Drug & supplement interaction

Arsenic + Pacritinib

Pacritinib brand name: Vonjo.

Major Interaction
The bottom line Major

Arsenic has a major interaction with Pacritinib. Arsenic trioxide can prolong the QT interval.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Arsenic and Pacritinib

Here is the interaction we found between these two, with the evidence behind it.

Major

QT INTERVAL-PROLONGING DRUGS

Why this applies to Pacritinib

Pacritinib falls under QT INTERVAL-PROLONGING DRUGS — the group Arsenic interacts with.

Arsenic trioxide can prolong the QT interval.
Up to 40% of patients treated with prescription arsenic trioxide have a prolonged QT interval on their electrocardiogram (ECG). Theoretically, non-prescription arsenic could have an additive effect when combined with drugs that prolong the QT interval.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with combining arsenic and Pacritinib (Vonjo). Pacritinib, which is used to treat myelofibrosis, can already stretch out the heart's electrical recovery time on an ECG (called the QT interval). Arsenic does the same thing. In fact, up to 40% of people given prescription arsenic trioxide show a prolonged QT. Stack the two together and that effect can add up, which in rare cases raises the risk of a dangerous, irregular heartbeat.

Pacritinib is active on its own, so this isn't a case of one drug switching another on or off. It's simply two QT-stretching effects piling up. There's no good reason to take arsenic anyway, so please avoid arsenic-containing products and check with your pharmacist or doctor if you're worried.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Arsenic Also Interacts With Other Medications

Arsenic has 160 major, known drug interactions in our database — the Pacritinib one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Arsenic

Covers the 2,830 medications we’ve checked against Arsenic. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pacritinib

This page covers Arsenic only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pacritinib page lists 158 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 8 major · 110 moderate · 40 minor.

From our pharmacist’s overview on the Pacritinib page

“Someone on pacritinib (Vonjo) is usually fighting myelofibrosis, and the supplements people reach for during cancer treatment, herbal blends, immune boosters, St. John's wort for mood, are where this list gets serious.”

Reviewed by 2 · Jul 18, 2026

Open the Pacritinib interaction page

One more smart check

Taking Arsenic as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4 real supplement products containing Arsenic, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Arsenic. Your product may carry other ingredients that interact with Pacritinib too, on top of Arsenic — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Arsenic and Pacritinib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Arsenic
Steady interest

#954 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pacritinib
Steady interest

#2,014 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Arsenic

What is Arsenic?

Arsenic
  • Homeopathic digestive complaints
  • Traditional remedy for inflammatory conditions
  • Prescription use in certain leukemias (medical, not supplement)
  • Anxiety and restlessness (homeopathic tradition)

Arsenic is a naturally occurring element that is toxic in its inorganic form, and it is not a supplement you should take to improve your health. While arsenic trioxide is a real, doctor-prescribed cancer medicine, and tiny homeopathic doses exist, there is no good reason to take arsenic on your own. Avoid arsenic-containing products and talk to a pharmacist or doctor about any concerns.

Read the full Arsenic monograph & all interactions
Medication

About Pacritinib

What Is Pacritinib Used For?

Brand name: Vonjo

Vonjo (pacritinib) is used to treat adults with intermediate or high-risk myelofibrosis (MF) — a serious bone marrow disease — including primary MF and secondary MF that developed after polycythemia vera or essential thrombocythemia (other blood disorders). It is specifically approved for patients whose platelet count is below 50 × 10⁹/L (very low platelets), a group that has limited treatment options.

This approval is based on demonstrated reductions in spleen size. Continued approval may depend on results from confirmatory trials showing broader clinical benefit.

See full Pacritinib drug information
Keep checking

Other Drugs & Arsenic

Browse every other medication we’ve checked against Arsenic — both the ones with a known interaction and the ones without. Select any drug for the full detail.

160Major
0Moderate
0Minor
2,669No known interaction
Major

160 interactions

Showing 60 of 160 major interactions — see all 160 on the Arsenic page.

No interaction 2,669 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Arsenic and Pacritinib Together: Common Questions

Can you take Arsenic with Pacritinib?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Arsenic and Pacritinib interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Pacritinib and Arsenic?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.