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Vincristine, doxorubicin and dexamethasone (VAD)

Find out what VAD is, how you have it and other important information.

VAD is a combination of chemotherapy drugs used to treat myeloma. It is made up of the drugs:

  • V - vincristine
  • A - (Adriamycin) now called doxorubicin
  • D- dexamethasone (a steriod)

How it works

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

How you have VAD

You have vincristine and doxorubicin into your bloodstream and dexamethasone as tablets.

Into a vein

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

These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

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.

When you have VAD

You have VAD in 4 weeks cycles of treatment, every 28 days. Most people have between 4 to 6 cycles of treatment over 4 to 6 months. The number of cycles you have depends on:

  • how well your cancer responds to the drugs
  • whether your cancer has spread

At the start of the treatment cycle you have all 3 drugs for 4 days. You have the vincristine and doxorubicin slowly over the 4 days through an infusion pump. The pump is connected to a drip line, but you can go home with the infusion pump on.

Then you have a break with no treatment for 24 days. This competes 1 cycle. At times during the treatment cycle you will have dexamethasone tablets to take. Usually you take them for 4 days at a time. You may take up to 3 lots of dexamethasone tablets during each cycle of chemotherapy.

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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