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Arsenic Trioxide Solution for injection

It slows the growth of cancer cells

Generic Name: arsenic trioxide

Brand Names: Trisenox

There is an FDA Alert for this drug. Click here to view it.

    Experience of Supervising Clinician
  • Use under the supervision of a qualified clinician experienced in the management of acute leukemia.
    Acute Promyelocytic Leukemia (APL) Differentiation Syndrome
  • Risk of developing potentially fatal APL differentiation syndrome.
  • If signs or symptoms suggestive of APL differentiation syndrome (e.g., unexplained fever, dyspnea, weight gain, abnormal chest auscultatory findings, radiographic abnormalities) occur, initiate high-dose corticosteroid therapy (e.g., dexamethasone phosphate 10 mg IV twice daily for 3 days or longer until symptoms resolve) immediately regardless of the patient's leukocyte count; discontinuance of arsenic trioxide generally is not required.
    ECG Abnormalities
  • Risk of potentially fatal atypical ventricular tachycardia (torsades de pointes) and complete atrioventricular block, particularly in patients with a history of torsades de pointes, CHF, or preexisting QT interval prolongation, and in those receiving drugs that might prolong the QT interval or produce electrolyte abnormalities (e.g., hypokalemia, hypomagnesemia).
    ECG and Electrolyte Monitoring
  • Prior to initiation of therapy, perform baseline ECG and determine serum electrolyte (potassium, calcium, and magnesium) and creatinine concentrations.
  • If baseline QTc interval >500 msec, institute appropriate corrective measures and reassess with serial ECGs prior to considering arsenic trioxide therapy.
  • Correct preexisting electrolyte abnormalities; if possible, discontinue drugs known to prolong the QT interval.
  • During therapy, maintain serum potassium concentrations >4 mEq/L and serum magnesium concentrations >1.8 mg/dL and monitor ECGs weekly (more frequently in clinically unstable patients).
  • If QT interval >500 msec during therapy, correct any concomitant risk factors immediately and weigh the risks/benefits of continued therapy.
  • If syncope and/or rapid or irregular heartbeat occurs, hospitalize patient for careful monitoring; discontinue arsenic trioxide until QTc interval decreases to <460 msec, electrolyte abnormalities are corrected, and syncope and irregular heartbeat resolve.

What is this medicine?

ARSENIC TRIOXIDE (AR se nik trye OX ide) is a chemotherapy drug. It slows the growth of cancer cells. This medicine is used to treat acute promyelocytic leukemia (APL).

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • irregular heartbeat
  • kidney disease
  • low levels of potassium, calcium, or magnesium in the blood
  • an unusual or allergic reaction to arsenic, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This drug is given as an infusion into a vein. It is administered in a hospital or clinic by a specially trained health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • cisapride
  • droperidol
  • herbal or dietary supplements with hawthorn, Crataegus laevigata
  • medicines for irregular heart beat like amiodarone, bepridil, dofetilide, encainide, flecainide, propafenone, quinidine
  • methadone
  • phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
  • ranolazine
  • sodium phosphate monobasic monohydrate; sodium phosphate dibasic anhydrous
  • some medicines for infection like chloroquine, gatifloxacin, gemifloxacin, halofantrine, levofloxacin, moxifloxacin, pentamidine, troleandomycin
  • some medicines for mental problems like haloperidol, pimozide, ziprasidone
  • some medicines to treat cancer like dasatinib, lapatinib, sunitinib, vorinostat

This medicine may also interact with the following medications:

  • alfuzosin
  • cyclobenzaprine
  • dolasetron
  • medicines for depression, anxiety, or psychotic disturbances
  • medicines for numbness, pain prevention, or sleep during surgery
  • octreotide
  • some medicines for infection like, clarithromycin, erythromycin, mefloquine, norfloxacin, ofloxacin
  • some medicines to treat cancer like daunorubicin, doxorubicin
  • tacrolimus
  • vardenafil

What should I watch for while using this medicine?

Visit your doctor for checks on your progress. This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

This medicine may affect blood sugar levels. If you have diabetes, check with your doctor or health care professional before you change your diet or the dose of your diabetic medicine.

Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.

Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.


Last Updated: March 10, 2009
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