Drug interactions
Arsenic trioxide + Captopril-hydrochlorothiazide
Severity: Major
Arsenic trioxide and Captopril-hydrochlorothiazide: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Arsenic trioxide prolongs the QT interval and can cause torsades de pointes, and diuretic-induced hypokalemia or hypomagnesemia markedly raises this risk. Captopril adds no QT effect but the thiazide component is the main concern.
What this interaction means in plain words
Arsenic trioxide and Captopril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Arsenic trioxide belongs to Oncology; Captopril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Thiazide-induced hypokalemia and hypomagnesemia potentiate arsenic-related QT prolongation.
What to do
Correct potassium and magnesium before and during arsenic trioxide therapy and monitor ECG and electrolytes frequently. Consider an alternative to the thiazide if electrolytes cannot be kept in range.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Arsenic trioxide and Captopril-hydrochlorothiazide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
- Arsenic Trioxide 1 mg/ml concentrate for solution for infusion - SmPC sections 4.3/4.5 (class statement: diuretics; "Patients who are receiving, or who have received, medicinal products known to cause hypokalemia or hypomagnesaemia, such as diuretics or amphotericin B, may be ") — electronic medicines compendium (UK SmPC)
Other interactions of Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-hydrochlorothiazide Major
Other interactions of Arsenic trioxide
- Amiodarone + Arsenic trioxide Contraindicated
- Amisulpride + Arsenic trioxide Contraindicated
- Arsenic trioxide + Clomipramine Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Arsenic trioxide + Fluphenazine Contraindicated
- Arsenic trioxide + Gemifloxacin Contraindicated
Frequently asked questions
Can I take Arsenic trioxide with Captopril-hydrochlorothiazide?
MediHelp rates the interaction as major. Arsenic trioxide and Captopril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Arsenic trioxide prolongs the QT interval and can cause torsades de pointes, and diuretic-induced hypokalemia or hypomagnesemia markedly raises this risk. Captopril adds no QT effect but the thiazide component is the main concern.
How serious is the interaction between Arsenic trioxide and Captopril-hydrochlorothiazide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Correct potassium and magnesium before and during arsenic trioxide therapy and monitor ECG and electrolytes frequently. Consider an alternative to the thiazide if electrolytes cannot be kept in range.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
