Details of the Drug

General Information of Drug (ID: DM61TA4)

Drug Name
Arsenic trioxide
Synonyms
Arsenox; Arsentrioxide; Naonobin; Trisenox; Trixenox; Acide arsenieux [French]; Anhydride arsenieux [French]; Arseni trioxydum; Arsenic blanc [French]; Arsenic trioxide [JAN]; Arsenigen saure [German]; Arsenious Acid Anhydride; Arsenious trioxide; Arsenous oxide [ISO]; Oxyde Arsenieux; Arsenic trioxide [UN1561] [Poison]; Arsenic oxide (As2O3); Arsenic(III) trioxide; Oxyde Arsenieux [ISO-French]; Trisenox (TN); Arsenic trioxide (JP15/USAN); Arsenic(3+)
Indication
Disease Entry ICD 11 Status REF
Acute lymphoblastic leukaemia 2A85 Approved [1]
Leukemia N.A. Approved [2]
Refractory plasma cell neoplasm N.A. Approved [2]
Endometrial carcinoma N.A. Investigative [2]
Therapeutic Class
Anticancer Agents
Affected Organisms
Humans and other mammals
ATC Code
L01XX27: Arsenic trioxide
L01XX: Other antineoplastic agents
L01X: OTHER ANTINEOPLASTIC AGENTS
L01: ANTINEOPLASTIC AGENTS
L: ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski):
0		 Molecular Weight 197.841
Logarithm of the Partition Coefficient Not Available
Rotatable Bond Count 0
Hydrogen Bond Donor Count 0
Hydrogen Bond Acceptor Count 3
ADMET Property
Metabolism
The drug is metabolized via the methyltransferases in the liver [3]
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.7582 micromolar/kg/day [4]
Adverse Drug Reaction (ADR)
ADR Term Variation Related DOT DOT ID REF
Necrotising enterocolitis neonatal Not Available HSPD1 HSP60 RCJMB04_7g5 OTPI5OM0 [5]
Necrotising enterocolitis neonatal Not Available HSPB1 OTUZZ67L [5]
Chemical Identifiers
Formula
As2O3
IUPAC Name
arsenic(3+);oxygen(2-)
Canonical SMILES
[O-2].[O-2].[O-2].[As+3].[As+3]
InChI
InChI=1S/2As.3O/q2*+3;3*-2
InChIKey
QTLQKAJBUDWPIB-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
14888
CAS Number
1327-53-3
UNII
S7V92P67HO
DrugBank ID
DB01169
TTD ID
D07VIK
VARIDT ID
DR00119
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug
Repurposed Drugs (RPD) Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Inhibitor of nuclear factor kappa-B kinase beta (IKKB) TTJ3E9X IKKB_HUMAN Inhibitor [6]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Multidrug resistance-associated protein 2 (ABCC2) DTFI42L MRP2_HUMAN Substrate [7]
P-glycoprotein 1 (ABCB1) DTUGYRD MDR1_HUMAN Substrate [8]

Drug Off-Target (DOT)
DOT Name DOT ID UniProt ID Interaction REF
(3R)-3-hydroxyacyl-CoA dehydrogenase (HSD17B8) OTX1DWEF DHB8_HUMAN Gene/Protein Processing [9]
1,25-dihydroxyvitamin D(3) 24-hydroxylase, mitochondrial (CYP24A1) OTG2T749 CP24A_HUMAN Gene/Protein Processing [10]
1-acyl-sn-glycerol-3-phosphate acyltransferase beta (AGPAT2) OT5I4Y9K PLCB_HUMAN Drug Response [11]
1-acyl-sn-glycerol-3-phosphate acyltransferase delta (AGPAT4) OT5CTQKO PLCD_HUMAN Gene/Protein Processing [12]
1-acyl-sn-glycerol-3-phosphate acyltransferase epsilon (AGPAT5) OTNY3VMD PLCE_HUMAN Gene/Protein Processing [13]
1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase gamma-2 (PLCG2) OTGVC9MY PLCG2_HUMAN Post-Translational Modifications [14]
14-3-3 protein beta/alpha OTGBS3RF 1433B_HUMAN Gene/Protein Processing [15]
14-3-3 protein eta OTP8NJFJ 1433F_HUMAN Gene/Protein Processing [16]
14-3-3 protein gamma OTYQTMPI 1433G_HUMAN Gene/Protein Processing [15]
14-3-3 protein sigma (SFN) OTLJCZ1U 1433S_HUMAN Drug Response [11]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Acute lymphoblastic leukaemia
ICD Disease Classification 2A85
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Inhibitor of nuclear factor kappa-B kinase beta (IKKB) DTT IKBKB 5.74E-08 0.26 0.88
P-glycoprotein 1 (ABCB1) DTP P-GP 9.39E-02 1.07E-01 2.80E-01
Multidrug resistance-associated protein 2 (ABCC2) DTP MRP2 7.16E-01 -1.28E-02 -6.06E-02
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Arsenic trioxide (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Ivosidenib DM8S6T7 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Ivosidenib. Acute myeloid leukaemia [2A60] [17]
Midostaurin DMI6E0R Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Midostaurin. Acute myeloid leukaemia [2A60] [17]
Idarubicin DMM0XGL Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Idarubicin. Acute myeloid leukaemia [2A60] [17]
Arn-509 DMT81LZ Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Arn-509. Acute myeloid leukaemia [2A60] [17]
Gilteritinib DMTI0ZO Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Gilteritinib. Acute myeloid leukaemia [2A60] [17]
Oliceridine DM6MDCF Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Oliceridine. Acute pain [MG31] [17]
Ivabradine DM0L594 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Ivabradine. Angina pectoris [BA40] [18]
Bepridil DM0RKS4 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Bepridil. Angina pectoris [BA40] [17]
Bedaquiline DM3906J Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Bedaquiline. Antimicrobial drug resistance [MG50-MG52] [17]
Posaconazole DMUL5EW Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Posaconazole. Aspergillosis [1F20] [17]
Levalbuterol DM5YBO1 Moderate Increased risk of prolong QT interval by the combination of Arsenic trioxide and Levalbuterol. Asthma [CA23] [19]
Pirbuterol DMI5678 Moderate Increased risk of prolong QT interval by the combination of Arsenic trioxide and Pirbuterol. Asthma [CA23] [20]
Lisdexamfetamine DM6W8V5 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Lisdexamfetamine. Attention deficit hyperactivity disorder [6A05] [17]
Clarithromycin DM4M1SG Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Clarithromycin. Bacterial infection [1A00-1C4Z] [17]
Sparfloxacin DMB4HCT Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Sparfloxacin. Bacterial infection [1A00-1C4Z] [21]
Retigabine DMGNYIH Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Retigabine. Behcet disease [4A62] [17]
Eribulin DM1DX4Q Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Eribulin. Breast cancer [2C60-2C6Y] [17]
Lapatinib DM3BH1Y Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Lapatinib. Breast cancer [2C60-2C6Y] [17]
Bosutinib DMTI8YE Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Bosutinib. Breast cancer [2C60-2C6Y] [17]
PF-04449913 DMSB068 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and PF-04449913. Chronic myelomonocytic leukaemia [2A40] [17]
Olodaterol DM62B78 Moderate Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Olodaterol. Chronic obstructive pulmonary disease [CA22] [20]
Vilanterol DMF5EK1 Moderate Increased risk of prolong QT interval by the combination of Arsenic trioxide and Vilanterol. Chronic obstructive pulmonary disease [CA22] [19]
Indacaterol DMQJHR7 Moderate Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Indacaterol. Chronic obstructive pulmonary disease [CA22] [20]
Arformoterol DMYM974 Moderate Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Arformoterol. Chronic obstructive pulmonary disease [CA22] [20]
Panitumumab DMQPD1F Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Panitumumab. Colorectal cancer [2B91] [17]
Sevoflurane DMC9O43 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Sevoflurane. Corneal disease [9A76-9A78] [17]
Probucol DMVZQ2M Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Probucol. Coronary atherosclerosis [BA80] [17]
Pasireotide DMHM7JS Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Pasireotide. Cushing syndrome [5A70] [17]
Osilodrostat DMIJC9X Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Osilodrostat. Cushing syndrome [5A70] [17]
Escitalopram DMFK9HG Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Escitalopram. Depression [6A70-6A7Z] [22]
Clomipramine DMINRKW Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Clomipramine. Depression [6A70-6A7Z] [17]
Tetrabenazine DMYWQ0O Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Tetrabenazine. Dissociative neurological symptom disorder [6B60] [17]
Deutetrabenazine DMUPFLI Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Deutetrabenazine. Dystonic disorder [8A02] [17]
Solifenacin DMG592Q Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Solifenacin. Functional bladder disorder [GC50] [17]
Sunitinib DMCBJSR Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Sunitinib. Gastrointestinal stromal tumour [2B5B] [17]
Fostemsavir DM50ILT Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Fostemsavir. Human immunodeficiency virus disease [1C60-1C62] [17]
Saquinavir DMG814N Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Saquinavir. Human immunodeficiency virus disease [1C60-1C62] [23]
Lopinavir DMITQS0 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Lopinavir. Human immunodeficiency virus disease [1C60-1C62] [17]
Rilpivirine DMJ0QOW Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Rilpivirine. Human immunodeficiency virus disease [1C60-1C62] [17]
Polyethylene glycol DM4I1JP Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Polyethylene glycol. Irritable bowel syndrome [DD91] [24]
Phenolphthalein DM5SICT Moderate Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Phenolphthalein. Irritable bowel syndrome [DD91] [22]
Osimertinib DMRJLAT Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Osimertinib. Lung cancer [2C25] [17]
Selpercatinib DMZR15V Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Selpercatinib. Lung cancer [2C25] [17]
Lumefantrine DM29GAD Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Lumefantrine. Malaria [1F40-1F45] [25]
Halofantrine DMOMK1V Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Halofantrine. Malaria [1F40-1F45] [26]
Hydroxychloroquine DMSIVND Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Hydroxychloroquine. Malaria [1F40-1F45] [17]
Vemurafenib DM62UG5 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Vemurafenib. Melanoma [2C30] [17]
LGX818 DMNQXV8 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and LGX818. Melanoma [2C30] [17]
Panobinostat DM58WKG Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Panobinostat. Multiple myeloma [2A83] [17]
Siponimod DM2R86O Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Siponimod. Multiple sclerosis [8A40] [25]
Fingolimod DM5JVAN Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Fingolimod. Multiple sclerosis [8A40] [22]
Ozanimod DMT6AM2 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Ozanimod. Multiple sclerosis [8A40] [27]
Romidepsin DMT5GNL Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Romidepsin. Mycosis fungoides [2B01] [17]
Nilotinib DM7HXWT Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Nilotinib. Myeloproliferative neoplasm [2A20] [17]
Dasatinib DMJV2EK Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Dasatinib. Myeloproliferative neoplasm [2A20] [17]
Entrectinib DMMPTLH Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Entrectinib. Non-small cell lung cancer [2C25] [17]
Polythiazide DMCH80F Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Polythiazide. Oedema [MG29] [17]
Levomethadyl Acetate DM06HG5 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Levomethadyl Acetate. Opioid use disorder [6C43] [18]
Lofexidine DM1WXA6 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Lofexidine. Opioid use disorder [6C43] [17]
Rucaparib DM9PVX8 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Rucaparib. Ovarian cancer [2C73] [17]
Triclabendazole DMPWGBR Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Triclabendazole. Parasitic worm infestation [1F90] [17]
Pimavanserin DMR7IVC Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Pimavanserin. Parkinsonism [8A00] [17]
Macimorelin DMQYJIR Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Macimorelin. Pituitary gland disorder [5A60-5A61] [28]
Lefamulin DME6G97 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Lefamulin. Pneumonia [CA40] [17]
Degarelix DM3O8QY Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Degarelix. Prostate cancer [2C82] [17]
ABIRATERONE DM8V75C Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and ABIRATERONE. Prostate cancer [2C82] [17]
Enzalutamide DMGL19D Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Enzalutamide. Prostate cancer [2C82] [17]
Levomepromazine DMIKFEL Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Levomepromazine. Psychotic disorder [6A20-6A25] [17]
Quetiapine DM1N62C Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Quetiapine. Schizophrenia [6A20] [17]
Aripiprazole DM3NUMH Moderate Increased risk of prolong QT interval by the combination of Arsenic trioxide and Aripiprazole. Schizophrenia [6A20] [25]
Iloperidone DM6AUFY Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Iloperidone. Schizophrenia [6A20] [17]
Paliperidone DM7NPJS Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Paliperidone. Schizophrenia [6A20] [17]
Amisulpride DMSJVAM Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Amisulpride. Schizophrenia [6A20] [17]
Asenapine DMSQZE2 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Asenapine. Schizophrenia [6A20] [17]
LEE011 DMMX75K Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and LEE011. Solid tumour/cancer [2A00-2F9Z] [17]
Vandetanib DMRICNP Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Vandetanib. Solid tumour/cancer [2A00-2F9Z] [17]
Triptorelin DMTK4LS Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Triptorelin. Solid tumour/cancer [2A00-2F9Z] [17]
Pitolisant DM8RFNJ Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Pitolisant. Somnolence [MG42] [17]
Telavancin DM58VQX Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Telavancin. Staphylococcal/streptococcal disease [1B5Y] [17]
Lenvatinib DMB1IU4 Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Lenvatinib. Thyroid cancer [2D10] [17]
Cabozantinib DMIYDT4 Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Cabozantinib. Thyroid cancer [2D10] [17]
Trimeprazine DMEMV9D Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Trimeprazine. Vasomotor/allergic rhinitis [CA08] [17]
Propafenone DMPIBJK Major Increased risk of prolong QT interval by the combination of Arsenic trioxide and Propafenone. Ventricular tachyarrhythmia [BC71] [17]
Flecainide DMSQDLE Major Increased risk of ventricular arrhythmias by the combination of Arsenic trioxide and Flecainide. Ventricular tachyarrhythmia [BC71] [17]
⏷ Show the Full List of 84 DDI Information of This Drug

References

1 FDA Approved Drug Products from FDA Official Website. 2009. Application Number: (ANDA) 078729.
2 Arsenic trioxide FDA Label
3 European Public Assessment Report: Trisenox
4 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
5 ADReCS-Target: target profiles for aiding drug safety research and application. Nucleic Acids Res. 2018 Jan 4;46(D1):D911-D917. doi: 10.1093/nar/gkx899.
6 How acute promyelocytic leukaemia revived arsenic. Nat Rev Cancer. 2002 Sep;2(9):705-13.
7 MRP2 and acquired tolerance to inorganic arsenic in the kidney of killifish (Fundulus heteroclitus). Toxicol Sci. 2007 May;97(1):103-10.
8 Arsenic trioxide induces apoptosis equally in T lymphoblastoid leukemia MOLT-4 cells and P-gp-expressing daunorubicin-resistant MOLT-4 cells. Cancer Chemother Pharmacol. 2003 Feb;51(2):119-26.
9 Gene expression profile induced by arsenic trioxide in chronic lymphocytic leukemia cells reveals a central role for heme oxygenase-1 in apoptosis and regulation of matrix metalloproteinase-9. Oncotarget. 2016 Dec 13;7(50):83359-83377.
10 19-Nor-1,25(OH)2D2 (a novel, noncalcemic vitamin D analogue), combined with arsenic trioxide, has potent antitumor activity against myeloid leukemia. Cancer Res. 2005 Mar 15;65(6):2488-97.
11 The NRF2-mediated oxidative stress response pathway is associated with tumor cell resistance to arsenic trioxide across the NCI-60 panel. BMC Med Genomics. 2010 Aug 13;3:37. doi: 10.1186/1755-8794-3-37.
12 Aberrantly expressed genes in HaCaT keratinocytes chronically exposed to arsenic trioxide. Biomark Insights. 2011 Feb 8;6:7-16.
13 Identification of transcriptome signatures and biomarkers specific for potential developmental toxicants inhibiting human neural crest cell migration. Arch Toxicol. 2016 Jan;90(1):159-80.
14 Arsenic trioxide-mediated antiplatelet activity: pivotal role of the phospholipase C gamma 2-protein kinase C-p38 MAPK cascade. Transl Res. 2010 Feb;155(2):97-108. doi: 10.1016/j.trsl.2009.08.005. Epub 2009 Sep 15.
15 Proteomic and functional analyses reveal a dual molecular mechanism underlying arsenic-induced apoptosis in human multiple myeloma cells. J Proteome Res. 2009 Jun;8(6):3006-19.
16 Characterization of arsenic trioxide resistant clones derived from Jurkat leukemia T cell line: focus on PI3K/Akt signaling pathway. Chem Biol Interact. 2013 Oct 5;205(3):198-211. doi: 10.1016/j.cbi.2013.07.011. Epub 2013 Aug 2.
17 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]
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