Cancer drugs A to Z list
ICE is the name of a chemotherapy combination. You have:
ifosfamide (pronounced eye-foss-fa-mide)
carboplatin (car-bo-pla-tin)
etoposide (ee-top-oh-side) - also known as Etopophos
It is a treatment for:
Hodgkin and non-Hodgkin lymphoma that has come back (relapsed) or not gone away (refractory)
lymphoma of the brain or spinal cord. This is also known as central nervous system (CNS) lymphoma
Most people who have ICE will also have a .
Some people have ICE with a monoclonal antibody called rituximab. This combination is called R-ICE.
Go to information about having R-ICE
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Find out more about how chemotherapy works
You have ifosfamide, carboplatin and etoposide as a drip 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
Find out more about having a central line
You usually have ICE chemotherapy as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover.
You have between 2 and 6 cycles. Each cycle lasts 21 days (3 weeks).
You can have ICE chemotherapy in a number of ways. A common way of having it is described below.
You have etoposide as a drip into your bloodstream over 1 hour.
You have etoposide as a drip into your bloodstream over 1 hour.
You have carboplatin as a drip into your bloodstream over 1 hour.
You have ifosfamide and mesna as a drip into your bloodstream over 24 hours.
You finish the ifosfamide drip.
You have etoposide as a drip into your bloodstream over 1 hour.
You have no treatment.
You then start a new treatment cycle.
You usually have ifosfamide with another drug called mesna. You have mesna either as a drip (infusion) into your bloodstream or as tablets.
Mesna is not a chemotherapy drug. It stops the ifosfamide from irritating your bladder and making the lining bleed.
You usually 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.
Find out more about having G-CSF
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).
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.
Less commonly you might have other areas of bleeding such as in your pee or poo. Let the team know straight away if you have any other bleeding.
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.
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.
You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a laxative if needed.
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
You might have liver changes that are usually mild and unlikely to cause symptoms. These changes are usually picked up on blood tests.
Let your healthcare team know if you are having the following symptoms: yellowing of the skin and white parts of the eyes, feeling or being sick, dark or tea coloured urine, pain in your tummy, a rash and feeling tired and weak.
You have regular blood tests to check for any changes in the way your liver is working.
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.
To help prevent kidney damage, it is important to drink plenty of water. You also have fluids into your vein during treatment.
You have regular blood tests to check how well your kidneys are working.
Cystitis can cause symptoms such as needing to pee more often than usual. Or you might feel that you can't wait when you need to go. It might be painful, sting or burn. You might want to go but can’t. Some people have blood or pass blood clots when they pee. This is called haemorrhagic cystitis.
It helps to drink plenty of fluids. Don't take any over the counter medicines for cystitis. Tell your healthcare team if you have any of these symptoms.
You may have changes in the levels of and salts in your blood. This includes low levels of sodium, potassium, calcium, and magnesium. Less commonly you might have high levels of that can cause gout. You have regular blood tests during treatment to check this.
You might take a medicine called allopurinol. It lowers the amount of uric acid in the blood and helps to reduce the symptoms of gout.
This is usually mild. You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard and eat a well balanced diet.
Talk to your doctor or nurse if this effect is stopping you from doing your usual daily activities.
Skin problems can include changes to your skin colour, such as your skin getting darker. You might get a skin rash, itching, or a raised itchy rash on the skin (hives), but this is less common.
Rarely, some people can develop a severe skin reaction. It might 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.
Also rare, is a sunburn like rash. This can happen to areas of skin that have been in contact with radiotherapy.
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:
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, alert your nurse or doctor if you notice any of these symptoms
dizziness
, such as an irregular heartbeat and . Symptoms of heart problems can include feeling dizzy, faint, weak, short of breath and you might have pain in your chest. Contact your advice line or doctor straight away if you have any of these symptoms
blood pressure changes. Tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath, it might be a sign your blood pressure is high. Rarely it may drop and you might feel lightheaded or dizzy
diarrhoea
mouth sores, ulcers and the lining of your throat and food pipe might become sore and swollen
redness, swelling, pain or leaking at the entrance to where your central line goes in
numbness or tingling in fingers and toes can make it difficult to do fiddly things such as doing up buttons
a burning or prickling sensation
taste changes or loss of taste
hearing changes, such as ringing in your ears or hearing loss loss
problems with your eyes, such as worsening of your eyesight or changes in vision. Rarely you might have of the optic nerve. This can cause pain, blurred vision, loss of colour, and temporary eyesight loss
lung problems - symptoms include tightening of the chest, wheezing, shortness of breath, chest pain and a cough. Rarely you might have a build up of scar tissue in your lungs (fibrosis). Let your team know straight away if you have trouble breathing
a second cancer such as acute
pain or discomfort in your muscles, joints or bones
nerve damage that reduces the reflex reaction between tendons and bones
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
seizures (fits)
problems swallowing (dysphagia)
a high temperature
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:
sepsis which is a serious reaction to an infection - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
inflammation of the pancreas – symptoms include severe tummy pain, feeling or being sick, a high temperature or diarrhoea
blood clots that can be life threatening - signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line or doctor straight away if you have any of these symptoms
changes in the brain that are usually reversible, causing a sudden onset of symptoms including headaches, dizziness, confusion, fits (seizures) and changes to vision
changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) - you have regular blood tests to check for this
a blood disorder where your red blood cells get destroyed faster than they can be made (haemolytic anaemia)
small blood clots developing throughout the bloodstream, blocking small blood vessels
an imbalance of substances in your blood (metabolic acidosis) – it can cause confusion, tiredness, shortness of breath and headaches
slow wound healing. If you need to have an operation your doctor will normally stop the ifosfamide for a while beforehand. They will let you know when you can start having it again
a - symptoms can include drooping of one side of the face, being unable to smile, having numbness or weakness on one side of the body or being unable to talk. Dial 999 immediately if you have these symptoms
small blood clots in the blood vessels inside the kidney (haemolytic uremic syndrome). Symptoms can include bloody diarrhoea, weakness, high temperature or being sick
SIADH – a syndrome where the body makes too much of the hormone that holds water in the body
changes to your mental state such as panic attacks and not being able to speak
If you have other 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 not become pregnant for at least a year after the end of treatment.
Men should not get someone pregnant for at least 6 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 become pregnant while having treatment.
Don’t breastfeed during this treatment. 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: 02 Oct 2025
Next review due: 02 Oct 2028
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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.
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