CARBARSONE TOXICITY: A REVIEW OF THE LITERATURE AND REPORT OF 45 CASES

Abstract

Reactions are usually heralded by gastrointestinal symptoms of epigastric burning, right upper quadrant pain and tenderness, diarrhea, nausea and vomiting, which may progress to exfoliative dermatitis, central nervous system involvement or hepatic dysfunction. Mechanisms of toxicity appear to be hypersensitivity, direct effect of carbarsone on tissues usually due to overdosage, and/or toxicity of carbarsone preparation containing arsanilic acid. Carbarsone is an effective adjuvant agent in antiamebic therapy and is a relatively safe form of arsenic, but due regard for proper manufacture and storage safeguards must be maintained. Carbarsone should not be prescribed in excess of 0.25 mg 3 times daily for 10 days for average sized males, and twice daily for females and smaller males. The course should not be repeated in less than 10 days after the last dose. British anti-lewisite (BAL), 10% in oil, is effective in therapy of these reactions, but must be employed at the earliest sign of toxicity and in the full dose plan as recommended by the manufacturers.