甲基苄肼Natulan

【Function and Indications】
Methyl procarbazine Natulan is mainly used to treat Hodgkin’s disease, and is also used for Hodgkin’s disease, brain tumors, chronic myeloid leukemia, polycythemia vera, lung cancer, ovarian cancer, and multiple myeloma.
It is usually used in combination with other drugs. For example:
MOPP regimen, nitrogen mustard + vincristine + methyl procarbazine + prednisone
CVPP regimen, cyclophosphamide + vinblastine + methyl procarbazine + prednisone
EBVP regimen, chlorambucil + vinblastine + methyl procarbazine + prednisone

【Usage and Dosage】
Oral, starting from 50mg~100mg/m2 per day, gradually increasing after 1 week to 150mg~200mg/m2 per day, generally divided into 3 doses, used for 2~3 weeks, then stopped for 2 weeks before using again, or used at a maintenance dose of 100mg/m2 per day until toxicity occurs.

【Clinical Research】
This product is a non-specific drug for the cell cycle. After entering the human body, it oxidizes to form H2O2 and OH-, which can cause effects similar to ionizing radiation, especially methylation at the 3rd position of guanine and the 1st position of adenine, inhibiting the synthesis of RNA, DNA and protein. It has a delaying effect on the G1/S phase, inhibits cell mitosis, significantly reduces the division index, and prolongs the G1-G2 interval. This product has no cross-resistance with alkylating agents, vincristine, corticosteroids and radiotherapy. Pharmacological studies have found that this product has multiple biological effects such as chromosomal disorders, teratogenicity, carcinogenesis, immunosuppression and cytotoxicity.

[Precautions]
(1) This product can be used in combination with central nervous system depressants or antihypertensive drugs to increase the therapeutic effects of these two drugs.
(2) This product has a monoamine oxidase inhibitory effect. Avoid using it in combination with sympathomimetic drugs such as ephedrine, amphetamine, metaraminol, phenylpropanolamine, as well as imipramine and amitriptyline, so as to avoid increased blood pressure and excessive excitement in patients with hypertension. During the medication period, foods containing high levels of amides, such as cheese and bananas, should not be consumed, and alcohol should also be consumed less.
(3) Insulin, hypoglycemic agent, Ritalin, sodium thiopental, etc. can prolong and enhance the effects of this product.
(4) This product can produce neurotoxicity when used in combination with nitrogen mustard.
(5) A small number of young women may experience amenorrhea, which can be restored after stopping the medication.

[Adverse Reactions and Contraindications]
1. Common gastrointestinal reactions include nausea and vomiting, and occasionally stomatitis, dry mouth, dysphagia, diarrhea and constipation.
2. Bone marrow suppression can cause leukopenia and thrombocytopenia, bleeding tendency, and anemia.
3. More common symptoms include headache, fatigue, drowsiness, and occasionally dizziness, depression, insomnia, hallucinations, ataxia, diplopia and nystagmus. Muscle pain and joint pain can also be seen. Coma and convulsions are rare.
4. Allergic dermatitis, herpes, prurigo, pigmentation and hair loss are occasionally seen.
5. Other symptoms include chills, fever and sweating, and occasionally tachycardia and hypotension.
6. Patients with poor liver and kidney function should use with caution or reduce the dosage. Pregnant women should not use it.

[Contraindications]
(1) Pregnant women and those with severe bone marrow suppression and liver and kidney damage are prohibited.
(2) Patients with diabetes, infection or who have used other chemotherapy drugs should use it with caution.
(3) Patients with bleeding, allergies, stomatitis and those who have used sleeping pills or anesthetics should use it with caution.

[Pregnant women use]
Pregnant women are prohibited from using it. Especially in the first three months of pregnancy, the pregnancy risk classification is Class D.

[Children use]
Children may experience excessive neurotoxicity. The dosage should be individualized and used under strict clinical monitoring.

【Drug Interactions】
1. Methyl procarbazine and barbiturates: Methyl procarbazine can inhibit the metabolism and inactivation of barbiturates, prolonging their duration of action and increasing their intensity of action; when used together, they can cause headaches, dizziness, nausea, vomiting, coma and even shock. Therefore, caution should be exercised when used together.
2. Methyl procarbazine and chloral hydrate: The multiple drug metabolizing enzymes of methyl procarbazine can slow down the metabolism and inactivation of chloral hydrate, significantly increase the effect of chloral hydrate, and can cause hypertensive crisis.
3. Methyl procarbazine and chlorpromazine: When used together, they can enhance the effect of chlorpromazine.