Medical use of arsenic trioxide

Arsenic trioxide
ATC code L01XX27
use during pregnancy category D
half-life 92 hours
plasma protein binding insignificant
metabolism methylation
excretion through urine (60% within 8 days)
routes of administration intravenous
Sample of arsenic trioxide in powder form

Medical use of arsenic trioxide refers to the use of arsenic trioxide (Latin: Arsenum trioxydatum,[1] also known as "arsenic") as an chemotherapeutic agent in the treatment of acute promyelocytic leukemia. Arsenic trioxide has orphan drug status[2] and is available as the pharmaceutical preparation Trisenox. When in contact with water, it forms arsenous acid, which is believed to be the biologically active substance.

The action of this substance involves inhibiting the proliferation of cancer cells and inducing their differentiation or apoptosis, although the exact mechanism of the drug's action is not fully understood. Arsenic, due to its toxic properties, had been used for centuries as an effective and virtually undetectable[3] poison for the senses.[4] In the 20th century, its anticancer properties were observed, but attempts at oral administration were unsuccessful. Only intravenous administration of the substance yielded positive results, particularly in the treatment of a rare form of cancer – acute promyelocytic leukemia. This therapy is introduced after failure of treatment with retinoids and chemotherapy.[5] The treatment is characterized by relative safety and few side effects. Research is ongoing to find other uses for the drug.

  1. ^ Modrzejewski, Feliks (1977). Farmacja stosowana, podręcznik dla studentów farmacji [Applied Pharmacy: A Textbook for Pharmacy Students] (in Polish). Vol. V. Warsaw: Państwowy Zakład Wydawnictw Lekarskich. p. 384.
  2. ^ "FDA Grants Orphan Drug Designation To Trisenox (Arsenic Trioxide) For Treatment Of Chronic And Acute Myeloid Leukemia". pslgroup.com. Archived from the original on 2008-05-11.
  3. ^ "Agency for Toxic Substances and Disease Registry. Arsenic". atsdr.cdc.gov. 2007. Archived from the original on 2001-12-16.
  4. ^ Aronson, S. M. (1994). "Arsenic and old myths". Rhode Island Medicine. 77 (7): 233–234. ISSN 1061-222X. PMID 7919541.
  5. ^ Siderov, Jim; Duggan, John (2010). "Arsenic trioxide associated toothache". Journal of Oncology Pharmacy Practice. 16 (2): 127–128. doi:10.1177/1078155209338727. ISSN 1078-1552. PMID 19525303.