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Drug Interactions between arsenic trioxide and LA-12

This report displays the potential drug interactions for the following 2 drugs:

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Moderate

cyanocobalamin arsenic trioxide

Applies to: LA-12 (cyanocobalamin) and arsenic trioxide

MONITOR: Arsenic trioxide can cause QT interval prolongation and complete atrioventricular block. Theoretically, use of arsenic trioxide during intensive vitamin B12 therapy for the treatment of megaloblastic anemia may potentiate the risk of cardiac arrhythmias such as ventricular tachycardia and torsade de pointes because of the hypokalemia that may develop during the early phase of vitamin B12 therapy due to increasing potassium requirements as normal erythropoiesis is established. Hypokalemia is a known risk factor for ventricular arrhythmias associated with QT interval prolongation.

MANAGEMENT: Caution is advised when arsenic trioxide is administered to patients requiring vitamin B12 for severe megaloblastic anemia. Serum electrolytes should be evaluated and any abnormalities corrected prior to initiating therapy with arsenic trioxide. During therapy, potassium concentrations should be kept above 4 mEq/dL.

References

  1. "Product Information. Nascobol (cyanocobalamin nasal)." Schwarz Pharma, Mequon, WI.
  2. "Product Information. Hydro-Cobex (hydroxocobalamin)." Major Pharmaceuticals Inc PROD (2001):
  3. "Product Information. Trisenox (arsenic trioxide)." Cephalon Inc PROD (2001):

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Drug and food interactions

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Therapeutic duplication warnings

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Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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