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CMF

Find out what CMF is, how you have it and other important information about having CMF.

CMF is the name of a chemotherapy combination. It includes the drugs:

  • C - cyclophosphamide
  • M - methotrexate
  • F - fluorouracil (5FU)

It is a treatment for breast cancer.

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have it

You usually have CMF into your bloodstream. You can have cyclophosphamide as tablets.

Drugs into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking tablets

You must take tablets according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You have each treatment over 3 or 4 weeks as cycles of treatment.

You usually have 4 to 6 cycles of CMF. CMF is often given as E-CMF where you have 4 cycles of epirubicin and then 4 cycles of CMF. 

Day 1 and Day 8
  • cyclophosphamide as a drip or injection into your bloodstream (intravenously)
  • methotrexate as a drip into your bloodstream (intravenously)
  • 5FU as an injection into your bloodstream (intravenously)

You then have a 2-3 week break. This completes one treatment cycle.

If you have cyclophosphamide as tablets:

Day 1 and Day 8
  • cyclophosphamide as tablets
  • methotrexate as a drip into your bloodstream (intravenously)
  • 5FU as an injection into your bloodstream (intravenously)
Day 2 to Day 14
  • cyclophosphamide as tablets

You then have a 1-2 week break. This completes one treatment cycle. 

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, food and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

DPD deficiency

Around 5 out of 100 people (5%) have low levels of an enzyme called DPD in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from fluorouracil. It doesn’t cause symptoms so you won’t know if you have a deficiency. Contact your doctor if your side effects are severe.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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