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Arsenic Trioxide Injection

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WARNING

Arsenic trioxide should only be administered under the direction of a physician with experience treating leukaemia patients (cancer of the white blood cells).

APL differentiation syndrome, a dangerous or sometimes fatal collection of symptoms, may be brought on by arsenic trioxide. Your doctor will keep a close eye on you to see if this syndrome is developing. Weight gain is a symptom of APL differentiation syndrome, therefore during the first few weeks of your treatment, your doctor may ask you to weigh yourself every day. Call your doctor right away if you suffer any of the following symptoms: fever, weight gain, wheezing, laboured breathing, chest pain, or cough. Your doctor will recommend one or more medications to treat APL differentiation syndrome as soon as you experience its initial symptoms.

Arsenic trioxide may result in QT prolongation, which can lead to serious or fatal heart rhythm issues by causing the heart muscles to take longer to recover between beats due to an electrical disruption. Your doctor will order an electrocardiogram (ECG; test that records the electrical activity of the heart) and other tests before you start treatment with arsenic trioxide to determine whether you already have an electrical disturbance in your heart or are more likely than average to develop this condition. Throughout your arsenic trioxide therapy, your doctor will keep a careful eye on you and may request an ECG in addition to other testing. If you have QT prolongation, heart failure, an irregular heartbeat, or low levels of potassium or magnesium in your blood, let your doctor know.Additionally, let your doctor know if you’re taking any of the following drugs: amiodarone (Nexterone, Pacerone), amphotericin (Abelcet, Amphotec, Fungizone), cisapride (Propulsid), disopyramide (Norpace), diuretics (water pills), dofetilide (Tikosyn), erythromycin (E.E.S., E-Mycin, Erythro (Geodon). If you experience an irregular or rapid heartbeat or feel dizzy while taking arsenic trioxide, call your doctor right once.

Injection of arsenic trioxide may result in encephalopathy (confusion, memory problems, and other difficulties caused by abnormal brain function). Inform your doctor if you use furosemide, have malabsorption syndrome (issues absorbing food), consume high amounts of alcohol now or have ever consumed excessive amounts of alcohol (Lasix). Call your doctor right away if you have any of the following symptoms: Confusion, loss of consciousness, seizures, altered speech, issues with balance or walking, or visual changes like blurred vision, difficulty reading, or double vision. In the event that you are unable to call for help on your own, make sure your family or caretaker is aware of any potentially dangerous symptoms.

Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to arsenic trioxide, your doctor will prescribe specific tests both before and after the procedure.

Discuss the dangers of taking arsenic trioxide with your doctor.

Why is this medication prescribed?

Acute promyelocytic leukaemia (APL; a kind of malignancy in which there are too many immature blood cells in the blood and bone marrow) is treated as a first line of therapy in certain patients with arsenic trioxide and tretinoin. It is also used to treat APL in certain individuals who have not responded to conventional chemotherapy treatments or whose health has improved but then deteriorated after receiving retinoid treatment and other chemotherapy treatments (s). Arsenic trioxide belongs to the group of drugs known as anti-neoplastics. It inhibits or stops the development of cancer cells.

How should this medicine be used?

In a doctor’s office or clinic, a nurse or other medical professional administers arsenic trioxide as an injection into a vein as a solution (liquid). Arsenic trioxide is typically injected over a period of 1 to 2 hours, however if side effects occur during the infusion, it may be administered for a period of up to 4 hours. It is typically administered once daily for a predetermined amount of time.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before receiving arsenic trioxide injection,

  • If you have an allergy to arsenic trioxide, any other drugs, or any of the ingredients in arsenic trioxide injection, let your doctor and pharmacist know right away. Request a list of the components from your pharmacist.
  • Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Mention all of the drugs that are listed in the IMPORTANT WARNING section. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
  • If you have or have previously had liver or kidney disease, let your doctor know.
  • Inform your physician if you are expecting, intend to become pregnant, or intend to father a child. You must perform a pregnancy test before beginning therapy if you are a female, and you must use birth control to avoid getting pregnant while receiving treatment and for at least six months after your last dose. If you are a guy, you should use reliable birth control during your arsenic trioxide injection and for three months after it is finished, along with your female companion. Call your doctor if you or your partner becomes pregnant while taking this medicine. While receiving treatment with arsenic trioxide, discuss birth control options with your doctor. The foetus could be harmed by arsenic trioxide.
  • Inform your doctor if you are nursing a child. Breastfeeding is likely to be prohibited throughout treatment and for two weeks following your last dosage, according to your doctor.
  • You should be aware that this drug may reduce male fertility. Discuss the dangers of obtaining arsenic trioxide with your doctor.
  • Inform your doctor or dentist if you are having surgery, including dental surgery, and that you are taking arsenic trioxide.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What side effects can this medication cause?

An injection of arsenic trioxide may raise your blood sugar levels. If you experience any of the following signs of hyperglycemia (high blood sugar), call your doctor right away:

  • Severe thirst
  • Often urinating
  • Severe hunger
  • Weakness
  • Distorted vision

Diabetic ketoacidosis is a dangerous, sometimes fatal illness that can arise from untreated high blood sugar. If any of these symptoms apply to you, seek medical attention right away:

  • Mouth ache
  • Nausea and diarrhoea
  • Breathing difficulty
  • Fruity-smelling breath
  • Decreased awareness

Injections of arsenic trioxide may have adverse effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Excessive fatigue
  • Dizziness
  • Headache
  • Diarrhea
  • Arms, hands, foot, ankles, or lower legs swelling
  • Rash
  • Itching

Some adverse effects can be very harmful. Call your doctor right away if you have any of these signs or any of those in the IMPORTANT WARNING section:

  • Abnormal bleeding or bruising
  • Vomit that is red or resembles coffee grounds
  • Tarry, dark-colored stool or one that has vivid crimson blood in it
  • Less urinations
  • Hives

Other negative effects from arsenic trioxide injection are possible. If you have any strange side effects while taking this medicine, call your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

  • Seizures
  • Weakened muscles
  • Confusion

What other information should I know?

If you have any queries regarding arsenic trioxide injection, consult your physician or pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Trisenox®
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