Drug General Information (ID: DDI9K4JBA5)
Drug Name			Arsenic trioxide		Drug Info		Mecobalamin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Vitamins
Structure

Mechanism of Arsenic trioxide-Mecobalamin Interaction (Severity Level: Moderate)
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Arsenic trioxide				Mecobalamin
Mechanism 1		Delay atrioventricular conduction				Hypokalemia
Key Mechanism Factor 1
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Mecobalamin
Mechanism 2		Prolong QT interval				Hypokalemia
Key Mechanism Factor 2
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Mecobalamin

Recommended Action
Management		Caution is advised when arsenic trioxide is administered to patients requiring vitamin B12 for severe megaloblastic anemia. Serum electrolytes should be evaluated and any abnormalities corrected prior to initiating therapy with arsenic trioxide. During therapy, potassium concentrations should be kept above 4 mEq/dL.

References
1	Product Information. Hydro-Cobex (hydroxocobalamin). Major Pharmaceuticals Inc, Rosemont, IL.
2	Product Information. Nascobol (cyanocobalamin nasal). Schwarz Pharma, Mequon, WI.
3	Product Information. Trisenox (arsenic trioxide) Cephalon Inc, West Chester, PA.