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Arsenic trioxide

Generic Name: arsenic trioxide (AR sen ik trye OX ide)
Brand Name: Trisenox

Medically reviewed on March 30, 2018

What is arsenic trioxide?

Arsenic trioxide is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Arsenic trioxide is used to treat a cancer of the blood and bone marrow called acute promyelocytic (pro-MYE-loe-SIT-ik) leukemia, or APL.

Arsenic trioxide is sometimes given in combination with another medicine called tretinoin.

Arsenic trioxide may also be used for other purposes not listed in this medication guide.

Important Information

Arsenic trioxide can cause a serious and sometimes fatal complication by changing the way your immune system works. Call your doctor at once if you have a fever, swelling, weight gain, pain when you breathe, rapid heart rate, feeling short of breath, or feeling like you might pass out.

Arsenic trioxide can cause a serious heart problem. Your risk may be higher if you also use certain other medicines. Tell your doctor about all your current medicines and any you start or stop using.

Get emergency medical help if you have fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness.

Before taking this medicine

You should not be treated with arsenic trioxide if you are allergic to it.

Tell your doctor if you have ever had:

  • heart problems, or a heart rhythm disorder;

  • long QT syndrome (in you or a family member);

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

  • kidney disease; or

  • liver disease.

Both men and women using this medicine should use effective birth control to prevent pregnancy. Arsenic trioxide can harm an unborn baby or cause birth defects if the mother or father is using this medicine.

  • If you are a woman, keep using birth control for at least 6 months after your last dose.

  • If you are a man, keep using birth control for at least 3 months after your last dose.

This medicine may affect fertility (ability to have children) in men. However, it is important to use birth control to prevent pregnancy because arsenic trioxide may harm the baby if a pregnancy does occur.

It is not safe to breast-feed a baby while you are using this medicine. Also do not breast-feed for at least 2 weeks after your last dose.

How is arsenic trioxide given?

Arsenic trioxide is given as an infusion into a vein. A healthcare provider will give you this injection.

You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results.

You may be given other medications to help prevent serious side effects or allergic reaction. Keep using these medicines for as long as your doctor has prescribed.

You must remain under the care of a doctor while you are using arsenic trioxide.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving arsenic trioxide?

This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Arsenic trioxide side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Arsenic trioxide can cause a serious and sometimes fatal complication by changing the way your immune system works. Call your doctor at once if you have any signs of this condition, including:

  • fever, weight gain, feeling weak or tired;

  • swelling in your ankles or feet;

  • little or no urination;

  • cough, pain when you breathe, rapid heart rate, feeling short of breath; or

  • feeling like you might pass out.

Also call your doctor right away if you have:

  • fast or pounding heartbeats, fluttering in your chest;

  • shortness of breath, and sudden dizziness (like you might pass out);

  • fever, tiredness;

  • easy bruising or bleeding;

  • high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor; or

  • low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Arsenic trioxide dosing information

Usual Adult Dose for Acute Promyelocytic Leukemia:

-Induction: IV infusion of 0.15 mg/kg over 1 to 2 hours once a day until bone marrow remission.
Maximum Dose (Induction): Not to exceed 60 doses.

-Consolidation: IV infusion of 0.15 mg/kg over 1 to 2 hours once a day; begin 3 to 6 weeks after completion of induction therapy.
Maximum Dose (Consolidation): 25 doses over a period up to 5 weeks.

Use: Induction of remission and consolidation in patients with acute promyelocytic leukemia (APL) who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.

Usual Pediatric Dose for Acute Promyelocytic Leukemia:

Age 4 Years and Older:
-Induction: IV infusion of 0.15 mg/kg over 1 to 2 hours once a day until bone marrow remission.
Maximum Dose (Induction): Not to exceed 60 doses.

-Consolidation: IV infusion of 0.15 mg/kg over 1 to 2 hours once a day; begin 3 to 6 weeks after completion of induction therapy.
Maximum Dose (Consolidation): 25 doses over a period up to 5 weeks.

Use: Induction of remission and consolidation in patients with acute promyelocytic leukemia (APL) who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.

What other drugs will affect arsenic trioxide?

Arsenic trioxide can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Other drugs may affect arsenic trioxide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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