AC followed by paclitaxel: doxorubicin, cyclophosphamide and paclitaxel.
The medicines
Given every 3 weeks.
Tap the side effect you have on the map to see how severe it is and what to do. Not everyone gets every side effect, and most are mild.
From: Doxorubicin, Cyclophosphamide, Paclitaxel
Slightly raised temperature
A slightly raised temperature, otherwise well.
Fever: always an emergency during chemotherapy
A temperature of 38.0°C (100.4°F) or more, even once. Or shivering, chills, or feeling suddenly very unwell.
From: Doxorubicin, Cyclophosphamide, Paclitaxel
Feeling sick, eating a little less
Manage at home
Mild (grade 1)
Feeling sick and eating a little less than usual, no vomiting.
Moderate (grade 2)
Eating much less than usual, or vomiting 1 to 3 times in a day.
Severe (grade 3 or 4)
Vomiting more than 3 times in 24 hours, or cannot keep down water or medicines, or feeling dizzy.
From: Doxorubicin
Sore mouth, eating normally
Manage at home
Mild (grade 1)
Soreness or redness; eating normally.
Moderate (grade 2)
Painful ulcers; you can eat soft food only.
Severe (grade 3 or 4)
Cannot eat or drink, or cannot swallow saliva.
From: Doxorubicin, Cyclophosphamide, Paclitaxel
Tired, better with rest
Manage at home
Mild (grade 1)
Tired, but better with rest.
Moderate (grade 2)
Not better with rest; you cannot do housework, shopping or work as usual.
Severe (grade 3 or 4)
Cannot get out of bed or walk, fainting, dizziness on standing, or tiredness with breathlessness or confusion.
From: Doxorubicin, Cyclophosphamide, Paclitaxel
From: Doxorubicin, Paclitaxel
Dry skin or mild rash
Manage at home
Mild (grade 1)
Dry skin, mild rash or redness, without pain.
Moderate (grade 2)
Painful redness or peeling of the hands or feet, or a rash over a large area, that affects daily work.
Severe (grade 3 or 4)
Blisters, skin peeling off, a rash with fever, a rash in the mouth or eyes, or a red, hot, swollen area with pus.
From: Paclitaxel
Tingling, daily tasks normal
Manage at home
Mild (grade 1)
Tingling or numbness that does not affect daily tasks.
Moderate (grade 2)
Difficulty with buttons, writing, holding things, or walking feels unsteady.
Severe (grade 3 or 4)
Cannot dress or walk safely, or falls. Or sudden weakness of the legs, numbness around the bottom, or trouble passing urine or stools (this can be pressure on the spinal cord).
From: Doxorubicin
The medicine is red, so urine looks red or orange. This is not blood.
When: Day 1 to 2.
What helps:
From: Cyclophosphamide
Some medicines, including those given into the bladder, irritate the bladder lining, causing burning, passing urine often, or blood in the urine.
When: During and a day or two after treatment.
What helps:
From: Paclitaxel
Some medicines can cause a reaction while being given: flushing, rash, breathlessness, chest tightness or back pain.
When: During or soon after the drip, most often the first or second time.
What helps:
From: Paclitaxel
Aches in the legs, back or joints for a few days.
When: Days 2 to 5 after each drip.
What helps:
Uncommon but important. We look for these with blood tests, an ECG or scans.
From: Doxorubicin
Some medicines can weaken the heart muscle or affect its rhythm.
When: Can happen during or after treatment.
What helps:
From: Cyclophosphamide
Some medicines can stop periods or lower fertility in women and men.
When: Discuss before starting.
What helps:
Check your symptoms in My treatment
General information. Doses are not shown. Your own doctor may advise differently. When to seek help urgently
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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