Metabonomic study on the cumulative cardiotoxicity of a pirarubicin liposome powder

► Metabonomics-based findings showed that L-THP has less cumulative cardiotoxicity. ► Successive dosages of THP will lead to severe energy metabolic disturbance. ► THP metabolites will induce serious myocardial damage through ROS mechanism. ► In vitro toxicity results showed that L-THP has better efficacy against A549 cells.