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Regimen Information

For R + CHOP, including Side Effects

R + CHOP

For the treatment of Non-Hodgkin's Lymphoma

How R + CHOP chemotherapy is given and possible side effects.

R + CHOP for the treatment of Non-Hodgkin's Lymphoma

R + CHOP is the acronym for a chemotherapy regimen used in the treatment of non-hodgkin’s lymphoma.

Drugs in the R-CHOP combination:

R

= Rituximab

C

= Cyclophosphamide

H

= Doxorubicin Hydrochloride (Hydroxydaunomycin)

O

= Vincristine Sulfate (Oncovin)

P

= Prednisone

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

MOST COMMON SIDE EFFECTS OF R+ CHOP

  • Risk of Infection

  • Anemia

  • Nausea & Vomiting

  • Constipation

For more information, see the 'Expert Resources' tab below.

Community Responses

Often, the most helpful information regarding treatment side effects comes not from clinical brochures, but rather from other patients like you. We've collected the most helpful community resources to help you prepare for the side effects and coping tips for your chemotherapy regimen.

What side effects did you experience while on this medication?

The following have been voted the 3 most helpful responses to this question.

I'm bendeschaadsthinkingagain, and I'm a healthcare professional

I received 6 TX of R-CHOP. Takes about 4-5 hours every 2 weeks. Nurses were very effecient and comforting. Due to long period of 5 hr. a lunch from cafeteria was provided. The predisone was useful in giving me a ‘boost’ after each TX, however, once the prednsone wore off (about 3-5 days later I ‘crashed.’ Very tired, lethargic (doc provided small dose of ritalin daily for energy—very helpful), nausea (doc provided zofran which worked), muscle and bone pain-aches(doc provided pain meds which helped a little). Developed ‘chemo-fog’ i.e. forgetful, difficulty concentrating (nothing for this but it finally cleared after TX). Very low white blood count developed which left me open to infections (doc gave me a shot of neupogen)(avoided crowds, people with infections lot of had sanitizer…missed numerous family gatherings). Had pneumonia once and, mild cardiac toxicity (both cleared after TX completed). Heavy chills and ‘shakes’ came with TX (nothing for this except blankets). Extreme shortness of breath (cleared after TX). Could not continue working my job ( I retired). I did not lose weight as the predisone actually caused a weight gain. I was what the doctor called “an early responder” which is good. Had to budget my daily task and place myself first. I lost all of my hair (it grew back as before). Appetite was so-so with some foods tasting different and other foods causing me to vomit just from the smell. Had some mouth sores(used Biotene which helped a little). Drank lots of fluids i.e. water, gatorade etc. Wore a mask wherever I went and limited person to person contact to very brief encounters (majority of cancer pts. die from infection). I prayed and used visualization-meditation ( I had never meditated before). I will be 5 yr. cancer free November this yr. I am 63 yr of age this week. Recovery is long and takes a lot of work. Being a nurse I was not shy about asking for medications….ths is your life and your disease….claim it…own it….beat it.
You can access my journey at bendeschaadsthinking again as I kept a journal. Keep a copy of all lab work, x-rays etc as you may see other doctors. Get a second opinion.
Hope this is useful information.
Aaron

  • Thu Nov 8, 2012
Hi, I'm Rich

R+Chop x 6 doses for me for Non Hodgkins Lymphoma of the thyroid, just had #4 last Wednesday. Less side defects as I go on with the program. Prognosis is good.

After the first treatment I felt pretty awful, nauseous and poisoned. Only to be expected of course as I had indeed been poisoned. Next morning I woke with a hugely swollen neck, like a couple of lemons buried in there, and went straight to the hospital. All monitored, no problem, and the doc likes to see a reaction to the treatment anyway.

4 in. Prednisone really hacks me off, it keeps me up for the entire time I’m on it (5 days after each cycle). I end up completely wired, don’t take the car out etc, but get loads done around the house ;) After that, down to earth with a bump.

As I go on with the treatment I have some slight tingling of the fingertips, and some vision changes. Both are probably caused by the VIncristine, which has been reduced. It destroys nerve endings. Do bear in mind how chemo works. It attacks dividing cells. Thus your hair follicles, skin cells, mucous membranes (mouth to arse), white cells, platelets etc will all suffer.

Although I’m unable to work and am on the sort of income that will cost me the roof over my head as a result, I’m ok. Good doctors and nurses, good advice. Just be glad you’re getting some treatment, appreciate the daily stuff (daily!), and be glad to be alive.

  • Sun Jul 14, 2013
Hi, I'm wilhelm holly

I have Mantle Cell Lymphoma stage 4 with Mipi scale 2. I have completed 5 of 6 chemo cycles using RCHOP. the first cycle I was the weakest and had extremelynlow WBC and RBC counts. Dr. prescribed Levaquin to prevent infection. Unusually, I also developed a severe yeast infection caused by the increased glucose levels from the chemo. one pill from the doctor cured in three days, but it was very uncomfortable. before treatment I went through possible side effects with my Doctor and he prescribed preventative or propholactic medications.. I have learned not to be shy in battleing the disease or the symptoms or the side effects of treatment. I take Valtrex to prevent mouth sores, which so far I have not had, and use Biotene toothpaste, mouth spray and mouthwash. I take Emend™ on day 1,2 and 3 of chemo cycle to prevent nausea, I take zophran and compazine alternatively every 4 hours for 6 days, to prevent nausea and have had only mild nausea waves- except for my third treatment cycle. I experienced severe nausea in round three and Dr. prescribed the Sancuso™ patch to wear on my arm starting day 6 post chemo for 7 days. I have had no nausea since.
I take active culture probiotics to help with digestion, I take Nexium to help with the heartburn and reflux caused by the chemo and that has worked. I also take a mild laxative 2 times a day to manage the constipation caused by the chemo and the prednisone and the zophran- but only for 6 days. the symptoms from the nuelasta injection were the most surprising. This causes joint pain that can last for a few days. I take Claritan twice a day with two Tylenol for 7 days starting on the day of the Nuelasta injection. This helps a great deal. The Dr. recommended this course as the analgesic in the claritan reduces the joint discomfort. If the pain is too uncomfortable, I have a prescription for Hydrocodone that immediately alleviates any discomfort.
The fatigue is the most oppressive symptom from the chemo. I have learned that days 1 thru 5, because of the chemo and prednisone, I am both jumpy and fatigued. The prednisone also makes it difficult for me to sleep. But on day 6 and 7 I feel like I am crashing, barely able to stay awake or get comfortable. Days 8 thru 12 I feel very tired and lethargic. Taste for food changes, and certain smells can trigger a gag reflex. despite my best effort to avoid it, I have gained 8 pounds.
I have been fortunate to manage my low blood counts successfu

  • Fri Feb 1, 2013
Hi, I'm Rich

R+Chop x 6 doses for me for Non Hodgkins Lymphoma of the thyroid, just had #4 last Wednesday. Less side defects as I go on with the program. Prognosis is good.

After the first treatment I felt pretty awful, nauseous and poisoned. Only to be expected of course as I had indeed been poisoned. Next morning I woke with a hugely swollen neck, like a couple of lemons buried in there, and went straight to the hospital. All monitored, no problem, and the doc likes to see a reaction to the treatment anyway.

4 in. Prednisone really hacks me off, it keeps me up for the entire time I’m on it (5 days after each cycle). I end up completely wired, don’t take the car out etc, but get loads done around the house ;) After that, down to earth with a bump.

As I go on with the treatment I have some slight tingling of the fingertips, and some vision changes. Both are probably caused by the VIncristine, which has been reduced. It destroys nerve endings. Do bear in mind how chemo works. It attacks dividing cells. Thus your hair follicles, skin cells, mucous membranes (mouth to arse), white cells, platelets etc will all suffer.

Although I’m unable to work and am on the sort of income that will cost me the roof over my head as a result, I’m ok. Good doctors and nurses, good advice. Just be glad you’re getting some treatment, appreciate the daily stuff (daily!), and be glad to be alive.

  • Sun Jul 14, 2013
Hi, I'm MIRIAM E.

I have a question. I have made a mistake and took 20mg of prednisone (days 1 – 5), instead of the 80mg of prednisone!!! Should I restart and take the 60mg to compensate? Do I just wait and do it right next cycle of chemo?

  • Wed Sep 7, 2016
Hi, I'm Pipgarden

I have had 3 sessions of the R-CHOP for my Non-Hodgkins Lymphoma. I’ve been very lucky and have not experienced nausea. I have had fatigue. After this last session, the 2nd day I was severely sore on the outside of my skin. I took a Tylenol and drank lots of water and felt better the next day. Today I just feel very heavy boned.

I lost my hair after 2 1/2 weeks and have experienced a metallic taste in my mouth. After the second session i was eating all the time! This time it doesn’t seem to be so bad.

  • Tue Feb 28, 2017

This discussion needs your voice!

What were the specific side effects that you experienced while taking this medication? How did you manage them?

What coping tips would you give to new patients on this regimen?

Hi, I'm Pipgarden

Every session is different, every day is different. Love yourself and allow yourself to just be. Don’t “fight” with yourself.

  • Tue Feb 28, 2017

This discussion needs your voice!

What do you wish you had known before taking this medication? What information would you like to pass on to patients who are beginning this medication?

Treatment Overview

This chemotherapy regimen is commonly used to treat:

Other chemotherapy regimens for the treatment of Non-Hodgkin's Lymphoma:

See Expert Resources

The Navigating Care Library includes articles about cancer, chemotherapy regimens and drugs from the the National Cancer Institute and other experts.

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