Search

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 vitrophysicochemical 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 1Cytotoxic drug (1 ml)Interaction with ironCytotoxic drug (1 ml)Interaction with ironFe 2+ (0.1 ml) Fe3+ (0.1 ml) Fe2+ (0.1 ml) Fe3+ (0.1 ml) Etoposide +RedDoxorubicin/Epirubicin black+Carboplatin – Yellow Vincristine – – Cyclophosphamide – Yellow Ifosfamid – Yellow Cytarabine +RedCisplatin – 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

BackgroundFurosemide is a diuretic widely indicated in paediatric diseases especially for the treatment of oedema associated with congestive heart failure, cirrhosis of the liver or renal disease. Its stability is very important and must be proved to ensure paediatric patient safety.PurposeThe aim of this study was to determine the physicochemical stability for furosemide 1 mg/ml in polypropylene syringes stored in different conditions.Material and methodsNine polypropylene syringes were prepared using the generic product of furosemide (1 mg/ml) in NaCl 0.9%. The nine syringes were stored in different conditions for 72 hours. The following table describes these conditions:Abstract 3PC-009 Table 1Number of syringes of furosemide 1 mg/ml 3 3 3 Temperature25°C±3°C 8°C±3°C 25°C±3°C LightDaylight Absent Artificial We studied several physical and chemical parameters immediately after preparation (0 hour) and after 6, 24, 48 and 72 hours. These parameters are colour, opacity, presence of precipitation or microagregate, pH and absorbance.Each preparation was visually inspected in front of a black and white background. Preparations were centrifuged and aliquots were examined by microscope. pH measurements were carried out by pH-metre and spectrophotometric measurements were obtained after dilution of solutions, at three wavelengths: 229, 278 and 331 nm with a UV-visible spectrophotometer.ResultsAfter 72 hours, no colour change, no opacity, no precipitation and no microaggregate were observed. For chemical parameters, there was no variation in pH absorbance in all conditions of storage.For spectrophotometric measurements, there is no significant change in absorbance in all conditions of storage. Studies showed that degradation products do not absorb at the same wavelengths of furosemide. We can deduce that the method used is specific for the determination of furosemide.ConclusionFurosemide 1 mg/ml in NaCl 0.9% propylene syringes preserved its physical and chemical properties for at least 72 hours in all conditions of storage. So we can prepare many paediatric injections in our hospital that we can store for 72 hours.References and/or Acknowledgements1. HansBundgaard, et al. Photodegradation and hydrolysis of furosemide and furosemide esters in aqueous solutions. Int J Pharma, 1988; 42: 217–224.No conflict of interest

BackgroundPhysicochemical incompatibilities of parenteral drugs cause several problems in hospital practice. These incompatibilities can be represented by precipitation, complexation or colour change before or during administration to patients. Understanding these incompatibilities allow pharmacists to avoid many problems during preparation and administration.PurposeTo determine physicochemical incompatibilities of a cytotoxic drug widely used in paediatric oncology (methotrexate) with certain trace elements existing in food and medicines, as well as in food supplements.Material and methodsWe performed several mixtures to study physicochemical reactions between methotrexate reconstituted in infusion bags (25 mg/ml) and five cations: calcium (Ca2+), copper (Cu2+), iron (bivalent and trivalent), magnesium (Mg2+) and zinc (Zn2+). An interaction was elucidated by formation of a precipitate visible to the naked eye. Infrared spectroscopy was the method of authentication of precipitates.ResultsPrecipitates were formed with the copper, zinc, bivalent and trivalent iron. On the other hand, there was no precipitate with calcium and magnesium. Functional analysis of infrared spectra of precipitates showed the presence of methotrexate.ConclusionThe study of the physicochemical incompatibilities of methotrexate can avoid possible interactions with medicines, food or nutritional supplements containing trace elements.Recording to the results, methotrexate precipitates in the presence of copper, zinc and iron ions. The absence of the precipitate or change of colour in the other mixtures does not exclude a possible complexation.Reference and/or Acknowledgements1. Benaji B, et al. Compatibility study of methotrexate with PVC bags after repackaging into two types of infusion admixtures. Int J Pharma1994;105(1):83–87.No conflict of interest