Arsenic trioxide is a prescription medication belonging to the antineoplastics group of medications that is used in the treatment of acute promyelocytic leukemia (APL). APL is a type of cancer where the blood and bone marrow have excess immature blood cells. Arsenic trioxide works by interfering with the growth and multiplication of cancer cells in the body.
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Arsenic trioxide Uses
Arsenic trioxide is used in the treatment of promyelocytic leukemia (APL) in patients who have tried chemotherapy, but it has not yielded success, or in patients who have experienced improvement followed by worsening of cancer despite using chemotherapy. APL is a cancer type whereby the blood and bone marrow have too many immature blood cells. Arsenic trioxide causes morphological changes and DNA fragmentation. Arsenic trioxide also causes degradation or damage of the fusion protein RAR-alpha/PML. Arsenic trioxide works by stopping or slowing the growth and spread of cancer cells.
- Acute promyelocytic leukemia
Arsenic trioxide Dosage
A health care professional injects Arsenic trioxide into a vein through an IV. While using Arsenic trioxide, patients may need regular blood tests. The patient may also need to be checked with the use of an electrocardiograph or ECG. Patients may remain under the doctor"s care while using Arsenic trioxide.
- Arsenic trioxide needs to be diluted with USP or 0.9% Sodium chloride injection, 100-250 ml 5% Dextrose injection, or USP. Arsenic trioxide should be intravenously administered over a period of 1-2 hours. The duration may be extended to 4 hours in case of any observations of acute vasomotor reactions.
- Induction treatment schedule: Arsenic trioxide needs intravenous administration at 0.15mg/kg every day until bone marrow remission. Total induction should not go beyond 60 doses.
- Consolidation treatment schedule: This treatment should commence 3-6 weeks after induction therapy is complete. Arsenic trioxide needs intravenous administration at 0/15 mg/kg for 25 doses over a 5-week period.
Arsenic trioxide Side Effects
Arsenic trioxide can cause some side effects and should be used with great caution. In some cases, Arsenic trioxide can cause serious or fatal complications by changing how the patients" immune system works. Common Arsenic trioxide side effects
- Mild itching or rash
- Tired feeling
- Joint or muscle pain
- Trouble sleeping
- Stomach pain
- Tingly feeling
Serious Arsenic trioxide side effects
- Feeling like one may pass out
- Swelling in the ankles or feet
- Weight gain
- Feeling weak or tired
- Pain where one breathes
- Feeling short of breath
- Rapid heart rate
- High blood sugar (hunger, dry mouth, increased thirst, weight loss, blurred vision, dry skin, drowsiness, fruity breath odor, increased urination)
- Pale skin
- Easy bruising or bleeding
- Sore throat
- Low potassium (extreme thirst, uneven heart rate, confusion, increased urination, muscle weakness or limp feeling, leg discomfort
Arsenic trioxide Interactions
Drug interactions can change how Arsenic trioxide works or increase the risk for serious side effects. Patients should notify their doctors about the use of other medications to enable the doctors evaluate those drugs for any interactions. The following products should not be used with Arsenic trioxide because of the possibility of an interaction:
- A diuretic or water pill"
- Amphotericin B
- An antibiotic such as erythromycin, azithromycin, clarithromycin, moxifloxacin, levofloxacin, pentamidine
- Medications used to in the prevention or treatment of nausea and vomiting (such as ondansetron, droperidol, dolasetron)
- An antidepressant such as citalopram, amitriptyline, desipramine, clomipramine
- Heart rhythm medications such as dronedarone, ibutilide, flecainide, dofetilide, amiodarone, disopyramide, sotalol, propafenone, procainamide, quinidine
- Migraine headache medication such as zolmitriptan or sumatriptan
- Anti malaria medication like chloroquine, mefloquine, halofantrine
- Medication used in the treatment of psychiatric disorder such as clozapine, mesoridazine, haloperidol, chlorpromazine, ziprasidone, pimozide, thioridazine