Drug General Information (ID: DDIOTXN6KY)
Drug Name			Bumetanide		Drug Info		Arsenic trioxide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Diuretics				Antineoplastics
Structure

Mechanism of Bumetanide-Arsenic trioxide Interaction (Severity Level: Major)
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Bumetanide				Arsenic trioxide
Mechanism 1		Hypokalemia				Prolong QT interval
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 Bumetanide and Arsenic trioxide
Mechanism 2		Hypomagnesemia				Prolong QT interval
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 Bumetanide and Arsenic trioxide

Recommended Action
Management		Caution is advised if arsenic trioxide must be used concomitantly with medications that can cause significant potassium and/or magnesium loss. Serum electrolytes should be evaluated and any abnormalities corrected prior to initiating therapy with arsenic trioxide. Patients should also have frequent ECGs and be monitored for serious arrhythmias when QT intervals are prolonged. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

References
1	Ohnishi K, Yoshida H, Shigeno K, et al. "Prolongation of the QT interval and ventricular tachycardia in patients treated with arsenic trioxide for acute promyelocytic leukemia." Ann Intern Med 133 (2000): 881-5. [PMID: 11103058]
2	Product Information. Trisenox (arsenic trioxide) Cephalon Inc, West Chester, PA.