Trisenox

Risk of differentiation syndrome (may be life-threatening or fatal); if suspected, withhold treatment, initiate high-dose steroid (eg, dexamethasone IV 10mg) and monitor hemodynamically until resolved. Risk of cardiac conduction abnormalities (eg, QT prolongation, AV block, torsade de pointes). Assess QT interval and correct electrolyte abnormalities (maintain K⁺ above 4mEq/L and Mg⁺⁺ above 1.8mg/dL) prior to initiation. Withhold treatment if QTc >450msec (men) or >460msec (women); resume at reduced dose. Monitor ECG weekly; more frequently in unstable patients. Patients with ventricular arrhythmia, prolonged QT interval: do not administer. History of torsade de pointes. CHF. Thiamine deficiency or risk of. Monitor for neurological symptoms, nutritional status; if Wernicke's encephalopathy is suspected, immediately interrupt and initiate parenteral thiamine. Monitor for second primary malignancies. Monitor hematology, chemistries, LFTs at least 2–3 times weekly. Severe renal impairment (CrCl <30mL/min): may need lower doses; monitor. Hepatic impairment: monitor if severe. Elderly. Embryo-fetal toxicity. Advise to use effective contraception during and for 6 months (females) or 3 months (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 2 weeks after the last dose).