Find out what arsenic trioxide is, how you have it and other important information about having arsenic trioxide.
Arsenic trioxide is a chemotherapy drug and is also called Trisenox or ATO.
It is a treatment for a type of acute myeloid leukaemia called acute promyelocytic leukaemia (APL). Researchers are also looking into it as a treatment for other types of cancer.
How it works
Arsenic works by speeding up the death of leukaemic cells and encouraging normal blood cells to develop properly. It does this by working on particular proteins within the cell.
How you have it
You have arsenic trioxide as a drip into the bloodstream. The drip lasts for between 1 and 2 hours. But if you have a reaction to the drip you may have it more slowly over 4 hours.
Drugs into your bloodstream
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
When you have it
You may have arsenic trioxide to get rid of the leukaemic cells (induction treatment) or to stop your leukaemia coming back (consolidation treatment).
You have arsenic trioxide every day until there is no sign of the leukaemia in your bone marrow. This is called remission induction. You have this induction treatment for up to 50 to 60 days.
You usually have 25 doses of arsenic trioxide. You generally have it for 5 days a week with a 2 day break, for 5 weeks.
Tests during treatment
You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment and regularly during the treatment you have a test of your heart called an ECG.
Other medicines, food and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
We don’t know how this treatment might affect fertility. You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Some men might be able to store sperm before starting treatment. Some women might be able to store eggs or embryos before treatment.
Don’t breastfeed during this treatment because the drug may come through in your breast milk.
Treatment for other conditions
Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine
- be in contact with other people who've had live vaccines as injections
Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.
You also need to avoid anyone who has had oral polio or typhoid vaccination recently.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.