Cancer drugs A to Z list
DHAP is the name of a combination. It includes the drugs we list below, next to each drug we have how you pronounce the drug in brackets.
D – dexamethasone (deks-uh-meth-uh-zone), which is a steroid
HA – high dose Ara C, also known as cytarabine (sigh-tar-a-been)
P – cisplatin (sis-plait-in)
It is a treatment for:
high grade non-Hodgkin lymphoma that has come back
Hodgkin lymphoma that has come back
Hodgkin lymphoma that got worse during or after treatment
Find out more about non-Hodgkin lymphoma
Find out more about Hodgkin lymphoma
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells. Dexamethasone is a steroid and can help the chemotherapy to work better.
Ara C and cisplatin are clear fluids and you have them into your bloodstream (intravenously).
You usually have the steroid drug dexamethasone as daily tablets (orally) but you may have it into your bloodstream instead.
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
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 healthcare team before you stop taking a cancer drug or if you miss a dose.
You usually have DHAP chemotherapy as . You may have between 2 and 6 cycles and each cycle lasts 3 weeks.
You have each cycle of treatment in the following way:
You have cisplatin as a drip into your vein (intravenously) for up to 24 hours.
You start taking dexamethasone tablets or have dexamethasone into your vein.
You have cytarabine (Ara C) as a drip into your vein, twice. Each drip lasts for 2 to 3 hours and you have them 12 hours apart.
You take dexamethasone tablets or have dexamethasone into your vein.
If you have the dexamethasone as tablets you will be able to go home and carry on taking the tablets at home. If you have the dexamethasone into your vein, you will need to go back to the hospital for 2 more days.
You take dexamethasone tablets or have dexamethasone into your vein.
You have no treatment.
You then start the next cycle.
You have fluids (hydration) into your vein during your first two days of treatment. This is because DHAP can cause kidney damage and the extra fluids help to keep your kidneys working properly. You may also take a drug called allopurinol on your first cycle of treatment. This is to help keep the levels of uric acid in your blood stable.
Your doctor will give you steroid eye drops to take for 5 to 7 days. The drops help to stop your eyes getting sore.
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.
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 white blood cells. 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 red blood cells. 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.
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.
Your anus could become inflamed, sore and develop ulcers. This can be painful. Contact your advice line or talk to your doctor or nurse if this happens.
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 fibre. 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.
Tell your treatment team if you have this. They can check the cause and give you medicine to 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 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.
This can happen about 6 to 12 hours after having cytarabine.
It is a combination of symptoms including a high temperature, aching muscles, bone pain, occasionally chest pain, a rash, sore eyes, and extreme weakness. You have steroids to help to prevent this syndrome. Contact your advice line or tell your doctor or nurse if this happens.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.
A less common side effect is skin ulcers.
With high dose cytarabine your skin might also peel.
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
You may have changes in levels of minerals and salts in your blood, such as low sodium. This will most likely go back to normal when you finish treatment. You have regular blood tests during treatment to check this.
High doses of cytarabine can make you drowsy.
High dose cytarabine can:
make you feel confused
cause slurred speech
affect your level of consciousness making you sleepy or not alert
Contact your advice line or tell your doctor or nurse if you or someone else notice these changes.
High dose cytarabine can cause eye problems.
You might have eye problems including blurred vision, sore, red, itchy, dry eyes (conjunctivitis) or an infection. Tell your healthcare team if you have this. They can give you eye drops or other medicines to help.
High dose cytarabine can cause a life threatening syndrome called acute respiratory distress syndrome (ARDS). Symptoms are:
severe shortness of breath
rapid, shallow breathing
tiredness, drowsiness or confusion
feeling faint
You might also get fluid on the lung which can cause difficulty breathing.
Contact your advice line or tell your doctor or nurse if you have any of these symptoms.
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:
infection or inflammation of the lining of the bowels causing feeling bloated, swelling of the tummy (abdomen), blood in your poo, diarrhoea, loss of appetite and being sick
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.
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. Contact your advice line straight away if you have any of these symptoms.
changes to your heartbeat. This can be either slower or faster.
These side effects happen in fewer than 1 in 100 people (fewer than1%). 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 notice any of these symptoms.
a low level of magnesium in the blood
hearing problems including loss of hearing
a blood cancer (leukaemia). Talk to your doctor if you are concerned about this.
a metallic taste in the mouth
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:
changes to your personality
changes to your mood such as feeling high, feeling low, depression, anxiety, thinking about suicide
mood swings
feelings of being alone
hearing or seeing things that aren’t there (hallucinations)
feeling agitated and restless
unable to settle
unable to concentrate
poor sleep or unable to sleep (insomnia)
an increase in appetite
high levels of sugar in the blood. Talk to your doctor about this if you are a diabetic.
swelling of the face (moon face)
Contact your advice line or tell your doctor or nurse if you have any of these symptoms.
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:
loss of appetite
pain, redness and inflammation at the injection site
dizziness
inflammation of the tissue surrounding the heart
inflammation of the veins
inflammation of the pancreas
ulcers and inflammation of the food pipe (oesophagus)
yellowing of the white of the eyes and skin (jaundice)
red, sore and peeling of the skin of the soles of the feet and palms of the hands
chest pain
not enough fluid in the body (dehydration)
stroke
sore muscles and muscle spasms
kidneys not working
infections such as hepatitis B can become active again if you've had it in the past
If you have side effects that aren’t listed on this page you can read the individual drug pages:
We have more information about side effects and tips on how to cope with them.
Read more about how to cope with side effects
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 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 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're having treatment and for at least 6 months afterwards.
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.
Read more about immunisations and cancer treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 24 Oct 2023
Next review due: 26 Oct 2026
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Hodgkin lymphoma is a cancer that starts in white blood cells called lymphocytes. Find out more about the tests, treatments and support available if you have Hodgkin lymphoma.
Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system. There are more than 60 different types of non-Hodgkin lymphoma. They can behave in very different ways and need different treatments.
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