Arsenic Trioxide (Systemic)

Brand Names : Trisenox

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For arsenic trioxide, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to arsenic.

Pregnancy - There is a chance that this medicine may cause birth defects if it is taken at time of conception or if it is taken by the mother during pregnancy. Studies in rats and mice have shown that arsenic trioxide causes birth defects in the fetus and other problems (including miscarriage). Studies on the effects in pregnancy have not been done in humans.

Be sure that you have discussed these possible effects with your doctor before receiving this medicine. Before receiving arsenic trioxide make sure your doctor knows if you are pregnant or if you may become pregnant. It is best to use some kind of birth control while you are receiving arsenic trioxide. Tell your doctor right away if you think you have become pregnant while receiving arsenic trioxide.

Breast-feeding - Arsenic is distributed into human breast milk. Arsenic trioxide is not recommended during breast-feeding, because it may cause unwanted effects in nursing babies.

Children - Studies on this medicine have been done only in a limited number of patients over the age of 5 years, and there is no specific information comparing use of arsenic trioxide in children under the age of 5 with use in other age groups.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of arsenic trioxide in the elderly with use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking arsenic trioxide, it is especially important that your health care provider know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antiarrhythmics (acebutolol [e.g., Sectral], adenosine [e.g., Adenocard], amiodarone [e.g., Cordarone], atenolol [e.g., Tenormin], digoxin [e.g., Lanoxin], digitoxin [e.g., Crystodigin], diltiazem [e.g., Cardizem], disopyramide [e.g., Norpace], encainide [e.g., Enkaid], esmolol [e.g., Brevibloc], flecainide [e.g., Tambocor], metoprolol [e.g., Lopressor], mexiletine [e.g., Mexitil], moricizine [e.g., Ethmozine], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], phenytoin [e.g., Dilantin], procainamide [e.g., Procan], propafenone [e.g., Rythmol], propranolol [e.g., Inderal], quinidine [e.g., Quinaglute], sotalol [e.g., Betapace], timolol [e.g., Blocadren], tocainide [e.g., Tonocard], verapamil [e.g., Isoptin]) or
• Antifungals, azole (fluconazole [e.g., Diflucan], itraconazole [e.g., Sporanox], ketoconazole [e.g., Nizoral]) or
• Antihistamines or
• Fluoroquinolones (ciprofloxacin [e.g., Cipro], enoxacin [e.g., Penetrex], grepafloxacin [e.g., Raxar], levofloxacin [e.g., Levaquin], lomefloxacin [e.g., Maxaquin], norfloxacin [e.g., Noroxin], ofloxacin [e.g., Floxin], sparfloxacin [e.g., Zagam]) or
• Diuretics, potassium-depleting (bumetanide [e.g., Bumex], ethacrynic acid [e.g., Edecrin], furosemide [e.g., Lasix], indapamide [e.g., Lozol], thiazide diuretics [water pills]) or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Pamelor], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - These medicines may increase the risk of experiencing a life threatening heart rhythm problem while taking arsenic trioxide and concurrent use of these agents with arsenic trioxide may cause blood disorders or
• Thioridazine (e.g., Mellaril) - These medicines may increase the risk of experiencing a life threatening heart rhythm problem while taking arsenic trioxide.

Other medical problems - The presence of other medical problems may affect the use of arsenic trioxide. Make sure you tell your doctor if you have any other medical problems, especially:

• Abnormal heart rhythms or
• Congestive heart failure or
• Low magnesium levels in the blood or
• Low potassium levels in the blood - These medical problems may increase the risk of experiencing a life threatening heart rhythm problem while taking arsenic trioxide.

• Kidney problems - Arsenic trioxide is removed from the body by the kidneys; kidney problems may cause the drug to build up.