Cancer drugs A to Z list
R-GCVP includes the drugs below. How to pronounce the drug names are in brackets.
R – rituximab (ri-tuk-si-mab)
G – gemcitabine (jem-site-uh-been)
C – cyclophosphamide (sike-low-foss-fa-mide)
V – vincristine (vin-kris-teen)
P – prednisolone (pred-nis-oh-lone)
You might have R-GCVP if you have high grade B cell non Hodgkin lymphoma (NHL) and have heart problems and can’t have some types of chemotherapy, such as the combination R-CHOP.
Rituximab is a type of targeted cancer drug called a . It targets a protein called CD20 on the surface of the cancer cells. Rituximab sticks to all the CD20 proteins it finds. Then the cells of the immune system pick out the marked cells and kill them.
Gemcitabine, cyclophosphamide and vincristine are types of chemotherapy drugs. These drugs destroy quickly dividing cells, such as cancer cells.
Prednisolone is a type of steroid. It treats the cancer by stopping the cancer cells growing and killing them. It may also help you feel less sick during treatment. And help reduce your body’s immune response, to try and prevent an allergic reaction to rituximab.
You take prednisolone as tablets. You swallow the tablets whole after a meal, or with milk, as they can irritate your stomach. It is best to take them after breakfast.
You usually have all the other drugs 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.
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 have R-GCVP as cycles of treatment. This means you have the drugs and then a rest to allow your body to recover.
Each cycle of treatment lasts 21 days (3 weeks). You usually have 6 cycles of treatment.
Rituximab can cause an allergic reaction. So before each dose you have paracetamol, a steroid and an antihistamine drug such as chlorphenamine (Piriton).
For the first cycle of rituximab, you have it as a drip into your bloodstream slowly over a few hours. This is to prevent an allergic reaction. Your nurse will increase how fast it goes in (rate). This is approximately every 30 minutes if you have no allergic reaction.
Your next rituximab drip will usually go in quicker, but this will depend on how you got on with the first cycle.
You have R-GCVP in the following way:
You take prednisolone tablets once a day in the morning with or after food.
You have rituximab as a drip (infusion) into your bloodstream.
You have gemcitabine as a drip into your bloodstream for about 30 minutes.
You have vincristine as a short drip into your bloodstream over 10 minutes.
You have cyclophosphamide as a short drip into your bloodstream over 10 to 30 minutes.
You take prednisolone tablets once a day in the morning with or after food.
You have no treatment.
You have gemcitabine as a drip into your bloodstream for about 30 minutes.
You have no treatment.
You then start the next cycle of treatment.
You usually also have G-CSF. This is an injection under the skin (subcutaneous). It helps your body make to lower your chance of getting an infection.
You have G-CSF daily for 5 days from day 9 of your cycle.
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.
Rarely your body might develop blood clotting problems for other reasons. Let your nurse or doctor know if you notice any bruising or are bleeding from anywhere.
A reaction may happen during the infusion. This can cause symptoms such as a skin rash, itching, swelling of the lips, face or throat, breathing difficulties, fever and chills.
Allergic reactions can sometimes be life threatening. Your nurse will give you medicines beforehand to try to prevent a reaction.
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.
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.
Small amounts of blood and protein in your urine may be found when your nurse tests your urine. This usually goes away on its own. If there are large amounts of protein you may have tests to check how well your kidneys are working.
You might feel that you have to pass urine more often than usual or find it difficult to pass urine. It may burn or sting when you do. Or you might feel that you can't wait when you need to go. 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.
Tell your healthcare team if you have soreness. They can prescribe medicines to help.
Skin problems include a skin rash and itching. Less commonly you might get a raised itchy rash known as hives or urticaria.
Rarely this treatment can cause a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might have flu-like symptoms such as a fever and your eyes may be more sensitive to light. This is serious and could be life threatening.
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.
It is important to tell your doctor or nurse straight away if you have difficulty in breathing. It usually happens soon after having this treatment and is usually mild and will soon pass. But it could be for another reason.
You might have inflammation, irritation or a feeling of tightness of the lungs, but these are less common. Rarer breathing problems include scarring of the lung tissue or swelling and narrowing of the air passages (tubes) in the lungs (asthma).
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.
This treatment commonly causes liver changes that are usually mild which are picked up on blood tests.
Less commonly you might get yellowing of the skin and whites of the eyes. This is due to high levels of in the blood.
In some severe cases some people get liver failure, but this is rare.
You have regular blood tests to check for any changes in the way your liver is working.
This can happen a few hours after treatment. It may include headaches, muscle aches (myalgia), a high temperature and shivering. Taking paracetamol every 6 to 8 hours can help.
Swelling in the face, hands and feet. Rarely your tummy and might swell. This usually goes away on its own but tell your doctor or nurse if you have it.
Tell your healthcare team if you keep getting headaches. They can give you painkillers 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.
You might get a high temperature. Or you might feel cold or start shivering (chills).
This treatment can cause pain in different parts of your body such as the tummy (abdomen), muscle and bone. Occasionally you might have pain in the back, mouth, jaw, throat, chest, joints, neck and where the cancer is.
Let your treatment team know if you have this so that they can give you painkillers.
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.
Immunoglobulin G is an antibody made by the immune system to fight bacteria and viruses. You have regular blood tests during and after treatment to check for this.
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:
a serious reaction to an infection (sepsis) - 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
high blood sugar levels – you might have to check them more often if you are diabetic
indigestion symptoms include heartburn, bloating and burping
mouth sores and ulcers
mood changes such as feeling anxious and restless. Rarely people may get very low in mood (depressed) or feel very nervous
sleeping problems - difficulty falling or staying sleeping (insomnia), difficulty staying awake (somnolence)
feeling generally unwell (malaise)
loose watery poo (diarrhoea)
eye problems including an eye infection and inflammation (conjunctivitis) and making more tears
blood pressure changes so it might go high or too low. Symptoms can include feeling lightheaded, dizzy, headaches, confusion, vision problems or chest pain
changes to the levels of minerals, salts and enzymes in the blood – you have regular blood tests to check this
sweating more than usual or you may get drenching sweats at night
changes to your hearing. You may have ringing in your ears or ear pain. You might have hearing loss but this is rare
difficulty swallowing
dizziness
heart problems including changes to the heart rhythm or a heart attack. Rarely it can be it harder for the heart to pump blood to the rest of the body. Contact your healthcare team straight away if you feel tightness or pain in your chest, lightheaded, dizzy, sweating or anxious
episodes of feeling warm and reddening of the skin (flushing)
unusual feelings of the skin – such as numbness, tingling, pricking, burning, a creeping skin feeling or a reduced sense of touch
runny nose
a cough
cold hands and feet
getting stiff and difficulty moving due to the brain telling the muscles in your body to tighten (hypertonia)
infections such as hepatitis B can become active again if you've had it in the past
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 leukaemia
changes in the way your kidneys work
taste changes
too little oxygen reaching the body’s organs
confusion
a condition where the is unable to make all types of blood cells (aplastic anaemia)
a condition where the are destroyed faster than they can be made (haemolytic anaemia)
a rare disorder of the nerves causing headaches, fits, confusion and changes in vision - contact your health team straight away. This condition is reversible
fits (seizures)
high 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
enlarged tummy (abdomen)
swelling of the lymph nodes or glands
several body parts (organs) might stop working
high levels of fat (cholesterol) in the blood
a
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 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.
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 6 months after your last treatment. This is because the drug may come through into 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 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: 08 May 2024
Next review due: 08 May 2027
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.
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Targeted cancer drugs work by ‘targeting’ the differences that help a cancer cell to survive and grow. They are one of the main treatments for some cancers.
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.
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.
