Hcvad Chemo Regimen

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

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HCVAD chemo regimen:

This regimen may also be called hyper-CVAD. Hyper is short for hyperfractionated. This means the total amount of medicine is divided into smaller doses given more often. Your doctor will prescribe your dose and schedule. You will receive most of these 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 regimen has 2 parts that alternate every 21 days. The 2 parts together make 1 cycle. Each cycle may be repeated up to 4 times:

• Part A:
  • Cyclophosphamide IV, given over 3 hours every 12 hours on Days 1, 2, and 3
  • Vincristine IV, given over 15 minutes on Days 4 and 11
  • Doxorubicin (Adriamycin) IV, given over 2 to 24 hours on Day 4
  • Dexamethasone tablets by mouth, taken on Days 1, 2, 3, 4, and then Days 11, 12, 13, and 14
• Part B:
  • Methotrexate IV, given over 24 hours on Day 1
  • Prednisolone given as eye drops every 6 hours before cytarabine dose 1
  • Cytarabine IV, given over 2 hours every 12 hours on Days 2 and 3
  • Leucovorin IV or tablet by mouth, started 12 hours after methotrexate ends, and then given every 6 hours while methotrexate level is monitored

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.
• This treatment may cause infertility. Talk with your doctor if you plan to have children. This treatment may also cause premature menopause.
• Tell your doctor about your medical history. Include any diseases or conditions you have or had. Examples include kidney, liver, heart, or lung disease, anemia, and a nerve or muscle disease, especially Charcot-Marie-Tooth disease. Also tell your doctor if you have a history of an allergic reaction to thiol compounds (including amifostine).

On infusion days:

• Blood may be drawn to make sure the doses you are being given are right for you.
• Medicines may be given to help with nausea and vomiting and to decrease your risk for reactions.
• Mesna IV will be given over 24 hours on Days 1, 2, 3, and 4 of Part A. Mesna is not a chemotherapy medicine. It helps your body get rid of waste produced by cyclophosphamide.

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.
• This treatment may cause birth defects if either partner is receiving it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant. Use an effective form of birth control during treatment and for 2 months to 1 year after the last dose, or as directed. The amount of time depends on if you are female or male.
• Do not breastfeed during treatment and for 1 week after the last dose, or as directed.
• Do not drink alcohol while you are receiving these medicines.
• Tell any doctor or dentist who treats you that you are receiving these medicines. Certain medical test results could be affected.
• These medicines may make you dizzy or tired. Do not drive or do anything else that could be dangerous until you know how the medicines affect you.

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, trouble breathing, blue lips or fingers, or coughing up blood
• Seizures or confusion
• Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fast, pounding, or uneven heartbeat
• Dizziness, lightheadedness, or uncontrollable eye movements

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

• Blistering, peeling, red skin rash, skin changes or growths, or new freckles
• Blurred vision or other changes in vision, trouble seeing, or eye pain
• Weight gain around your neck, upper back, breast, face, or waist
• Severe nausea, mouth sores, diarrhea, or uncontrollable vomiting
• Depression, unusual thoughts, feelings, or behaviors, or trouble sleeping
• Unexplained muscle pain, cramps, or tenderness
• Numbness or tingling in your arms, hands, legs, or feet, bone pain, or trouble walking
• Blood in your urine or bowel movements, painful urination, or trouble urinating

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

• Fever, chills, dry cough, sore throat, body aches, headache
• Mild nausea, vomiting, diarrhea, weight loss, loss of appetite, or mouth sores or white patches
• Unusual bleeding, bruising, or weakness, or drowsiness during the day
• A lump under your skin where the needle was placed
• Red urine for 1 to 2 days after treatment
• Round, puffy face
• Changes in your menstrual periods
• Hair loss or thinning, changes in skin or nail color

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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