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FAD

Find out what FAD is, how you have it and other important information about having FAD.

FAD is a cancer drug combination made up of the drugs:

  • fludarabine
  • doxorubicin (also called Adriamycin)
  • dexamethasone (which is a steroid)

It is a treatment for some types of low grade lymphoma. 

How it works

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

How you have it

Fludarabine is a clear colourless fluid and doxorubicin is a red fluid. You have these drugs into your bloodstream (intravenously).

Dexamethasone comes as tablets or as a liquid that you have into your bloodstream.  

Drugs into your bloodstream

You have the treatment through a drip into your arm or hand. 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.

Taking your tablets

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

Speak to your pharmacist if you have problems swallowing the tablets.

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

You should take the right dose, no more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When you have it

You have FAD as cycles of treatment. Each cycle of treatment lasts 4 weeks.You may have up to 6 or 8 cycles.

You have each treatment cycle in the following way:

Day 1
  • You have fludarabine as an injection into your vein (intravenously)
  • You have doxorubicin as an injection into your vein
  • You take dexamethasone as tablets
Days 2 and 3
  • You have fludarabine as an injection into your vein
  • You take dexamethasone as tablets
Days 4 and 5
  • You take dexamethasone as tablets
Day 6 to 28
  • You have no treatment

You then start the next cycle of treatment.

Tests

You have blood tests before 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're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

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.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists 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 up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who have had live vaccines as injections

Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray. You should do so for 2 weeks following their vaccination if you have a severely weakened immune system.

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.

Last reviewed: 
30 Apr 2018
  • Electronic Medicines Compendium

    Accessed April 2018

  • Handbook of Cancer Chemotherapy (8th edition)
    Roland K Keel
    Lippincott, Williams and Wilkins, 2012

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

  • Fludarabine, adriamycin and dexamethasone (FAD) in newly diagnosed advanced follicular lymphoma: a phase II study by the British National Lymphoma Investigation (BNLI)
    L Yung and others
    British Journal of Cancer, 2004. Vol 91, Pages 695-698

Information and help