Cancer drugs A to Z list
ECF is the name of a . It includes the following drugs. How you pronounce the drug names are in brackets:
E – epirubicin (eh-pee-roo-bih-sin)
C – cisplatin (sis-pla-tin)
F – fluorouracil (floor-oh-yoor-uh-sil). Fluorouracil is also called 5FU.
You might have ECF as treatment for stomach cancer or cancer of the food pipe (oesophagus).
Find out about cancer of the oesophagus
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Find out more about how chemotherapy works
You have ECF 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 have ECF chemotherapy as cycles of treatment, each lasting 3 weeks (21 days). You might have between 3 and 8 cycles. Your treatment plan depends on the type of cancer you have.
On the first day of the cycle you have:
epirubicin as an injection into your bloodstream (intravenously)
cisplatin as a drip into your bloodstream over 1 to 4 hours
extra fluids through a drip before and after the cisplatin to protect your kidneys
fluorouracil as a drip through a pump continuously for 21 days
The fluorouracil pump might be a small portable one if you have a long line. This means that you can go home with it. You then go back to the hospital for the nurses to refill or disconnect it. Your doctor or nurse will tell you when you need to go back.
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 starting treatment with fluorouracil (5FU) you have a blood test to check levels of an enzyme called dihydropyrimidine dehydrogenase (DPD). A low DPD level means you are more likely to have severe side effects from this chemotherapy, so you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor, nurse or pharmacist will talk to you about this.
Find out more about having a DPD deficiency
You might also have tests to check how your heart is working during treatment.
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.
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.
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.
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 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.
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.
Moisturise your skin regularly. Your healthcare team will tell you what moisturiser to use.
This won't harm you. It’s due to the colour of the chemotherapy and lasts for one or two days.
You may have changes to how your heart works such as your heart rhythm. Tests such as a might pick this up.
You may have changes in levels of minerals and salts in your blood, including low levels of sodium or high levels of uric acid (causing gout). You have regular blood tests during treatment to check this.
We have some tips for coping with hot flushes in women and hot flushes in men. This information also includes some of the possible treatments. Talk to your doctor if your hot flushes are hard to cope with. They might be able to prescribe some medicines to help.
This might happen during the infusion or after. Symptoms include pain, tenderness, swelling, warm itchy skin, colour and texture changes where the chemotherapy is going in.
During the infusion if you have these symptoms tell your nurse straight away as the drug could be leaking into the tissue and causing damage to the tissue.
This might include inflammation of the conjunctiva (conjunctivitis) and inflammation of the cornea (keratitis).
More rarely you might have watery eyes, changes in vision, sensitivity to sunlight, or side to side movements of the eyes (nystagmus).
You might get a high temperature (fever) for a few hours after having this treatment. Tell your doctor or nurse if you have a fever.
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.
You might have darkening of the skin. This usually goes back to normal a few months after finishing treatment.
Occasionally a skin rash can be severe if you have chemotherapy soon after completing radiotherapy. This is called radiotherapy recall.
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.
Sodium is a salt and symptoms of low sodium include:
headaches
feeling or being sick
confusion
restlessness
seizures
Your sodium levels will most likely go back to normal when you finish treatment. You have regular blood tests during treatment to check this.
You may have difficulty breathing with wheezing and coughing. Let your healthcare team know straight away if this happens.
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:
lack of fluid in the body (dehydration)
tummy (abdominal) pain
blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms.
These side effects happen in fewer than 1 in 100 people (fewer 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 alert your nurse or doctor if notice any of these symptoms
low blood pressure
blood cancers such as acute myeloid leukaemia (AML) and acute lymphocytic leukaemia (ALL). Talk to your doctor if this is of concern to you.
a strong feeling of happiness, confidence or both (euphoria)
headaches
dizziness
symptoms of Parkinson's disease such as shaking hands
feeling very sleepy
low magnesium
changes to hearing
unsteadiness and confusion
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.
This drug may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment with this drug and for at least 7 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.
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.
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: 21 Dec 2023
Next review due: 21 Dec 2026
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
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