Decorative image


Find out what MVAC is, how you have it and other important information about taking MVAC.

MVAC is the name of a chemotherapy combination made up of the following drugs: 

  • methotrexate
  • vinblastine
  • doxorubicin (Adriamycin)
  • cisplatin

MVAC is a treatment for bladder cancer. It is often used to try to stop bladder cancer from coming back after surgery. This is called adjuvant therapy. 

Sometimes it is also used to shrink the cancer before surgery or radiotherapy. This is known as neoadjuvant therapy. 

How MVAC works

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

How you have MVAC

You have these drugs into your bloodstream (intravenously), usually through a long line: a central line, a PICC line or a portacath.

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.

When you have it

You usually have these drugs as cycles of treatment. Each cycle takes either 2 or 4 weeks. When you have MVAC over 2 weeks it is called accelerated MVAC. 

Usually, you have between 3 to 6 cycles of MVAC.  

If you have it over 2 weeks (accelerated MVAC)

Day 1
  • You have methotrexate as an injection into your bloodstream
  • You have vinblastine as a drip into your bloodstream
  • You have doxorubicin as a drip into your bloodstream
  • You have cisplatin as a drip into your bloodstream
Day 2 to 14
  • You have no treatment

You then start a new cycle of treatment.

After chemotherapy you may also have a drug called GCSF. You have it as injections under the skin. GCSF encourages the bone marrow (where the blood cells are made) to make more white blood cells. 

If you have it over 4 weeks

Day 1 or day 1 and 2
  • You have methotrexate as an injection into your bloodstream
  • You have vinblastine as a drip into your bloodstream
  • You have doxorubicin as a drip into your bloodstream
  • You have cisplatin as a drip into your bloodstream
Day 3 to 7
  • You have no treatment
Between day 8 and day 22
  • You have 2 doses of methotrexate as an injection into your bloodstream
  • You have 2 doses of vinblastine as a drip into your bloodstream
Day 23 to 28
  • You have no treatment

Then you start a new cycle of treatment. 

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, foods 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.


You may not be able to become pregnant or father a child after treatment with these drugs. 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.


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.


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

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.