may cause a disulfiram-like reaction such as flushing, nausea, vomiting, sweating, and low blood pressure.

Boxed Warning

Matulane has a boxed warning. It should only be given by or under the supervision of a physician experienced in the use of potent antineoplastic agents. Adequate clinical and laboratory monitoring is required because of the risk of serious toxicity, especially bone marrow suppression and severe drug or food interactions.

Matulane should not be used in individuals who:

• Have a known hypersensitivity or allergic reaction to procarbazine or any capsule ingredient.
• Have a severely reduced bone marrow reserve, unless your oncology team determines the benefit outweighs the risk.
• Are unable to follow the safety food and drug restrictions that prevent tyramine reactions.

Matulane starts working on cancer cells shortly after treatment begins, but the benefit is not felt right away. In Hodgkin lymphoma, treatment response is usually assessed over weeks to months using symptoms, blood tests, and imaging. Many people receive multiple chemotherapy cycles before a full response is clear. Your healthcare provider will track your progress and adjust your regimen if needed.

When Matulane is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Tyramine-rich foods (such as aged cheeses, cured meats, fermented foods, draft beer, or some soy products). Matulane weakly inhibits monoamine oxidase, so tyramine may trigger dangerously high blood pressure.
• Alcoholic beverages. May cause a disulfiram-like reaction and worsen central nervous system effects.
• Barbiturates.
• Antihistamines.
• Narcotic pain medicines.
• Phenothiazines. Tricyclic antidepressants such as amitriptyline or imipramine. May raise the risk of blood pressure problems and central nervous system effects due to MAO activity.
• Other monoamine oxidase inhibitors.
• Levodopa.
• Other chemotherapy drugs are used in the same regimen. Additive toxicity may occur, especially bone marrow suppression and gastrointestinal side effects.
• Disulfiram. Similar reaction risk when combined with alcohol and MAO-type effects.

Matulane is available as:

• Oral capsules containing 50 mg procarbazine hydrochloride.

Your oncology team will choose your exact dosing schedule. Doses are often calculated by body surface area and adjusted based on blood cell counts and treatment response.

Store at room temperature and keep out of reach of children.

Matulane is manufactured in the United States by Leadiant Biosciences. Different manufacturers may supply procarbazine hydrochloride in other regions.

Yes. Generic procarbazine hydrochloride capsules are available in many countries.

Do not stop Matulane on your own. Matulane is given as part of a specific chemotherapy regimen, and stopping early can reduce treatment success. If you develop severe side effects such as a serious rash, signs, abnormal bleeding, or symptoms of a hypertensive crisis, contact your healthcare provider immediately. They will decide whether to stop, pause, or adjust treatment.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. Matulane can harm an unborn baby. People who can become pregnant should use reliable contraception during treatment and for a period after the last dose, as advised by their healthcare provider. If pregnancy happens during treatment, inform your oncology team right away.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. Breastfeeding is not recommended while using Matulane because the drug may pass into breast milk and could harm a nursing infant.