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PAD

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

PAD is the name of a cancer drug combination. It includes:

  • bortezomib (Velcade) – this was originally called PS341, which is where the P comes from
  • doxorubicin (Adriamycin)
  • dexamethasone (a steroid)

It is treatment for myeloma.

How PAD works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells. The steroids can help the chemotherapy drugs work better.

How you have PAD

You have doxorubicin as an injection into your bloodstream (intravenously). You have bortezomib either as an injection under the skin or into your bloodstream. 

Dexamethasone come as tablets that you swallow whole, after breakfast.

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.

Injection under your skin

Taking your tablets

You must take tablets and capsules 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 PAD chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks. Depending on your needs, you may have up to 4 cycles, taking 12 weeks (3 months) in total.

You have each 3 week cycle of treatment in the following way. Day 1 is the first day of treatment for each cycle.

Day 1
  • Bortezomib as an injection under the skin or into your bloodstream
  • Doxorubicin as a continuous drip (infusion) into your bloodstream
  • Dexamethasone as tablets you swallow whole
Day 2 and 3
  • Doxorubicin as a continuous drip (infusion) into your bloodstream
  • Dexamethasone as tablets you swallow whole
Day 4
  • Bortezomib as an injection under the skin or into your bloodstream
  • Doxorubicin as a continuous drip (infusion) into your bloodstream
  • Dexamethasone as tablets you swallow whole
Day 5 to day 7
  • You have no treatment
Day 8
  • Bortezomib as an injection under the skin or into your bloodstream
  • Dexamethasone as tablets you swallow whole
Day 9 and 10
  • Dexamethasone as tablets you swallow whole
Day 11
  • Bortezomib as an injection under the skin or into your bloodstream
  • Dexamethasone as tablets you swallow whole
Day 12 to 14
  • You have no treatment
Day 15 to day 18
  • Dexamethasone as tablets you swallow whole
Day 19 to day 21
  • You have no treatment

Then you start on a new cycle of treatment. After the first cycle of treatment you have dexamethasone on days 1 to 4 only. 

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.

Breastfeeding

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

Fertility

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.

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.

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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