One report describes 5 patients taking procarbazine whose faces became very red and hot for a short time after drinking wine (See reference number 1). Another says that flushing occurred in 3 patients taking procarbazine after they drank beer (See reference number 2). Two out of 40 patients taking procarbazine in a third study complained of facial flushing after taking a small alcoholic drink, and one patient thought that effects of alcohol were markedly increased (See reference number 3). Yet another study describes a flush syndrome in 3 out of 50 patients who drank alcohol while taking procarbazine (See reference number 4).
Unknown, but it seems possible that in man, as in rats,(See reference number 5) procarbazine inhibits acetaldehyde dehydrogenase in liver causing a disulfiram-like reaction (see Alcohol + Disulfiram interaction).
An established interaction but of uncertain incidence. It seems to be more embarrassing,possibly frightening, than serious and if it occurs it is unlikely to require treatment, however patients should be warned. The manufacturers say it is best to avoid alcohol (See reference number 6). Procarbazine is also a weak MAOI and therefore interactions with certain foodstuffs,including alcoholic drinks, especially heavy red wines, although very rare, must be borne in mind (see Procarbazine + Sympathomimetics interaction).
Mathé G,Berumen L, Schweisguth O, Brule G, Schneider M, Cattan A, Amiel JL, Schwarzenberg L. Methyl-hydrazine in the treatment of Hodgkin’s disease and various forms of haematosarcoma and leukaemia. Lancet (1963) ii, 1077–80.
Dawson WB. Ibenzmethyzin in the management of late Hodgkin’s disease. In Natulan,Ibenzmethyzin. Report of the proceedings of a symposium, Downing College, Cambridge, June1965. Jelliffe AM and Marks J (Eds). Bristol: John Wright; 1965. P. 31–4.
Todd IDH. Natulan in management of late Hodgkin’s disease,other lymphoreticular neoplasms, and malignant melanoma. BMJ (1965) 1, 628–31.
Brulé G,Schlumberger JR, Griscelli C. N-isopropyl-:5.5pt; font-weight:normal; color:#000000″>α-(2-methylhydrazino)-p-toluamide, hydrochloride (NSC-77213) in treatment of solid tumors. Cancer Chemother Rep (1965) 44, 31–
8.
Vasiliou V,Malamas M, Marselos M. The mechanism of alcohol intolerance produced by various therapeutic agents. Acta Pharmacol Toxicol (Copenh) (1986) 58, 305–10.
Matulane (Procarbazine hydrochloride). Sigma-tau Pharmaceuticals,Inc. US Prescribing Information, February 2004.