Drug Interaction Report

Aprindine and Arsenic Trioxide Injection: Interaction Details

A pharmacist-reviewed analysis of the Aprindine and Arsenic Trioxide Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Arsenic Trioxide Injection

Trisenox Trisenox®
+

Aprindine

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 15 documented Aprindine interactions, 15 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)

Interaction Deep Dive

Coadministration of arsenic trioxide with other drugs that potentiallly prolong the QTc interval, such as Class I antiarrhythmics, is not recommended34.

Why it happens (mechanism)

Additive cardiac effects

Literature reports

2 reports — tap to read

a) QT/QTc prolongation should be expected during treatment with arsenic trioxide and torsade de pointes as well as complete heart block has been reported. Over 460 ECG tracings from 40 patients with refractory or relapsed APL treated with arsenic trioxide were evaluated for QTc prolongation. Sixteen of 40 patients (40%) had at least one ECG tracing with a QTc interval greater than 500 msec. Prolongation of the QTc was observed between 1 and 5 weeks after arsenic trioxide infusion, and then returned towards baseline by the end of 8 weeks after arsenic trioxide infusion. In these ECG evaluations, women did not experience more pronounced QT prolongation than men, and there was no correlation with age 1.

b) Prolongation of the QTc interval has been reported with propafenone 2.

Common questions

Can I take Aprindine and Arsenic Trioxide Injection together?

An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Aprindine and Arsenic Trioxide Injection interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Aprindine or Arsenic Trioxide Injection need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (4)

  1. Product Information: Trisenox(R), arsenic trioxide. Cell Therapeutics, Inc. Seattle, WA, 2001. DailyMed
  2. Larochelle P, Belanger L, Lemire F, et al: Dose-response effect of propafenone in patients with ventricular arrhythmias. Curr Ther Res 1984; 36:959-969. DOI
  3. Product Information: Trisenox(R), arsenic trioxide injection. Cell Therapeutics, Inc. Seattle, WA, 2001. DailyMed
  4. Product Information: Tambocor(R), flecainide acetate. 3M Pharmaceuticals, Northridge, CA, 1998. DailyMed
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