This page tells you about the chemotherapy drug combination BEACOPP and its possible side effects. There is information about
BEACOPP is the name of a combination of chemotherapy drugs that includes
- B – Bleomycin
- E – Etoposide
- A – Doxorubicin (also called Adriamycin)
- C – Cyclophosphamide
- O – Vincristine (also called Oncovin)
- P – Procarbazine
- P – Prednisolone (a steroid)
The links above take you to more information about the individual side effects of each of these drugs.
BEACOPP is a treatment for Hodgkin lymphoma.
You usually have chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks. You may have up to 8 cycles, taking about 6 months.
You take procarbazine as capsules and prednisolone as tablets. It is very important that you take the capsules and tablets according to the instructions your doctor or pharmacist gives you. For example, 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. And never stop taking a cancer drug without talking to your specialist first.
You have all the other drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula), put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.
You have each cycle of treatment in the following way.
- On the first day you have cyclophosphamide and doxorubicin as injections into your cannula or central line. You have etoposide as a drip. You also start taking procarbazine capsules for a week and prednisolone tablets (steroids) for 2 weeks
- You have etoposide as a drip (infusion) on the following 2 days
- You have vincristine and bleomycin by drip one week after the day you started the treatment cycle
When you stop taking the prednisolone tablets you have a week with no treatment. You then start a new treatment cycle.
The side effects associated with BEACOPP are listed below. You can use the underlined links to find out more about each one. For general information, see our cancer drug side effects section.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Hair loss occurs in up to 8 out of 10 people (80%) but the hair will grow back once the treatment ends
- Bruising more easily due to a drop in platelets – you may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being very sick affects up to 2 out of 10 people (20%), but is usually well controlled with anti sickness medicines
- Women may stop having periods (amenorrhoea) but this may be temporary
- Sensitivity to sunlight – don’t sit out in the sun. Do cover up or use sun block on exposed skin
- Brown skin markings may occur along the line of the vein where you have the chemotherapy injection
- Brittle, chipped and ridged nails may occur but this will grow out once the treatment has ended
- Gritty eyes, blurred vision or watery eyes may occur
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. 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
Between 1 and 10 in every 100 people have one or more of these.
- A sore mouth affects up to 8 out of 100 people (8%) and may be severe
- Numbness or tingling in fingers and toes affects about 1 in 20 people (5%). It can cause difficulty with small tasks such as doing up buttons. This may start a few days or weeks after the beginning of treatment. It usually gradually goes within a few months of treatment ending
- Inflammation of the lungs – let your doctor or nurse know if you have a dry cough, breathlessness, chest pain or a high temperature
- Damage to heart muscle – this is usually temporary but for a small number of people may be permanent. Your doctor will check your heart before and after your treatment
You may have a few of the side effects mentioned on this page. They may be mild or more severe. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on
- How many times you've had a drug before
- Your general health
- How much of the different drugs you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
These drugs may 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.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information about these drugs look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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