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Arsenic Trioxide (Trisenox®)

About This Drug

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

Possible Side Effects

  • Rapid increase in white blood cells
  • Decrease in the number of white blood cells and platelets. This may raise your risk of infection and raise your risk of bleeding
  • Increased or abnormal heart rate
  • Sore throat
  • Nausea and vomiting (throwing up)
  • Diarrhea (loose bowel movements)
  • Pain in your abdomen or joints
  • Fever
  • Chills
  • Tiredness
  • Swelling of your legs, ankles and/or feet
  • Changes in your liver function
  • Blood sugar levels may change
  • Electrolyte changes
  • Headache
  • Feeling dizzy
  • Numbness, tingling or a sensation of pins and needles in your arms, hands, legs or feet
  • Trouble sleeping
  • Feeling nervous or worried
  • Trouble breathing
  • Cough
  • Rash and itching

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. Symptoms are fever, weight gain, breathing problems, low blood pressure or swelling of legs, ankles or feet. Your heart, lungs, kidneys or liver can be affected. This syndrome 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
  • Changes in your central nervous system such as Wernicke’s encephalopathy can happen which can be life-threatening. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, have hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.

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.
  • Wernicke’s encephalopathy is a condition that can be caused by a lack of thiamine (vitamin B1) because of alcoholism, poor nutrition and other medical conditions. It can be prevented and treated with thiamine replacement therapy. Please let your doctor know if you have a history of a thiamine deficiency or any of the conditions above.

Treating Side Effects

  • To decrease the risk of 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 the risk of 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.
  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • 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 of water in the body from losing too much fluid).
  • If you have 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 stop or lessen these symptoms.
  • If you have diabetes, 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 over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are 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 supplements 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 100.4°F (38°C) or higher
  • Chills
  • Easy bleeding or bruising
  • Feeling dizzy or lightheaded
  • Headache that does not go away
  • Extreme tiredness, agitation or confusion
  • Symptoms of a seizure such as confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. If you or your family member suspects you are having a seizure, call 911 right away.
  • Hallucinations
  • Trouble understanding or speaking
  • Loss of control of bowels or bladder
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Have a seizure or coma
  • Coughing up yellow, green, or bloody mucus
  • Wheezing or trouble breathing
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/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)
  • Swelling of your legs, ankles, and/or feet
  • Tiredness that interferes with your daily activities
  • Trouble falling or staying asleep
  • 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 in your arms, hands, legs or feet
  • Signs of differentiation syndrome such as fever, weight gain, swelling, or 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 childbearing potential should use effective methods of birth control during your cancer treatment and for 6 months after treatment. Men with female partners of childbearing 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: Women should not breastfeed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding 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 June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. 

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.