Arsenic Trioxide

Indications
 Intravenous
Acute promyelocytic leukaemia
Adult: Induction: 150 mcg/kg once daily via IV infusion over 1-2 hr or up to 4 hr if acute vasomotor reactions occur. Induction dose can be repeated until remission occurs. Max no of induction doses: 50. Consolidation: 150 mcg/kg once daily given for 25 doses over a period of up to 5 wk. Consolidation therapy should be started 3-4 wk after completion of induction therapy.
Max Dosage: Total induction dose: 50 doses.
Contraindications
 Pregnancy; lactation; hypersensitivity.
Warnings / Precautions
 Renal impairment; APL differential syndrome; cardiac diseases; co-administration of other medications that can prolong the QT interval or lead to electrolyte abnormalities. Monitor 12-lead ECA; serum electrolytes and creatinine to be monitored before initiating therapy; ECG once weekly; electrolytes, blood count, and coagulation twice wkly during induction and at least once wkly during consolidation.
Adverse Reactions
 Leukocytosis; GI disturbances; fatigue, pyrexia, headache, dizziness, weakness; oedema; hyperglycaemia or hypoglycaemia, hyperkalaemia or hypokalaemia, hypomagnesaemia, hypocalcaemia and acidosis; dyspnoea, cough, chest pain; injection-site reactions; nonspecific pain; hypersensitivity reactions; wt changes.
Potentially Fatal: QT interval prolongation, complete atrioventricular block, torsade de pointes-type ventricular arrhythmia. Rarely, sudden death.
Lab Interactions
 Elevated ALT and AST.
Mechanism of Actions
 Arsenic trioxide is an antineoplastic agent that causes morphological changes and DNA fragmentation characteristic of apoptosis in NB4 human promyelocytic leukaemia cells in vitro and damage or degradation of the fusion protein PML/RAR-α.
Distribution: Stored in the liver, kidney, heart, lung, hair and nails.
Metabolism: Extensively metabolised in the liver by reduction.
Excretion: Urine.
Storage Conditions
 Intravenous: Store below 25°C.
ATC Classification
 L01XX27 - arsenic trioxide ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.
Storage
 Intravenous: Store below 25°C.
Available As
  • Arsenic Trioxide 1 mg

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