Cancer drugs A to Z list
Procarbazine, lomustine and vincristine is a combination of chemotherapy drugs. How you pronounce the drug names are in brackets.
procarbazine - (pro-kar-buh-zeen)
lomustine - (loh-must-teen). It is also known as CCNU
vincristine - (vin-kris-teen)
It is a treatment for a type of brain tumour called glioma.
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Read more about chemotherapy and how it works
You have vincristine into your bloodstream (intravenously). You take lomustine and procarbazine as capsules.
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.
Read more about having medicines into your bloodstream
When taking lomustine and procarbazine capsules you swallow them whole with a full glass of water. You should not open, crush or chew the capsules.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
You usually have procarbazine, lomustine and vincristine as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover.
Each cycle lasts about 42 days (6 weeks). You usually have up to 6 cycles. The treatment will stop sooner if the side effects are too bad, or the cancer progresses.
Exactly how you have your drugs may depend on your treatment centre. The following is an example.
You might have each cycle of treatment in the following way:
Day 1
You take procarbazine as capsules.
You have vincristine as a drip into your bloodstream (intravenously) over 10 to 15 minutes.
You take lomustine as capsules.
Day 2 to 10
You continue to take procarbazine as capsules once a day.
Day 11 to 42
You have no treatment.
You then start a new cycle of treatment.
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 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.
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 might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
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 feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Tell your treatment team if you have this. You might also have a bloated tummy and feel sick or pass more wind than usual but these symptoms are less common. If you have these symptoms, your treatment team can check the cause and give you medicine to help.
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.
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
You might feel some pain in your muscles and bones, particularly in your legs. You might also have pain in your jaw but this is less common. Speak to your doctor or nurse about painkillers you can take to help with this.
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 have headaches, aching muscles or joints, and a high temperature. Let your healthcare team know 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:
skin problems such as a rash
changes to the way your liver works which are usually temporary - you have regular blood tests to check this
loose or watery poo (diarrhoea)
a sore or painful mouth and mouth ulcers
changes to the way your kidneys work - you have regular blood tests to check this
problems passing urine. For example, not being able to have a wee when you feel you need to. This can cause pain and discomfort, call your hospital advice line if this happens to you
hearing loss
earache
dizziness
an unusual ringing in your ears (tinnitus)
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
a second cancer such as acute leukaemia or myelodysplastic syndrome some years after this treatment
redness, swelling, pain or leaking at your drip site
lung changes that can cause breathlessness and a cough
confusion or disorientation
difficulty in walking or speaking
problems with your eyesight such as loss of vision
risk of losing consciousness
heart problems
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:
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
high blood pressure that might cause headaches, confusion, vision problems or chest pain
low blood pressure that can cause you to feel lightheaded or dizzy
vincristine may leak outside of the vein and damage the tissue around while being given (extravasation). Tell the nurse straight away if you have any stinging, pain, redness, or swelling around the vein. Although uncommon, it is important that this is dealt with quickly
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.
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.
Alcohol
Avoid drinking alcohol while having this treatment. It may cause a reaction. Symptoms include flushing in your face and neck, an increased body temperature, sweating, feeling and being sick, itching and a headache.
Procarbazine can interact with alcohol, non alcoholic beers and other foods which are not fresh. More so if they have been fermented, pickled, smoked ‘hung’ or ‘matured’. Some of the foods that could cause an interaction include:
mature or processed cheeses
yeast or meat extracts - such as Marmite, Oxo or Bovril
salami and pepperoni
overripe fruit
wines and lagers
fermented or pickled foods
This treatment might 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 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 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.
Don’t breastfeed during this treatment and for 1 month after finishing your 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: 04 Oct 2024
Next review due: 04 Oct 2027
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.
Primary brain tumours are cancers that start in the brain.
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
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.
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