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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Pleurisy Drops
Brand Name
Pleurisy Drops
Generic Name
Pleurisy Drops
Active Ingredient
Arsenic TriiodideCategory
Non-Standardized Insect Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 30 [hp_X]/59mL | LIQUID | ORAL | 63083-2047 |
Detailed information about Pleurisy Drops
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Pleurisy Drops, you must consult a qualified healthcare professional.
Arsenic Triiodide is a specialized chemical compound utilized in non-standardized insect allergenic extracts and as an adrenergic modulator. It plays a role in immunotherapy and specific biochemical pathways involving alpha and beta-adrenergic receptors.
Dosage for Arsenic Triiodide is highly variable and depends strictly on the concentration and the specific therapeutic framework (e.g., allergenic extract vs. homeopathic dilution).
Arsenic Triiodide is generally not recommended for pediatric use unless specifically directed by a specialist in immunology or a qualified practitioner.
Since the kidneys are the primary route for arsenic and iodide excretion, patients with a GFR (Glomerular Filtration Rate) below 60 mL/min require significant dose reductions. In cases of severe renal failure (GFR < 30 mL/min), Arsenic Triiodide is typically contraindicated due to the risk of systemic arsenic toxicity.
The liver is responsible for the methylation (detoxification) of arsenic. Patients with Child-Pugh Class B or C impairment may have a reduced capacity to methylate trivalent arsenic, leading to higher levels of the more toxic inorganic form in the bloodstream. Monitoring of liver enzymes is required.
Geriatric patients often have reduced renal clearance and a higher prevalence of cardiovascular disease. Given the alpha and beta-adrenergic agonist properties of Arsenic Triiodide, elderly patients must be monitored for hypertension and tachycardia. Starting doses should be at the lowest end of the therapeutic range.
If you miss a dose of Arsenic Triiodide, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double the dose to make up for a missed one, as this increases the risk of acute arsenic or iodide toxicity.
Arsenic Triiodide overdose is a medical emergency. Signs of acute toxicity include:
Emergency Measures: If an overdose is suspected, contact a Poison Control Center immediately and seek emergency room care. Treatment typically involves gastric lavage and the administration of chelating agents like Dimercaprol (BAL) or Succimer (DMSA).
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance. Regular follow-up appointments are necessary to monitor for cumulative toxicity.
Patients taking Arsenic Triiodide may experience mild to moderate side effects, particularly during the initiation of therapy. These include:
> Warning: Stop taking Arsenic Triiodide and call your doctor immediately if you experience any of these.
Prolonged exposure to even low doses of inorganic arsenic (like that found in Arsenic Triiodide) is associated with serious long-term risks:
No FDA black box warnings are currently issued specifically for the homeopathic or allergenic extract forms of Arsenic Triiodide. However, the FDA has issued general warnings regarding the use of inorganic arsenic in medicinal products, emphasizing the risk of acute and chronic toxicity. In the context of Insect Allergenic Extracts, there is a general class warning regarding the risk of severe systemic allergic reactions, including anaphylaxis, which must be managed by healthcare professionals in a controlled environment.
Report any unusual symptoms to your healthcare provider. Monitoring for 'Mees' lines' (white lines on the fingernails) can be a clinical indicator of chronic arsenic exposure.
Arsenic Triiodide is a potent substance that must be handled with extreme care. It is not a standard over-the-counter supplement and should only be used under the guidance of a physician or a licensed practitioner experienced in its specific therapeutic use. Because it combines the physiological effects of arsenic, iodine, and adrenergic stimulation, its safety profile is narrow.
No FDA black box warnings for Arsenic Triiodide. However, practitioners are cautioned that products containing arsenic are subject to stringent purity and concentration standards to prevent accidental poisoning.
To ensure safety during treatment with Arsenic Triiodide, the following tests are typically required:
Arsenic Triiodide may cause dizziness, restlessness, or blurred vision due to its adrenergic effects. Patients should assess their response to the medication before driving or operating heavy machinery. If palpitations or tremors occur, these activities should be avoided.
Alcohol should be avoided while taking Arsenic Triiodide. Alcohol can exacerbate the gastrointestinal side effects and may increase the metabolic strain on the liver, which is already processing the arsenic. Furthermore, alcohol can worsen the cardiovascular effects (tachycardia) associated with adrenergic agonists.
Arsenic Triiodide should not be stopped abruptly if it is being used as part of an immunotherapy escalation. Doing so may result in a loss of desensitization, increasing the risk of a severe reaction if the patient is exposed to the allergen. For oral dilutions, tapering is generally not required unless the patient has been on a high-dose regimen for an extended period.
> Important: Discuss all your medical conditions, especially heart, liver, or kidney disease, with your healthcare provider before starting Arsenic Triiodide.
For each major interaction, the mechanism usually involves either competitive binding at the adrenergic receptor (pharmacodynamic) or interference with renal/hepatic clearance (pharmacokinetic). Management typically involves dose adjustment or choosing alternative therapies.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including those for thyroid or heart conditions.
Arsenic Triiodide must NEVER be used in the following circumstances:
Conditions requiring careful risk-benefit analysis include:
Patients who are allergic to other halides (like bromides or fluorides) may exhibit cross-sensitivity to the iodide portion of the molecule. Additionally, patients with 'sulfite allergies' should be screened, as many allergenic extracts use sulfites as preservatives, though this is independent of the Arsenic Triiodide itself.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of heavy metal exposure, before prescribing Arsenic Triiodide.
Arsenic Triiodide is classified as Category X (or the equivalent high-risk category) in pregnancy. Arsenic is a potent teratogen that readily crosses the placenta. Clinical data and animal studies have shown that inorganic arsenic exposure during pregnancy is associated with an increased risk of spontaneous abortion, stillbirth, and low birth weight. Furthermore, arsenic is linked to developmental neurotoxicity, potentially affecting the child's cognitive function later in life. There is no clinical scenario where the benefits of Arsenic Triiodide outweigh the risks to the fetus.
Arsenic and iodine are both excreted in human breast milk. Arsenic exposure in nursing infants can lead to developmental delays and potential organ damage. High levels of iodine in breast milk can interfere with the infant's developing thyroid gland, leading to transient hypothyroidism. Breastfeeding is not recommended while taking Arsenic Triiodide. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
The safety and effectiveness of Arsenic Triiodide in children have not been established. Children are more susceptible to the toxic effects of arsenic due to their lower body mass and developing organ systems. In the context of allergenic extracts, use in children under age 5 is generally avoided. If used in older children, it must be under the strict supervision of a pediatric allergist.
Clinical studies of Arsenic Triiodide did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. However, because elderly patients are more likely to have decreased renal function and pre-existing cardiac conditions (such as atrial fibrillation), they are at a much higher risk for both arsenic accumulation and adrenergic-induced arrhythmias. Fall risk is also a concern if the drug causes dizziness or orthostatic changes.
Arsenic Triiodide is primarily eliminated by the kidneys. In patients with moderate renal impairment (GFR 30-59 mL/min), the half-life of arsenic is significantly prolonged. Doses should be reduced by at least 50%, and urinary arsenic levels should be monitored. Use is contraindicated in severe renal impairment.
The liver's ability to methylate (and thus detoxify) arsenic is compromised in patients with cirrhosis or hepatitis. This leads to a higher systemic burden of inorganic trivalent arsenic. No specific dosage adjustments have been standardized, but extreme caution and frequent liver function monitoring are mandatory.
> Important: Special populations require individualized medical assessment. Always inform your specialist if you are planning to become pregnant or have underlying kidney or liver issues.
Arsenic Triiodide ($AsI_3$) functions through several distinct pathways. As an alpha and beta-adrenergic agonist, it mimics the action of endogenous catecholamines (like epinephrine) by binding to G-protein coupled receptors. Activation of alpha-1 receptors leads to an increase in intracellular calcium via the $IP_3$ pathway, causing smooth muscle contraction. Activation of beta-receptors stimulates adenylyl cyclase, increasing cAMP levels, which leads to bronchodilation and increased cardiac contractility.
In its role within insect allergenic extracts, the compound acts as a chemical modifier. The trivalent arsenic ($As^{3+}$) can bind to the thiol groups of allergenic proteins, potentially altering their tertiary structure and reducing their allergenicity while maintaining their ability to induce immune tolerance. The iodide component provides an acidifying activity that can influence the local microenvironment of the injection site, affecting the rate of antigen release.
The dose-response relationship for Arsenic Triiodide is narrow. Small increases in dose can lead to a transition from therapeutic adrenergic stimulation to toxic cellular inhibition. Arsenic is known to inhibit pyruvate dehydrogenase, a key enzyme in the Krebs cycle, thereby impairing cellular respiration and ATP production. This explains why the drug's toxic effects are so widespread, affecting the heart, brain, and kidneys.
| Parameter | Value |
|---|---|
| Bioavailability | 80% - 95% (Oral) |
| Protein Binding | High (primarily to hemoglobin and albumin) |
| Half-life | Distribution: 2-5 hours; Elimination: 3-7 days |
| Tmax | 1 - 2 hours |
| Metabolism | Hepatic methylation (MMA, DMA) |
| Excretion | Renal (60-70%), Fecal (trace) |
Arsenic Triiodide is categorized as a Non-Standardized Insect Allergenic Extract [EPC]. It is related to other arsenic-based compounds like Arsenic Trioxide (used in oncology) and other halides like Potassium Iodide (used for thyroid protection and as an expectorant). It is a unique hybrid of a heavy metal and a halogen.
Common questions about Pleurisy Drops
Arsenic Triiodide is primarily used as a component in non-standardized insect allergenic extracts for immunotherapy, helping patients with severe allergies to insect stings. It is also utilized in specific pharmacological contexts as an alpha and beta-adrenergic agonist to modulate the autonomic nervous system. Historically, it has been used in very dilute forms for chronic skin conditions like psoriasis and respiratory issues like chronic bronchitis. In modern medicine, its use is highly specialized and restricted to clinical settings or specific traditional practices. It is not a first-line treatment for any common condition and requires professional oversight.
The most common side effects include gastrointestinal issues such as nausea, a metallic taste, and increased salivation, primarily due to the iodine component. Patients may also experience restlessness, insomnia, or a 'jittery' feeling because of its adrenergic agonist properties. Skin flushing and mild headaches are also frequently reported during the start of treatment. Because it contains arsenic, long-term common side effects can include skin changes like darkening or thickening. Most mild side effects resolve as the body adjusts to the medication, but they should always be reported to a doctor.
Drinking alcohol while taking Arsenic Triiodide is strongly discouraged by healthcare professionals. Alcohol can irritate the gastrointestinal tract, worsening the nausea and stomach pain often caused by the drug. More importantly, both alcohol and arsenic are processed by the liver; combining them increases the risk of hepatotoxicity and liver strain. Alcohol can also exacerbate the cardiovascular side effects of the drug, such as a rapid heart rate or palpitations. To ensure safety and the best therapeutic outcome, it is best to avoid all alcoholic beverages during treatment.
No, Arsenic Triiodide is not considered safe during pregnancy and is generally classified in the highest risk categories (Category X). Arsenic is a known teratogen that can cross the placenta and cause significant harm to the developing fetus, including birth defects, developmental delays, or even fetal death. It is also associated with an increased risk of miscarriage and low birth weight. Women of childbearing age should use effective contraception while taking this medication. If you become pregnant while on Arsenic Triiodide, you must notify your healthcare provider immediately to discuss the risks.
The onset of action for Arsenic Triiodide depends on the condition being treated. For its adrenergic effects, such as bronchodilation, the impact may be felt within 1 to 2 hours of administration. However, when used in allergenic immunotherapy, the process is much slower, often taking several months of gradually increasing doses before a significant reduction in allergic sensitivity is achieved. For chronic skin or respiratory conditions, it may take 2 to 4 weeks of consistent use to observe noticeable improvements. Patients should not expect immediate results and must follow the prescribed schedule.
You should not stop taking Arsenic Triiodide suddenly, especially if it is being used for allergenic immunotherapy. Abruptly stopping an immunotherapy regimen can cause your body to lose its built-up tolerance to the allergen, putting you at risk for a severe reaction if you are stung or exposed later. For other uses, stopping suddenly might not cause withdrawal in the traditional sense, but it could lead to a rapid return of symptoms. Always consult your healthcare provider before making any changes to your medication schedule to ensure it is done safely and effectively.
If you miss a dose of Arsenic Triiodide, take it as soon as you remember, provided it is not almost time for your next dose. If you are within a few hours of your next scheduled dose, skip the missed one and continue with your regular timing. Never take two doses at once to make up for a missed one, as this significantly increases the risk of arsenic or iodine poisoning. If you miss multiple doses, especially during immunotherapy, contact your doctor, as you may need to restart the dose escalation at a lower level for safety.
Weight gain is not a commonly reported side effect of Arsenic Triiodide. In fact, chronic exposure to arsenic is more often associated with weight loss or 'wasting' due to its interference with cellular metabolism and potential to cause gastrointestinal distress. However, if the medication causes significant changes in thyroid function (such as hypothyroidism due to the iodine), a patient might experience some weight gain related to a slowed metabolism. Any sudden or unexplained change in weight while taking this medication should be discussed with a healthcare provider to rule out thyroid or organ dysfunction.
Arsenic Triiodide has several significant drug interactions and should only be taken with other medications under strict medical supervision. It can interact dangerously with drugs that prolong the QT interval, potassium-sparing diuretics, and thyroid medications. It may also interfere with the effectiveness of blood pressure medications like beta-blockers. Because of these risks, it is vital to provide your doctor with a complete list of all prescription drugs, over-the-counter medicines, and herbal supplements you are currently using. Your doctor will monitor you closely for any signs of adverse interactions.
Arsenic Triiodide is typically not marketed as a 'brand-name' or 'generic' drug in the way that common medications like ibuprofen are. Instead, it is available as a chemical ingredient in various non-standardized allergenic extracts and homeopathic preparations produced by specialized laboratories. These products are often labeled by the ingredient name itself. Because these are non-standardized, the formulations can vary between different manufacturers. You should always use the specific product recommended by your specialist to ensure consistency in your treatment and to minimize the risk of dosage errors.
Other drugs with the same active ingredient (Arsenic Triiodide)