Comparative Pharmacology
Head-to-head clinical analysis: ARSENIC TRIOXIDE versus XTANDI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARSENIC TRIOXIDE versus XTANDI.
ARSENIC TRIOXIDE vs XTANDI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Arsenic trioxide induces apoptosis in acute promyelocytic leukemia (APL) cells through degradation of PML-RARα fusion protein and modulation of mitochondrial pathways.
Androgen receptor inhibitor; binds to the androgen receptor, inhibits nuclear translocation, DNA binding, and transcription of androgen-responsive genes.
0.15 mg/kg IV daily until remission, then 0.15 mg/kg IV 5 days per week for 5 weeks (consolidation); dose based on actual body weight.
160 mg orally once daily.
None Documented
None Documented
Terminal elimination half-life of inorganic arsenic is approximately 10–14 hours for the trivalent form, but for total arsenic (including methylated metabolites) the half-life ranges from 10 to 32 hours. Clinical context: due to extensive tissue distribution and metabolic conversion, the effective half-life for pharmacodynamic effect is prolonged, with repeated dosing leading to accumulation. The terminal half-life is biphasic: an initial distribution phase of about 2 hours and a terminal phase of 10–14 hours.
Clinical Note
moderateArsenic trioxide + Digoxin
"Arsenic trioxide may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateArsenic trioxide + Digitoxin
"Arsenic trioxide may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateArsenic trioxide + Deslanoside
"Arsenic trioxide may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateArsenic trioxide + Acetyldigitoxin
Enzalutamide: 5.8 days; active metabolite N-desmethyl enzalutamide: 7.8-8.6 days. Steady state achieved after ~28 days.
Primarily renal excretion; after intravenous administration, approximately 15% of the dose is excreted unchanged in urine over 24 hours. Biliary/fecal excretion accounts for less than 5% as unchanged drug; the majority is eliminated as methylated metabolites (monomethylarsonic acid and dimethylarsinic acid) via urine, with total urinary excretion of arsenic species reaching 60-85% of the dose within 14 days.
Primarily hepatic metabolism; 77% of dose recovered in feces (as metabolites), 15% in urine (as metabolites); less than 1% excreted unchanged.
Category C
Category C
Antineoplastic
Antineoplastic
"Arsenic trioxide may decrease the cardiotoxic activities of Acetyldigitoxin."