This page tells you about the chemotherapy drug combination VIDE and its possible side effects. There is information about
VIDE is the name of a combination of chemotherapy drugs used to treat a type of bone cancer called Ewing's sarcoma. It is made up of the drugs
- V – Vincristine
- I – Ifosfamide
- D – Doxorubicin
- E – Etoposide
Doxorubicin is a red fluid. All the other drugs are clear colourless fluids. You have the 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 before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
You usually have chemotherapy as cycles of treatment. You may have up to 6 cycles. Each cycle of treatment lasts 3 weeks. So the whole course takes 18 weeks.
On the first day you have an injection of vincristine and doxorubicin into your cannula or central line alongside a drip of salt water (saline). You also have a 1 hour drip (infusion) of etoposide and a 3 hour drip of ifosfamide. You usually have ifosfamide with another drug called mesna, either as a drip or as tablets. If you have the tablets you must take them exactly as your doctor prescribes. Mesna stops the ifosfamide from irritating your bladder and making it bleed.
On the second day you have the same drugs again but without vincristine.
On the third day you have the same drugs as day 2. Then you have no treatment for almost 3 weeks. You then start the next treatment cycle.
After the course of VIDE you usually have surgery to remove the sarcoma. Then you have more chemotherapy treatment, with either VAI or VAC combination chemotherapy.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.
We've listed the side effects associated with VIDE chemotherapy below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having VIDE with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
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
- 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, 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 petechiae)
- 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 sick, which is usually well controlled with anti sickness medicines
- Hair loss
- Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your nurse straight away
- A sore mouth and throat can happen about 5 days after each treatment, which usually clears up over a couple of weeks
- A drop in blood pressure can happen if etoposide is given too quickly – if you feel dizzy or faint, call your nurse straight away to slow your drip down
- Your urine may become a light pink or red colour for one or two days after treatment with doxorubicin – this won't harm you
- Sensitivity to sunlight – don’t sit out in the sun, and do cover up or use sun block on exposed skin
- Black or brown discoloration may occur in the creases of your skin after doxorubicin
- Irritation of the bladder and kidneys – drink as much water as possible to flush out the ifosfamide and you may have fluids into your drip before and after your treatment. Tell your doctor or nurse straight away if you have pain or bleeding when passing urine
- Changes to your nails
- Severe constipation with abdominal pain occurs in 1 in 3 people (30%) – your doctor or nurse may give you laxatives to help prevent this. Tell them if you are constipated for more than 3 days
- Vincristine can temporarily stop the normal waves of contraction that go through the gut, causing sickness, a swollen abdomen, and cramps. Let your doctor or nurse know if you have this
- Women may stop having periods (amenorrhoea) – this may be temporary
- 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
- Confusion, sleepiness or extreme lack of energy (lethargy) and hallucinations occur in about one person in 8 (12%). If you have any of these effects, it is important to tell your doctor or nurse straight away
- Numbness or tingling in fingers and toes affects between 1 and 2 out of every 10 people (10 to 20%). It can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks and usually goes within a few months of finishing treatment
Between 1 and 10 in every 100 people have one or more of these.
- Temporary taste changes
- Loss of appetite
- Jaw pain, caused by vincristine affecting your nerves
- Fevers and chills
- Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished
- A skin rash, which may be itchy
- Your skin may temporarily become darker with ifosfamide
- An allergic reaction occurs in 3 people in 100 (3%) who have etoposide – you may have a sudden rash of pink, itchy bumps on your skin and a reddening of the skin along the veins. This should clear up within a few days
- Reddening of the skin may occur in areas where you had radiotherapy in the past. The skin may get dry and flaky and feel sore and hot. This goes away on its own but keep affected areas out of the sun
- Damage to heart muscle can occur, which is usually temporary but for a small number of people may be permanent. Your doctor will check your heart before, during and after your treatment
There is a small risk that you may get a second cancer some years after VIDE treatment.
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 these drugs that are very unlikely to affect you. For further information 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.
Question about cancer? Contact our information nurse team