Procarbazine Sympathomimetics

PROCARBAZINE SYMPATHOMIMETICS Co-administration of ephedrine, metaraminol, methylphenidate, phenylephrine or pseudoephedrine (including nasal and ophthalmic solutions) with procarbazine may cause prolongation and t intensity of cardiac stimulant effects and effects on BP, which may cause headache, arrhythmias and hypertensive or hyperpyretic crises The metabolism of sympathomimetics is impaired due to inhibition of MAO It is recommended that sympathomimetics not be administered during and within 14 days of stopping procarbazine. Do not use any OTC nasal decongestants (sprays or oral preparations) or asthma relief agents without consulting the pharmacist/doctor... 

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. 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 , p.657). 

BUSPIRONE ANTICANCER AND IMMUNOMODULATING DRUGS - PROCARBAZINE Risk of elevation of blood pressure Additive effect buspirone acts at serotonin receptors procarbazine inhibits the breakdown of sympathomimetics Avoid concurrent use... 

PROCARBAZINE COCAINE Risk of severe hypertensive episodes The metabolism of sympathomimetics is impaired due to inhibition of MAO Cocaine should not be administered during or within 14 days following administration of an MAOI... 

PROCARBAZINE LOCAL ANAESTHETICS WITH EPINEPHRINE Risk of severe hypertension Due to inhibition of MAO, which metabolizes epinephrine No sympathomimetic should be administered to patients receiving drugs that inhibit one of the metabolizing enzymes, e.g. MAO... 

Despite warnings, it seems doubtful that the weak MAO-inhibito-ry properties of procarbazine can under normal circumstances cause a hypertensive reaction with tyramine or other sympathomimetics. 

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