Arsenic Trioxide (Trisenox®)

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About This Drug

Arsenic trioxide is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • A rapid increase in your white blood cells may happen
  • Bone marrow depression - a decrease in the number of white blood cells and platelets. This may raise your risk of infection and raise your risk of bleeding
  • Nausea and throwing up (vomiting)
  • Loose bowel movements (diarrhea)
  • Pain in your abdomen
  • Tiredness
  • Swelling
  • Blood sugar levels may changes. If you have diabetes, changes may need to be made to your diabetes medication.
  • Cough
  • Rash and itching
  • Headache
  • Feeling dizzy
  • Changes in your liver function
  • Fever
  • Chills
  • Trouble sleeping
  • Increased or abnormal heart rate
  • Electrolyte changes
  • Trouble breathing
  • Feeling nervous or worried
  • Sore throat
  • Joint pain
  • Numbness, tingling or a sensation of pins and needles in your arms, hands, legs or feet

Note: Each of the side effects above was reported in 30% or greater of patients treated with arsenic trioxide. Not all possible side effects are included above. 

Warnings and Precautions

  • A serious syndrome may happen with the use of this drug which is known as Differentiation Syndrome. You may get a fever, weight gain, and have breathing problems. This can be life-threatening.
  • Abnormal heart beat which can be life-threatening
  • Changes in your liver function
  • This drug may raise your risk of getting a second cancer

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • If you’re diabetic, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you are dizzy, get up slowly after sitting or lying.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • To help with itching, moisturize your skin several times day.
  • Avoid sun exposure and apply sunscreen routinely when outdoors.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you are feeling anxious, talk to your nurse or doctor about it and they may be able to offer you some stress-relief techniques and/or support groups that may help relieve your anxiety.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better.

Food and Drug Interactions

  • There no known interactions of arsenic trioxide with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are a lot of known drug interactions with arsenic trioxide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Feeling dizzy or lightheaded
  • You cough up yellow, green, or bloody mucus.
  • Wheezing or trouble breathing
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinkingand/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Weight gain of 5 pounds in one week (fluid retention)
  • Fatigue that interferes with your daily activities
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Pain that does not go away, or is not relieved by prescribed medicines
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • Numbness, tingling, pins and needles, or pain your arms, hands, legs or feet
  • Signs of differentiation syndrome such as fever, weight gain, trouble breathing.
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • If you think you may be pregnant, or have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for 6 months after treatment. Men with female partners of child bearing potential should use effective methods of birth control during and for 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner
  • Breastfeeding warning: It is not known if this drug passes into breast milk. Women should not breast feed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

Revised January 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services.  The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication.  The dose, method of administration and contraindications for any administered medication should be confirmed before use.  UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.