3PC-033 In vitro physicochemical interactions study between iron and anticancer drugs administrated in hospital

Abstract

BackgroundIron is used like a medicine to treat or prevent haemolytic anaemia. When iron is administered concomitantly with certain drugs, it can change absorption of these drugs by complex reaction. Consequently, treatments become ineffective.PurposeTo study in vitro physicochemical behaviour of iron with different cytotoxic drugs used in oncology therapeutic protocols.Material and methodsWe prepared several mixtures of bivalent and trivalent iron solutions with 13 anticancer drugs after their reconstitution. We mixed 0.1 ml of 5% iron solution (Fe 2+or Fe3+) with 1 mL of diluted drugs in glass tubes, and we observed in the presence or absence of a precipitate.The formed precipitates were washed, dried and identified by infrared spectroscopy and UV-visible spectroscopy. Spectra obtained are compared with those of the anticancer drugs studied.ResultsResults are represented in the following table:Abstract 3PC-033 Table 1 Cytotoxic drug (1 ml ) Interaction with iron Cytotoxic drug (1 ml ) Interaction with iron Fe 2+ (0.1 ml) Fe3+ (0.1 ml) Fe2+ (0.1 ml) Fe3+ (0.1 ml) Etoposide + Red Doxorubicin/Epirubicin black + Carboplatin – Yellow Vincristine – – Cyclophosphamide – Yellow Ifosfamid – Yellow Cytarabine + Red Cisplatin – Yellow Vinblastine – Yellow Methotrexate + + Dacarbazine – Yellow Bleomycin – – +: presence of precipitate –: no precipitateSpectra obtained by UV-visible and IR spectroscopy of the precipitates correspond to the spectra of cytotoxic drugs. We can deduce that the iron complex is incompatible with etoposide, cytarabin, doxorubicin, epirubicin and methotrexate.ConclusionThe findings suggest that iron (Fe3 +and Fe2+) is not compatible with etoposide, cytarabine doxorubicin, epirubicin, and methotrexate. We can deduce that intravenous iron should preferably be taken at least 2 hours before or 2 hours after taking these anticancer drugs to limit the risk of developing complications. For oral formulae like etoposide and methotrexate, concomitant administration of oral iron should be avoided in order to ensure good absorption.References and/or Acknowledgements1. Arlet J-B, et al. Iron therapy: indications, limitations and modality. Rev Méd Int2012;34:26–31.2. Dan L Longo MD. Iron-deficiency anaemia. N Engl J Med2015;372:1832–43.No conflict of interest