Drug interactions
Arsenic trioxide + Isoflurane
Severity: Major
Arsenic trioxide and Isoflurane: major interaction.
Last updated
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 causes marked QT prolongation with a risk of torsades de pointes, and volatile anesthetics such as isoflurane can further prolong repolarization. Perioperative electrolyte shifts can add to the risk.
What this interaction means in plain words
Arsenic trioxide and Isoflurane 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; Isoflurane belongs to Central Nervous System.
Why it happens
Additive QT interval prolongation.
What to do
Obtain a baseline ECG and keep potassium above the normal lower limit and magnesium replete before anesthesia. Monitor the ECG continuously and have defibrillation and magnesium available.
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?
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Other interactions of Isoflurane
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 Isoflurane?
MediHelp rates the interaction as major. Arsenic trioxide and Isoflurane 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 causes marked QT prolongation with a risk of torsades de pointes, and volatile anesthetics such as isoflurane can further prolong repolarization. Perioperative electrolyte shifts can add to the risk.
How serious is the interaction between Arsenic trioxide and Isoflurane?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and keep potassium above the normal lower limit and magnesium replete before anesthesia. Monitor the ECG continuously and have defibrillation and magnesium available.
What other medicines interact with Isoflurane?
MediHelp also lists interactions of Isoflurane with, for example, Adrenaline-articaine, Amisulpride, Artemether / lumefantrine. The full list is on the Isoflurane page.
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