This page tells you about the chemotherapy drug combination CVP and its possible side effects. There is information about
CVP is the name of a combination of chemotherapy drugs made up of
- C – Cyclophosphamide
- V – Vincristine (also known as Oncovin)
- P – Prednisolone, which is a steroid
The links above take you to more information about the individual side effects of each drug.
CVP is a treatment for low grade non Hodgkin lymphoma.
Cyclophosphamide and vincristine are clear fluids. You have them 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 the drugs 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. The tube stays in place as long as you need it.
You have prednisolone as tablets. You need to swallow them after a meal, or with milk, as they can cause stomach irritation. Your doctor will advise you which dose you need to take. It is best to take prednisolone early in the day, preferably after breakfast.
You usually have chemotherapy as cycles of treatment. You may have between 6 and 8 cycles of CVP. Each cycle lasts 3 weeks, so it takes from 4 to 6 months.
You have each cycle of treatment in the following way. On the first day you have an injection of cyclophosphamide and vincristine into your cannula or central line, which takes about 30 minutes. You also start taking your prednisolone tablets and continue for 5 days. You then have no treatment for just over 2 weeks. The cycle then starts again.
The side effects associated with CVP are listed below. You can use the underlined links to find out more about each one. For general information, see our cancer drugs 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
- Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or 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
- Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons. This starts after a few days or weeks and usually goes within a few months of finishing treatment
- Vincristine can temporarily stop the normal muscle contractions of the bowel, causing sickness, a swollen abdomen and cramps for a few days
- Severe constipation with abdominal pain occurs in 1 in 3 people. It can generally be prevented with regular laxatives. If you are constipated for more than 3 days, tell your doctor or nurse
- Feeling or being sick is usually mild and well controlled with anti sickness medicines
- Loss of appetite
- Hair loss or thinning – this usually starts about 3 to 4 weeks after your first dose but your hair will grow back once the treatment ends
- Prednisolone can cause a change in blood sugar levels. Tell your doctor or nurse if you get very thirsty or if you are passing urine more than usual. If you are diabetic you need to monitor your blood sugar levels very carefully
- Women may stop having periods (amenorrhoea) but this may be temporary
- Loss of 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
Between 1 and 10 in every 100 people have one or more of these.
- Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
- Vincristine can have an effect on the bladder nerves, making urine leak from the bladder (incontinence)
- Temporary taste changes
- Mouth ulcers
- Jaw pain, caused by vincristine affecting your nerves
- Your nails may darken or become ridged, brittle or chipped
- Your skin may darken
- Cyclophosphamide can cause cystitis (inflammation of the bladder), pain, and occasionally blood in the urine. If you see blood in your urine, contact your doctor or nurse straight away. You need to drink 1 to 1.5 litres of fluid a day. You may have extra fluids through your cannula or central line too
Fewer than 1 in 100 people have these.
- Damage to heart muscle which is usually temporary but for a small number of people may be permanent. Your doctor will check your heart before and after your treatment
- Lung changes may lead to a cough or breathlessness
- A build up of fluid may cause swelling in the legs and feet
- Bone pain
- Blurred or double vision
- Hearing loss or dizziness
- Trouble sleeping
These side effects are temporary and usually go back to normal within two months of finishing CVP treatment. If you have any of these effects tell your doctor or nurse.
There is a small risk that you may get a second cancer some years after CVP treatment.
You may only have a few of these side effects. 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 drug 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 drugs 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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