Hydrazine Sulfate

Health Care Professional Information

Common Name

Sehydrin, hydrazine, hydrazine monosulfate, HS

Clinical Summary

A synthetic chemical (H4N2-H2SO4) primarily used in industrial manufacturing (e.g. agricultural chemicals, rocket fuel, etc), hydrazine sulfate is used to treat cancer, maintain or gain weight, and ameliorate cancer-related cachexia. It is thought to interfere with gluconeogenesis via the inhibition of phosphoenolpyruvate carboxykinase (1). It has moderate monoamine oxidase inhibitor (MAO-I) activity (3).

Animal studies suggest that hydrazine is carcinogenic, although it is not established in humans. Several large randomized clinical trials failed to show significant benefit from hydrazine supplementation (7) (8) (9) to alleviate cancer-related cachexia (10) or to improve cancer survival.
Potential adverse effects include nausea, pruritus, dizziness, peripheral neuropathies, hypoglycemia and insomnia (4). Case reports detailing fatal hepatorenal failure (5) and encephalopathy (6) exist in the literature. Potential drug interactions include increased hydrazine toxicity when combined with benzodiazepines, barbiturates, and alcohol (1) (4). Theoretically, foods high in tyramine content, meperidine, sympathomimetics, and dextromethorphan should be avoided due to MAO-I activity (3).

Purported Uses
  • Cancer treatment
  • Cancer-related cachexia
  • Weight gain
  • Weight maintenance
Constituents
  • Chemical formula: H4N2-H2SO4
    Molecular weight: 130
Mechanism of Action

Hydrazine sulfate is thought to inhibit phosphoenolpyruvate carboxykinase, an enzyme involved with the Cori cycle for gluconeogenesis from anaerobically metabolized lactic acid. Hydrazine therapy is used to antagonize the inappropriate activation of gluconeogenesis pathways, reduce excessive gluconeogenesis, and improve glucose tolerance particularly in patients with cancer and cancer-related cachexia (1). Hydrazine also has been shown to be a weak monoamine oxidase inhibitor (3). Inhibition and stabilization of glioblastoma cell growth was seen in vitro and in animal models (4), but significance in humans is unknown. Hydrazine sulfate appears to have no effect on prostate cancer cell lines in vitro (2).

Warnings

Hydrazine is classified as a carcinogen.

Contraindications

Patients with diabetes should use this product with caution due to potential hypoglycemic effects.

Adverse Reactions
  • Common: Nausea, pruritus, dizziness, sedation, peripheral neuropathies, hypoglycemia, insomnia. (4)
  • Case reports:
    Hepatorenal failure (5) and encephalopathy (6) have been reported with use of hydrazine sulfate.
    Multiple basal cell carcinoma has been associated with extensive exposure to hydrazine sulfate in a 68-year-old man (11).
Herb-Drug Interactions

Benzodiazepines: Increased toxicity of hydrazine suggested (1) (4).
Sympathomimetics: Theoretical interaction due to monoamine oxidase inhibition caused by hydrazine. Potential for hypertensive crisis (3).

Dosage (Inside MSKCC Only)
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References
  1. Kaegi E. Unconventional therapies for cancer: 4. Hydrazine sulfate. The Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. CMAJ 1998;158:1327-30.
  2. Kamradt JM, Pienta KJ. The effect of hydrazine sulfate on prostate cancer growth. Oncol Rep 1998;5:919-21.
  3. Chlebowski RT, et al. Hydrazine sulfate: clinical pharmacokinetics and influence on in vitro growth of human glioblastoma cell lines. Proc Am Assoc Cancer Res 1985;26:1002.
  4. Hydrazine sulfate (pdq). Available at http://www.cancer.gov/cancertopics/pdq/cam/hydrazinesulfate/healthprofessional. Accessed October 31, 2012.
  5. Hainer MI, et al. Fatal hepatorenal failure associated with hydrazine sulfate. Ann Intern Med 2000;133:877-80.
  6. Nagappan R, Riddel T. Pyridoxine therapy in a patient with severe hydrazine sulfate toxicity. Crit Care Med 2000;28:2116-8.
  7. Kosty MP, et al. Cisplatin, vinblastine, and hydrazine sulfate in advanced, non-small-cell lung cancer: a randomized placebo-controlled, double-blind phase III study of the cancer and leukemia group B. J Clin Oncol 1994;12:1113-20.
  8. Loprinzi CL, et al. Placebo-controlled trial of hydrazine sulfate in patients with newly diagnosed non-small cell lung cancer. J Clin Oncol 1994;12:1126-9.
  9. Loprinzi CL, et al. Randomized placebo-controlled evaluation of hydrazine sulfate in patients with advanced colorectal cancer. J Clin Oncol 1994;12:1121-5.
  10. Chlebowski RT, et al. Hydrazine sulfate in cancer patients with weight loss. A placebo-controlled clinical experience. Cancer 1987;59:406-10.
  11. Aigner BA, Darsow U, Grosber M, Ring J, Plötz SG. Multiple basal cell carcinomas after long-term exposure to hydrazine: case report and review of the literature. Dermatology. 2010;221(4):300-2.

Consumer Information

How It Works

Bottom Line: Hydrazine sulfate is not an approved cancer treatment. It has been shown to increase the incidence of some cancers.

Hydrazine sulfate is a chemical used in industrial manufacturing of agricultural chemicals and rocket fuel. Supporters of this therapy make the false claim that hydrazine sulfate limits the ability of tumor cells to make glucose, an important source of their energy, from body stores. In theory, this would also prevent the accelerated breakdown of protein in the body that causes cachexia (wasting) in patients with advanced cancer. However, this effect has never been shown in humans. Hydrazine sulfate was able to inhibit the growth of some tumors in laboratory animals when used alone or with chemotherapy drugs, but this effect has also not been shown in humans. Furthermore, hydrazine sulfate has been shown to increase the incidence of breast, lung, and liver cancers and basal cell carcinoma.

Purported Uses
  • To prevent wasting (cachexia), maintain weight, and increase appetite in patients with advanced cancer
    There is no scientific evidence to support this use.
  • To treat cancer
    Clinical trials do not support this use, and one actually showed that hydrazine sulfate was worse than no treatment at all.
Patient Warnings
  • Hydrazine sulfate is classified as a potential carcinogen by the U.S. Department of Health and Human Services.
Side Effects
  • Nausea
  • Itching
  • Dizziness
  • Sedation
  • Peripheral neuropathies
  • Low blood sugar
  • Insomnia
  • There have been isolated cases of liver and kidney failure and encephalopathy.
  • Multiple basal cell carcinomas were reported in a 68-year-old man following extensive exposure to hydrazine sulfate.
Special Point
  • Hydrazine sulfate is commercially available in the United States, but it is illegal to use it as a cancer therapy.
E-mail your questions and comments to aboutherbs@mskcc.org.