Arsenic Trioxide Brand Name– Trisenox
What is Arsenic Trioxide
Arsenic trioxide is a cytotoxic agent that promotes myeloid differentiation by degrading the promyelocytic leukemia alpha retinoic acid receptor-alpha fusion protein.
It is indicated for the treatment of newly-diagnosed, low-risk acute promyelocytic leukemia (APL) in combination with tretinoin.
Arsenic trioxide is also indicated as a single-agent for the treatment of relapsed or refractory APL.
Cardiac arrhythmias (e.g., ventricular arrhythmias, AV block) and differentiation syndrome (characterized by fever, dyspnea, respiratory distress, fluid retention or weight gain, hypotension and/or multi-organ dysfunction) have been reported.
Indications
- acute promyelocytic leukemia
Side Effects
- abdominal pain
- agitation
- anemia
- anorexia
- anxiety
- arthralgia
- atrial fibrillation
- atrial flutter
- AV block
- back pain
- bleeding
- blurred vision
- bone pain
- candidiasis
- chest pain (unspecified)
- chills
- coma
- confusion
- constipation
- cough
- depression
- diarrhea
- differentiation syndrome
- disseminated intravascular coagulation (DIC)
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- ecchymosis
- edema
- elevated hepatic enzymes
- encephalopathy
- epistaxis
- erythema
- fatigue
- fecal incontinence
- fever
- flushing
- GI bleeding
- headache
- hearing loss
- heart failure
- hemoptysis
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hypertension
- hypertriglyceridemia
- hypocalcemia
- hypoglycemia
- hypokalemia
- hypomagnesemia
- hypotension
- hypoxia
- infection
- injection site reaction
- insomnia
- leukocytosis
- lymphadenopathy
- metabolic acidosis
- myalgia
- nausea
- nephrotoxicity
- neurotoxicity
- neutropenia
- new primary malignancy
- night sweats
- ocular irritation
- oliguria
- otalgia
- pallor
- palpitations
- pancytopenia
- paresis
- paresthesias
- pericardial effusion
- peripheral edema
- peripheral neuropathy
- petechiae
- pharyngitis
- pleural effusion
- pruritus
- QT prolongation
- renal failure (unspecified)
- rhabdomyolysis
- seizures
- sinus tachycardia
- sinusitis
- skin hyperpigmentation
- tachypnea
- thrombocytopenia
- tinnitus
- torsade de pointes
- toxic epidermal necrolysis
- tremor
- urinary incontinence
- urticaria
- vaginal bleeding
- ventricular tachycardia
- vomiting
- weakness
- weight gain
- weight loss
- wheezing
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- blood glucose
- CBC with differential
- D-dimer
- ECG
- fibrin degradation products (FDPs)
- LFTs
- neurologic function
- partial thromboplastin time (PTT)
- prothrombin time (PT)
- serum creatinine/BUN
- serum electrolytes
- weight
Contraindications
- alcoholism
- AV block
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- children
- contraception requirements
- diabetes mellitus
- differentiation syndrome
- disseminated intravascular coagulation (DIC)
- electrolyte imbalance
- encephalopathy
- females
- geriatric
- heart failure
- hepatic disease
- hyperglycemia
- hypokalemia
- hypomagnesemia
- infants
- infertility
- leukocytosis
- long QT syndrome
- male-mediated teratogenicity
- malnutrition
- neonates
- neutropenia
- new primary malignancy
- pregnancy
- pregnancy testing
- QT prolongation
- renal failure
- renal impairment
- reproductive risk
- thiamine deficiency
- thrombocytopenia
- thyroid disease
- torsade de pointes
- ventricular arrhythmias
Interactions
- Abarelix
- Abciximab
- Acetazolamide
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Alpha interferons
- Alteplase
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphotericin B
- Anagrelide
- Anticoagulants
- Antithrombin III
- Antithymocyte Globulin
- Apixaban
- Apomorphine
- Arformoterol
- Argatroban
- Aripiprazole
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Dipyridamole
- Atomoxetine
- Azelastine; Fluticasone
- Azithromycin
- Beclomethasone
- Bedaquiline
- Bepridil
- Betamethasone
- Betrixaban
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Budesonide
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Carbamazepine
- Celecoxib
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciclesonide
- Cilostazol
- Ciprofloxacin
- Cisapride
- Cisplatin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clopidogrel
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Conivaptan
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Crizotinib
- Dabigatran
- Dalteparin
- Danaparoid
- Dasatinib
- Deflazacort
- Degarelix
- Desflurane
- Desipramine
- Desirudin
- Deutetrabenazine
- Dexamethasone
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diclofenac
- Diclofenac; Misoprostol
- Digoxin
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Enoxaparin
- Entrectinib
- Eptifibatide
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esomeprazole; Naproxen
- Etodolac
- Ezogabine
- Famotidine; Ibuprofen
- Fenoprofen
- Fingolimod
- Flecainide
- Fluconazole
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Fondaparinux
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Gallium Ga 68 Dotatate
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Halofantrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Heparin
- Histrelin
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Ibutilide
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indapamide
- Indomethacin
- Inotuzumab Ozogamicin
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Isoflurane
- Itraconazole
- Ivosidenib
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lapatinib
- Lefamulin
- Lenvatinib
- Lepirudin
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levofloxacin
- Levomethadyl
- Lithium
- Lofexidine
- Lomefloxacin
- Long-acting beta-agonists
- Loop diuretics
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Macimorelin
- Mannitol
- Maprotiline
- Meclofenamate Sodium
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Meperidine; Promethazine
- Mesoridazine
- Metaproterenol
- Methadone
- Methazolamide
- Methylprednisolone
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Mometasone
- Moxifloxacin
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Palifermin
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Penicillamine
- Pentamidine
- Pentosan
- Perphenazine
- Perphenazine; Amitriptyline
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pirbuterol
- Piroxicam
- Pitolisant
- Posaconazole
- Potassium-sparing diuretics
- Prednisolone
- Prednisone
- Primaquine
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Reteplase, r-PA
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Rivaroxaban
- Romidepsin
- Salmeterol
- Saquinavir
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Siponimod
- Solifenacin
- Sorafenib
- Sotalol
- Sparfloxacin
- Streptokinase
- Sulindac
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telavancin
- Telithromycin
- Tenecteplase
- Terbutaline
- Tetrabenazine
- Thiazide diuretics
- Thioridazine
- Thrombolytic Agents
- Ticlopidine
- Tinzaparin
- Tiotropium; Olodaterol
- Tolmetin
- Tolterodine
- Toremifene
- Trazodone
- Triamcinolone
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Tuberculin Purified Protein Derivative, PPD
- Umeclidinium; Vilanterol
- Urokinase
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Voriconazole
- Vorinostat
- Warfarin
- Ziprasidone