Is Arsenic sulfide-containing TCM formulations Safe with TCM supplements (Realgar / Xiong Huang)?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid concurrent use with arsenic trioxide (ATO) chemotherapy — additive arsenic toxicity risk is life-threatening. Obtain urinary arsenic levels before use. Avoid in patients with hepatic disease, QT prolongation, or neuropathy.
Why this interaction occurs
Realgar (As4S4) is found in products such as Niuhuang Jiedu Pian. Arsenic is a Group 1 carcinogen. Combined use with arsenic trioxide (used in APL leukemia) can cause fatal QT prolongation, hepatotoxicity, and peripheral neuropathy. Chronic low-level arsenic from TCM supplements has been independently linked to bladder and skin cancer.
Evidence
Evidence level: strong.
Frequently asked questions
All Arsenic sulfide-containing TCM formulations interactions → · All TCM supplements (Realgar / Xiong Huang) interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.