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Drug interactions

Arsenic trioxide + Voriconazole

Severity: Major

Arsenic trioxide and Voriconazole: major interaction.

Last updated Sources: Health Canada product monograph

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

Both can prolong the QT interval, and arsenic trioxide is associated with torsades de pointes and complete AV block. Combined use increases arrhythmia risk.

What this interaction means in plain words

Arsenic trioxide and Voriconazole 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; Voriconazole belongs to Anti Fungals.

Evidence level: Moderate

Why it happens

Additive QTc prolongation.

What to do

Avoid if possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium within normal limits.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Arsenic trioxide with Voriconazole?

MediHelp rates the interaction as major. Arsenic trioxide and Voriconazole 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. Both can prolong the QT interval, and arsenic trioxide is associated with torsades de pointes and complete AV block. Combined use increases arrhythmia risk.

How serious is the interaction between Arsenic trioxide and Voriconazole?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible and use a non-QT-prolonging antifungal. If unavoidable, monitor ECG and keep potassium and magnesium within normal limits.

What other medicines interact with Voriconazole?

MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.

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