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R-CVP

Read about the cancer drug combination R-CVP, how you have it and what the side effects can be.

R-CVP is the name of a combination of cancer drugs used to treat low grade non Hodgkin lymphoma. It is made up of the drugs:

  • R – Rituximab (Mabthera), a targeted cancer drug (biological therapy)
  • C – Cyclophosphamide, a chemotherapy drug
  • V – Vincristine, a chemotherapy drug
  • P – Prednisolone, a steroid

How you have it

You have prednisolone as tablets. The rest of the drugs are given into your bloodstream (intravenously). 

Taking your tablets or capsules

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

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

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

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

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 R-CVP as cycles of treatment. You have between 6 and 8 cycles. Each cycle lasts 3 weeks and you have it in the following way.

Day 1
  • Rituximab as a drip – the first time it lasts about 4 hours, but after that it usually lasts 2 hours
  • Vincristine as a short drip (infusion)
  • Cyclophosphamide as an injection into your vein or as a drip over 30 minutes
  • Prednisolone as tablets. You take it for 5 days. After the first dose you take the rest at home.
Days 2 to 5
  • Continue taking prednisolone tablets

You need to swallow the tablets whole after a meal, or with milk, as they can irritate your stomach. It is best to take them after breakfast.

Once you have finished your prednisolone tablets you have no treatment for just over 2 weeks. Then you start the next cycle.

Some people can have an allergic reaction to rituximab so your first dose is given slowly over about 4 hours. To help prevent a reaction you will have paracetamol and a drug called chlorphenamine (Piriton).

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 drug may come through in your breast milk.

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.

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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