Cancer drugs A to Z list
AC is the name of a chemotherapy combination. You have:
A - doxorubicin (pronounced docs-oh-roo-bi-sin) – this may also be called Adriamycin
C – cyclophosphamide (sike-low-foss-fa-mide)
It is a treatment for breast cancer.
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Find out how chemotherapy works
You have doxorubicin and cyclophosphamide into your bloodstream (intravenously).
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.
When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.
Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.
You have AC as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover. Each cycle of treatment lasts 21 days (3 weeks). You might have between 4 and 6 cycles of AC.
You usually have each cycle of treatment in the following way:
You have doxorubicin as an injection or as a drip into your bloodstream over about 15 minutes.
You have cyclophosphamide as an injection or as a drip into your bloodstream over about 30 minutes.
You have no treatment.
You might also have a drug called granulocyte colony stimulating factor (G-CSF). This makes your produce more quickly after the chemotherapy. It helps lower your risk of getting an infection after having this treatment.
Your healthcare team will let you know what day to start your G-CSF injections.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
You also have heart tests such as as an , or both before treatment. You may continue to have heart tests during and after treatment with doxorubicin.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
You might be breathless and look pale due to a drop in . This is called anaemia.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. 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. This is known as petechiae.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
You might feel that you have to pee more often than usual or find it difficult to go. And you may have a burning feeling when you do. Or you might feel that you can't wait when you need to pee. This is called cystitis.
It helps to drink plenty of fluids. Don't take any over the counter medicines for cystitis. Contact your advice line instead.
You could also have blood in your pee. Your healthcare team might do urine tests to keep a check in this.
Your pee might be red or pink for a few days after treatment, but this is only temporary. Your healthcare team can check it is from the doxorubicin and is not blood.
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
Talk to your healthcare team if you have either chills or shivering.
You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Less common skin changes include a rash or raised itchy skin bumps (hives). You might notice your nails or areas of skin appear darker.
Rarely this treatment can cause a severe skin reaction. It may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish, and your eyes may be more sensitive to light. This is serious and could be life threatening.
It’s not known how often this happens, but you might have skin changes to an area where you have had radiotherapy before. This usually looks like sunburn.
Your skin might also be more sensitive to sunlight causing a reaction. It’s not known how often this happens but it’s important to protect your skin. The best way is to find shade, cover up your skin and wear sunscreen. The sunscreen should be at least SPF 30 with a 4 or 5 star UVA protection rating.
Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
It’s very common with this treatment to have changes to the heart muscle or rhythm that can be picked up on an ECHO, ECG or both. Less commonly this treatment can cause heart failure or a faster heart rate.
Rarely your heart may have difficulty pumping blood around your body due to inflammation, stiffening or thickening of the heart muscle.
Some of the symptoms of heart changes can include tiredness, shortness of breath, ankle or feet swelling, chest pain, a fast heart rate, fluttering or a pounding heart.
You have tests to check how well your heart is working before, during and after treatment.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
You have regular blood tests to check for any changes in the way your liver is working.
You may gain weight while having this treatment. You may be able to control it with diet and physical activity. Tell your healthcare team if you are finding it difficult to control your weight.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- signs can include feeling very unwell, not peeing, a very high or very low temperature, shivering, slurred speech or confusion, breathlessness, mottled or discoloured skin, extreme shivering or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
inflammation of the lining of your food pipe (oesophagus) – symptoms include pain or difficulty swallowing, heartburn or chest pain. You might have inflammation of other areas of your such as your bowel, but it’s not known how often this happens
tummy (abdominal) pain. Other areas of pain include your joints, muscles, throat or head, but it’s not known how often this happens
eye changes such as sore, red, itchy eyes (conjunctivitis). Rarely you might have changes to your vision such as blurring
unexpected bleeding such as blood in your poo, vaginal bleeding, or coughing up blood. If you have any other unusual bleeding contact your healthcare team straight away
redness and swelling may develop at site of injection – tell your nurse or doctor straight away if this happens
liver changes - symptoms may include yellowing of the skin or eyes, feeling or being sick, bleeding or bruising, dark urine, and stomach pain. You have regular blood tests to check how well your liver is working
generally feeling unwell
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. Some allergic reactions can be life threatening, tell your nurse or doctor if you notice any of these symptoms
a blockage in the bloodstream. This is called an clot (embolism). This might be because of a blood clot or air bubble. The symptoms vary depending on the type of embolism. Symptoms might include signs of pain, swelling and redness where the embolism is. Feeling breathless can be a sign of a blood clot on the lung. An embolism can be life threatening, dial 999 or contact your advice line or doctor straight away if you have any of these symptoms
flushing
hearing loss
nerve changes - symptoms can include weakness, pain, tingling or a burning sensation. You might have numbness or tingling in your fingers or toes. This is often temporary and can improve after you finish treatment
lower levels of female
blood tests showing you have high levels of inflammation or tissue damage in the body
developing a second cancer including acute , bladder cancer, ureteric cancer and
a change to the amount of chemicals in your blood caused by the breakdown of the cancer cells, this can affect how your heart and kidneys work. If you are at risk of this happening you might have extra fluids with your chemotherapy
dizziness
an excessive uncontrolled release of a hormone called antidiuretic hormone (ADH) causing feeling sick, loss of appetite, sore muscles and weakness
not enough fluid in the body (dehydration)
seizures (fits)
small blood clots developing throughout the bloodstream, blocking small blood vessels (disseminated intravascular coagulation)
small blood clots in the blood vessels inside the kidney (haemolytic uremic syndrome) - symptoms can include bloody diarrhoea, weakness, high temperature or being sick
acute respiratory distress syndrome (ARDS) – symptoms include sudden breathlessness, changes in how fast you breath, feeling tired, faint, drowsy or confused
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
damage to the lining of the stomach wall
blood sugar changes – you might have blood tests to check this. If you have you may need to check your blood sugar levels more often than usual
changes in the brain that are usually reversible, causing a sudden onset of symptoms including headaches, dizziness, confusion, fits (seizures) and changes to vision (reversible posterior leukoencephalopathy syndrome)
If you have side effects that aren't listed on this page, you can look at the individual drug pages:
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to become pregnant or get someone pregnant 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 might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment.
Women must use 2 effective methods of contraception during treatment and for 7 months afterward. Men should not get someone pregnant for at least 4 months after treatment.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner becomes pregnant while having treatment.
Don’t breastfeed during this treatment and for 10 days afterwards. This is because the drugs may come through in your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
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, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic Medicines Compendium (eMC) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 01 Jul 2026
Next review due: 01 Jul 2029
Find out about breast cancer, including symptoms, diagnosis, treatment, survival, and how to cope with the effects on your life and relationships.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
About Cancer generously supported by Dangoor Education since 2010. Learn more about Dangoor Education
Search our clinical trials database for all cancer trials and studies recruiting in the UK.
Connect with other people affected by cancer and share your experiences.
Questions about cancer? Call freephone 0808 800 40 40 from 9 to 5 - Monday to Friday. Alternatively, you can email us.
