Background Iron 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.

Purpose To study in vitro physicochemical behaviour of iron with different cytotoxic drugs used in oncology therapeutic protocols.

Material and methods We 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.

Results Results are represented in the following table:

Spectra 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.

Conclusion The 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 Acknowledgements 1. 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