Can iron (Fe) infusion be given with XELOX (oxaliplatin and capecitabine)?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

Iron (Fe) infusions can be administered with XELOX (capecitabine plus oxaliplatin) chemotherapy regimen, but careful timing and monitoring are recommended. When considering the administration of iron infusions with XELOX, it is essential to prioritize the management of anaemia and iron deficiency in patients with cancer, as outlined in the ESMO clinical practice guidelines 1. The guidelines suggest that intravenous iron can be given as a single dose of 1000 mg iron or an equivalent total dose in several infusions, and that oral iron should only be considered for patients with ferritin < 30 ng/mL and non-inflammatory conditions. Key considerations for the administration of iron infusions with XELOX include:

  • Scheduling iron infusions on a different day from oxaliplatin administration to minimize potential interactions and side effects
  • Completing the iron infusion before starting chemotherapy if given on the same day
  • Monitoring patients for infusion reactions during and after iron administration, particularly hypersensitivity reactions
  • Using common iron formulations such as iron sucrose, ferric carboxymaltose, or iron dextran The rationale for combining these treatments is to manage anaemia and iron deficiency in cancer patients undergoing chemotherapy, as outlined in the guidelines 1.

From the Research

Iron Infusion with Xelox

  • There is no direct evidence in the provided studies regarding the administration of iron infusion with Xelox.
  • However, the studies discuss the use of intravenous iron in various clinical contexts, including the treatment of iron deficiency anemia 2, 3, 4, 5.
  • The studies also highlight the importance of iron supplementation in patients receiving epoetin therapy 2, 3.
  • Additionally, the studies discuss the safety and efficacy of different intravenous iron preparations, including iron gluconate and iron sucrose 3, 4, 5.
  • One study compares the effects of oral liposomal iron and intravenous iron sucrose on hemoglobin levels in non-dialysis chronic kidney disease patients 6.
  • While the studies provide information on iron infusion and its administration, they do not specifically address the use of iron infusion with Xelox.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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