Da Epoch Chemo Regimen

Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.

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DA EPOCH chemo regimen:

Your doctor will prescribe your dose and schedule. The regimen is called dose adjusted (DA) because 3 of the medicines may be increased or decreased each cycle. This depends on how well each is working and if it is causing side effects. You may receive all medicines while you are in a hospital or cancer treatment center. The medicines need to be given on a fixed schedule. If you need to miss a dose, call your doctor or treatment clinic immediately. The following cycle will repeat every 21 to 28 days, up to 8 times:

• Etoposide, IV given over 24 hours on Days 1, 2, 3, and 4 (given together with doxorubicin and vincristine)
• Prednisone, by mouth 2 times each day on Days 1, 2, 3, 4, and 5
• Oncovin (vincristine), IV given over 24 hours on Days 1, 2, 3, and 4
• Cyclophosphamide, IV given over 2 hours on Day 5
• Hydroxydaunorubicin (doxorubicin), IV given over 24 hours on Days 1, 2, 3, and 4
• Rituximab, IV may be given on Day 1 (this regimen is called DA EPOCH-R)

Before you receive these medicines:

• Ask questions if you do not understand what your doctor or nurse is telling you about the medicines. Make sure you understand all the risks and benefits of this treatment.
• Talk to your doctor about all your current medicines and supplements. Do not take any medicines or supplements unless they have been discussed with your doctor.
• Talk to your doctor before you get a flu shot or other vaccine.
• Tell your doctor about any health problems you currently have, or if you had a recent heart attack. Also tell your doctor if you have had mental or emotional problems (such as depression).
• Prevent pregnancy during treatment and for as long after treatment as directed by your doctor. Use an effective form of birth control and a condom during treatment and for 6 months after the last dose, or as directed.
• Tell your doctor if you are currently breastfeeding.

On each infusion day:

• Blood may be drawn to make sure the doses you are being given are right for you. You may also have blood tests 2 times each week to make sure the treatment plan is working. X-ray, CT scan, or PET scan pictures may be used to see how well the regimen is working. Based on the results of all the tests, your doctor may increase or decrease medicine doses or change the regimen schedule.
• Medicines may be given to help with nausea and vomiting and to decrease your risk for reactions.

Infusion precautions:

• Contact your doctor or nurse immediately if you feel short of breath or have trouble breathing during or after your infusion.
• Tell the doctor or nurse right away if you notice redness, pain, or swelling at the infusion site.

Drugs used to treat this and similar conditions

After each infusion:

• If possible, have someone stay with you to call for help if you have serious side effects.
• Drink extra liquids to help prevent nausea and to keep your kidneys and liver working well.
• You may be at risk for infections. Wash your hands often with soap and water. Do not have close contact with anyone who is sick. Ask your doctor about vaccines you may need to prevent infections.

Call your local emergency number (911 in the US) if you have any of the following:

• Chest pain or tightness
• Signs of an allergic reaction, such as itching or hives, swelling or tingling in your mouth or throat, or trouble breathing
• Seizures

Call your nurse or doctor immediately if you have any of the following:

• Fast, pounding, or uneven heartbeat, lightheadedness, dizziness, or fainting
• Blurred vision, trouble seeing, eye pain, or headache
• Blistering, peeling, red skin rash, new dark freckles, or skin color changes
• Rapid weight gain, or swelling in your hands, ankles, or feet
• Mouth sores, severe stomach pain, nausea, vomiting, constipation, or red or black bowel movements
• Dark urine or pale bowel movements, trouble controlling your bladder, or pain when you urinate
• Muscle pain or weakness, severe muscle cramps, or bone pain
• Eye movements you cannot control, changes in your voice, or trouble walking
• Depression, unusual thoughts, feelings, or behaviors, trouble sleeping

Talk to your nurse or doctor if you have any of the following:

• Pain, swelling, redness, itching, or a lump under the skin where the IV was given
• Fever, chills, cough, sore throat, and body aches
• Increased appetite or loss of appetite
• Unusual bleeding, bruising, or weakness, or changes to your menstrual cycle
• Numbness or tingling in your arms or legs
• Round, puffy face, or weight gain around your neck, upper back, breast, face, or waist
• Red urine for 1 to 2 days after treatment

Follow up with your oncologist as directed:

Your oncologist will need to check your progress at regular visits. Blood tests may be needed to check for side effects.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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