Drug Interaction Report

Arsenic Trioxide and Sultopride: Interaction Details

A pharmacist-reviewed analysis of the Arsenic Trioxide and Sultopride 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

Trisenox
+

Sultopride

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 310 documented Arsenic Trioxide interactions, 286 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

Prolongation of the QTc interval and/or torsades de pointes

Interaction Deep Dive

Arsenic trioxide can prolong the QT interval in some patients, which may result in ventricular tachycardia, ventricular fibrillation, and torsades de pointes and should not be administered with other drugs that may prolong the QT interval4. Several antipsychotic agents have demonstrated QT prolongation including haloperidol 5, paliperidone 6, risperidone 7, sertindole 8, quetiapine 2, sultopride 1, , and zotepine 9.

Why it happens (mechanism)

Additive effects on QTc prolongation

Literature reports

1 report — 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 3.

Common questions

Can I take Arsenic Trioxide and Sultopride together?

Prolongation of the QTc interval and/or torsades de pointes Always confirm with your pharmacist or prescriber before making any change.

How serious is the Arsenic Trioxide and Sultopride 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 Arsenic Trioxide or Sultopride 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 (9)

  1. Lande G, Drouin E, Gauthier C, et al: Arrhythmogenic effects of sultopride chlorhydrate: clinical and cellular electrophysiological correlation. Ann Fr Anesth Reanim 1992; 11:629-635.
  2. Owens R: Risk assessment for antimicrobial agent-induced QTc prolongation and torsades de pointes. Pharmacother 2001; 21(3):310-319.
  3. Product Information: Trisenox(R), arsenic trioxide injection. Cell Therapeutics, Inc. Seattle, WA, 2001. DailyMed
  4. Product Information: Trisenox(R), arsenic trioxide injection. Cell Therapeutics, Inc. Seattle, WA, 2001. DailyMed
  5. O'Brien JM, Rockwood RP, & Suh KI: Haloperidol-induced torsade de pointes. Ann Pharmacother 1999; 33(10):1046-1050. PubMed
  6. Product Information: INVEGA(TM) extended-release oral tablets, paliperidone extended-release oral tablets. Alza Corporation, Mountain View, CA, 2006. DailyMed
  7. Duenas-Laita A, Castro-Villamor MA, Martin-Escudero JC, et al: New clinical manifestations of acute risperidone poisoning (letter). Clin Toxicol 1999; 37(7):893-894. PubMed
  8. Agelink MW, Zeit T, Baumann B, et al: In vivo cardiovascular effects of the new atypical neuroleptic sertindole. Int J Psychiatry Clin Pract 2001; 5:33-40. DOI
  9. Sweetman S (Ed): Martindale: The Complete Drug Reference. London: Pharmaceutical Press. Electronic version, MICROMEDEX, Greenwood Village, Colorado, Edition expires 06/2003.
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