Arsenic trioxide (Injection)

How to Use This Medicine

Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using amphotericin B (Fungizone®, Ambisome®), diuretics or "water pills" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®), or medicine for heart rhythm problems (such as verapamil, Sectral®, Rythmol®, or Cardioquin®).
• Tell your doctor if you are using medicines that can cause heart rhythm problems (prolong the QT interval) when combined with arsenic trioxide; such as cisapride (Propulsid®), dofetilide (Tikosyn®), medicine for depression (such as amitriptyline, fluoxetine, nortriptyline, Elavil®, Pamelor®, Prozac®, Sarafem®, or Vivactil®), certain antibiotics (such as erythromycin, levofloxacin, moxifloxacin, sparfloxacin, Avelox®, Levaquin®, or Zagam®), or medicine to treat mental illness (such as haloperidol, mesoridazine, pimozide, prochlorperazine, quetiapine, thioridazine, ziprasidone, Compazine®, Geodon®, Haldol®, Mellaril®, Orap®, Serentil®, or Seroquel®).

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney disease, liver disease, heart disease, congestive heart failure, hypokalemia (low potassium in the blood), hypomagnesemia (low magnesium in the blood), or a history of heart rhythm problems (such as prolonged QT interval or torsade de pointes).
• Tell your doctor right away if you have chest pain or discomfort, chills, cough, difficulty with breathing, eye pain, fever, general feeling of illness, headache, shortness of breath, sore throat, unusual tiredness or weakness, or weight gain while using this medicine. These may be symptoms of a serious condition called retinoic-acid-APL (RA-APL) or APL differentiation syndrome.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• Cancer medicines can cause nausea and/or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain or discomfort.
• Confusion, weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips.
• Difficulty with breathing.
• Dry mouth, increased thirst, muscle cramps, or nausea or vomiting.
• Fast, pounding, or uneven heartbeat or pulse.
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness or fainting.
• Rapid weight gain.
• Red or black stools.
• Seizures or tremors.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, stomach pain or tenderness, or upset stomach.
• Dizziness or drowsiness.
• Headache.
• Loss of appetite.
• Muscle, joint, or bone pain.
• Redness, pain, swelling, itching, blistering, or rash where the needle is placed.
• Skin dryness or itching.
• Tiredness.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Introduction

Arsenic Trioxide (AR-se-nik trye-OX-ide)

Treats a type of leukemia (cancer of the blood cells) called acute promyelocytic leukemia (APL).

Brand Name(s)

Trisenox

When This Medicine Should Not Be Used